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

Groth, Susan W.

Tuesday, 1 November 2011: 9:10 AM

Susan W. Groth, PhD, RN, WHNP-BC
School of Nursing, University of Rochester, Rochester, NY
Dianne Morrison-Beedy, PhD, RN, WHNP-BC, FNAP, FAANP, FAAN
College of Nursing, University of South Florida, Tampa, FL

Learning Objective 1: The learner will be able to describe the perspectives of pregnant African-American women on pregnancy weight gain.

Learning Objective 2: The learner will be able to discuss the challenges and potential strategies for tailoring interventions to prevent excessive pregnancy weight gain in African-American women.

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.

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