Certified Nurse-Midwives' Experiences with Gestational Weight Management.

Excessive gestational weight gain is associated with fetal metabolic reprogramming and subsequent childhood obesity, as well as maternal recalcitrant obesity and its successive morbidities. We conducted a review of the literature and an explorative, descriptive study of the techniques and strategies used by a subset of certified nurse-midwives to help women achieve optimal gestational weight gain. We also identified barriers to this outcome. With more effective management approaches to gestational weight gain, adverse maternal and neonatal health outcomes could potentially be prevented. http://dx.doi.org/10.1016/j.nwh.2015.12.007.

Women's stories of their experiences as overweight patients.

AIM: This paper is a report of a study to illuminate the meaning of women's experiences as overweight patients in their encounters with healthcare services and healthcare providers. BACKGROUND: Overweight and obesity are increasingly important issues for women's health internationally. Overweight or obese women may delay or avoid health care if care providers have previously reacted negatively to them based on weight. However, studies focusing on the meaning of women's experiences as overweight patients and as recipients of healthcare services are lacking. METHOD: A hermeneutic phenomenological approach was used. Face-to-face interviews were conducted in the United States of America in 2007 with eight women volunteers who self-identified as being overweight patients. The framework of van Manen's lifeworld existentials of lived space, lived body, lived time and lived relation-guided reflection for data analysis. FINDINGS: The essence of women's experiences was a battle to fit into the world of healthcare services. Four major themes were identified. 'Struggling to fit in' consisted of trying to fit into limited physical space (examination rooms, equipment), limited time, and limited satisfaction and support in relationships with healthcare providers. 'Being dismissed' consisted of demeaning and embarrassing interactions with providers. 'Feeling not quite human' involved the stigma of being different because of body size. 'Refusing to give up' consisted of persistence in seeking support and advice from professionals despite negative past experiences. CONCLUSION: Awareness of these findings could reform understanding of women's experiences as overweight patients and raise the consciousness of nurses worldwide to develop sensitive communication strategies and healthcare environments that support holistic care.