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Table 3 Emerging themes and a sample of supporting verbatim quotes

From: Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioners' perspectives

Themes

Verbatim quotes

Awareness of the issues/identifiable problems of overweight/obesity/excess weight gain

"But certainly weight is important, and mostly because of gestational diabetes. Really because that impacts on the mother and the baby, and the whole birth outcome."(GP005)

 

"Well, gestational diabetes definitely. Possibly pregnancy induced hypertension. And also just complications with delivery because like if, for example they need to have a caesarean, I mean that's going to be really difficult if they're really obese, so, yes, sort of delivery complications as well."(GP026)

 

"Well yes there is evidence that it affects the foetus and the wellbeing of the child in future life."(GP016)

 

"So I do normally tell the overweight woman about the implication of the long term health problem, plus the implication for young children, because whatever you're doing, your children will be doing the same."(GP018)

 

"But obviously children will be obese if mum puts on weight, and keeps going putting on weight or something."(GP017)

Provision of advice regarding gestational weight gain and healthy lifestyle behaviour advice

"Actually I'm not quite sure how much is too much. Well certainly gaining to...like 20 kg, that's probably too much."(GP019)

 

"I mean we used to work on the sort of one and a half kilograms a month was acceptable. But then when you've got people that are perhaps overweight or obese to start with, we always tried to keep their weight gain at a lot less than that."(GP006)

 

"......there's a feeling that exercise during pregnancy may be harmful, particularly in early pregnancy, and to encourage them to keep exercising, I think, is also helpful."(GP006)

 

"Actually, when women are pregnant, they're actually very receptive to lifestyle and healthy lifestyle advice."(GP012)

Attitudes and practices around

"So I think that weight wasn't a good indicator of maternal or foetal wellbeing, so I think it fell out of favour."(GP005)

 

"I noticed that on the shared care antenatal chart established by the hospital the column for weight has disappeared."(GP006)

routine gestational weighing

"I'm not sure what the reason why not weighing."(GP008)

 

"Weighing (as standard practice) is coming back."(GP005)(GP007)(GP010)

 

"Weighing pregnant women is actually very useful when it comes to pre eclampsia."(GP003)

Practical barriers to weighing

"I think time is the most significant thing because (I) always have to rush to see patients."(GP019)

 

"Space, time, funding, who's going to organise it? So all the organisational and implementation issues."(GP019)

How GPs feel they could be best supported

"So, I guess from my point of view it's not just what the doctor says, it's what other health professionals can offer, and motivation."(GP010)

 

"If there was a Dietitian attached to this clinic that would be readily available, that would be marvellous, because any woman who I even eyeball to be overweight and therefore at risk of gestational diabetes, I would talk to them about healthy eating in pregnancy and risk of gestational diabetes, and I refer most of my women to this Dietitian."(GP005)

 

"......so having access to either a Dietitian or an Exercise Physiologist, or both, that we'd be able to send people to would be good."(GP028)

 

"And so you know that people don't remember a lot about a consultation, and so like I say, some written information I think is always good."(GP004)

 

"I think that would be a really helpful thing if it was on different aspects of the pregnancy. Because mail - outs or emails, I think that pregnant women are very - they're very centred on doing everything right."(GP011)