Towards an Understanding of Pregnancy Weight Gain in African-American Women

Abstract

(41st Biennial Convention) Problem: A large proportion of women gain more weight than is needed during pregnancy. This is a major health issue because excessive gestational weight gain contributes to postpartum weight retention, which contributes to long term obesity in women and their offspring. African-American women in particular have high rates of obesity with half (49.6%) classified as obese and 14.2% as grade 3 obesity (BMI>=40kg/m2). Theoretical base: A common construct across multiple behavior change theories, including social cognitive theory, is that behavior change is impacted by personal factors including risk appraisal and motivation to change. Purpose: In order to determine the perspective of pregnant African-American women on weight gain in pregnancy we conducted formative work to elicit these antecedents to behavior change. Method: Focus groups were conducted using rigorous approaches (e.g., trained moderator, standardized interview guide, taped transcripts analyzed verbatim) with 26 impoverished African-American women (age range 18-39 years). Results: Between- and within- group analyses identified four themes: (a) Weight gain, no matter how much, means a healthy baby, (b) There is a limit: Weight gain impact on appearance, (c) Reluctant acceptance: It happens, and (d) Nebulous plans for controlling weight. These women clearly identified the need for weight gain to ensure a healthy baby. However, there was a great tolerance with amount of weight they could gain before it became unacceptable. Although they identified a few strategies for controlling weight (e.g. reducing fried foods), most women were unenthusiastic and half-hearted about controlling gestational weight gain. Conclusions/implications: The negative impact of excessive pregnancy weight gain on the infant was not identified. Intolerance of weight gain was almost exclusively due to appearance; it was never related to health risks. Understanding women's appraisal of risk and motivation to address excessive weight gain in pregnancy is key to successful intervention development tailored for this population.