Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Objective: to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. Design: a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. Setting: one NHS Trust maternity and dietetic services, North East England, UK. Participants: fifteen pregnant women with a booking body mass index >= 30 kg/m(2) attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51 kg/m(2). Findings: four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. Key conclusions: women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.