To explore perceived motivators and barriers to weight loss after childbirth and ideas for postpartum weight loss interventions among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Approach:
Four (2 with English-speaking and 2 with Spanish-speaking participants) focus groups were conducted.
Setting:
A WIC clinic in Southern California.
Participants:
Of 22 participants, the majority were Hispanic/Latina. The mean age of the mothers’ infants was 6.18 months.
Measures:
A structured focus group guide was used.
Analysis:
Audio-recordings were transcribed verbatim. The Spanish transcriptions were reviewed for discrepancies by a bilingual coinvestigator and translated into English for analysis. Transcriptions of the focus group audio-recordings were organized in ATLAS.ti version 8.0. and analyzed using content analysis.
Results:
Participants had a mean age of 30.5 and a mean prepregnancy body mass index of 32.4. Motivators for weight loss after childbirth included modeling healthy behavior for children and a fear of developing chronic illness. Barriers to weight loss included lack of knowledge, self-efficacy, time, child care and support, postpartum depression, the 40-day rule, and having a c-section. Intervention ideas included providing accountability and peer support for weight loss, providing nutrition/exercise weight loss strategies, and integrating mobile phone technologies into weight loss programs.
Conclusions:
Weight loss strategies for postpartum WIC participants should provide knowledge, support, accountability, and preferably integrate technology.
HalesCMCarrollMDFryarCDOgdenCL. NCHS Data Brief No. 288. Prevalence of obesity among adults and youth: United States, 2015–2016. Hyattsville, MD: National Center for Health Statistics; 2017:1–8.
2.
RaynorHAChampagneCM. Position of the academy of nutrition and dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016;116(1):129–147.
3.
Ashley-MartinJWoolcottC. Gestational weight gain and postpartum weight retention in a cohort of Nova Scotian women. Matern Child Health J. 2014;18(8):1927–1935.
4.
HollisJLCrozierSRInskipHM, et al.Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention. Int J Obes. 2017;41(7):1091–1098.
5.
MartinJEHureAJMacdonald-WicksLSmithRCollinsCE. Predictors of post-partum weight retention in a prospective longitudinal study. Matern Child Nutrn. 2012;10(4):496–509.
6.
Siega-RizAMHerringAHCarrierKEvensonKRDoleNDeierleinA. Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum. Obesity. 2010;18(10):1996–2003.
7.
RasmussenKMYaktineAL; IOM (Institute of Medicine). Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; 2009:1–250.
8.
GundersonEP. Childbearing and obesity in women: weight before, during, and after pregnancy. Obstet Gynecol Clin North Am. 2009;36(2):317–332.
9.
Siega-RizAMKingJC. Position of the American dietetic association and American society for nutrition: obesity, reproduction, and pregnancy outcomes. J Am Diet Assoc. 2009;109(5):918–927.
10.
MartinCLTateDFShaffnerA, et al.Acculturation influences postpartum eating, activity, and weight retention in low-income hispanic women. J Womens Health (Larchmt). 2017;26(12):1333–1339.
11.
McKinleyMCAllen-WalkerVMcGirrCRooneyCWoodsideJV. Weight loss after pregnancy: challenges and opportunities. Nutr Res Rev. 2018;31(2):225–238.
12.
KoleilatMWhaleySEEsguerraKBSekhoboJP. The role of WIC in obesity prevention. Curr Pediatr Rep. 2017;5(3):132–141.
13.
LimSOreillySBehrensHSkinnerTEllisIDunbarJA. Effective strategies for weight loss in post-partum women: a systematic review and metanalysis. Obes Rev. 2015;16(11):972–987.
14.
KimLPKoleilatMWhaleySE. A qualitative study to examine perceptions and barriers to appropriate gestational weight gain among participants in the special supplemental nutrition program for Women Infants and Children (WIC) program. J Pregnancy. 2016;2016:4569742. doi:10.1155/2016/4569742.
15.
KoleilatMKimLWhaleySE. Focusing on excessive gestational weight gain through weight tracking among participants of the special supplemental nutrition program for Women, Infants and Children (WIC) program in Southern California. Calif J Health Promot. 2017;15(3):15–24.
16.
HochbaumGRosenstockIKegelsS. Health belief model. Washington, DC: U.S. Public Health Service; 1952.
17.
BraunVClarkeV. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
18.
CreswellJW. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 2nd ed. Thousand Oaks, CA: Sage Publication; 2003.
19.
DevineCMBoveCFOlsonCM. Continuity and change in women’s weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events. Soc Sci Med. 2000;50(4):567–582.
20.
NeitermanEFoxB. Controlling the unruly maternal body: losing and gaining control over the body during pregnancy and the postpartum period. Soc Sci Med. 2017;174:142–148.
21.
FoxBNeitermanE. Embodied motherhood: women’s feelings about their postpartum bodies. Gend Soc. 2015;29(5):670–693.
22.
GlanzKLewisFMRimerBK. Health Behavior and Health Education. Theory, Research, and Practice. San Francisco, CA: Jossey-Bass; 1997.
23.
LambertLRaidlMSafaiiSConnerCGearyEJAultS. Perceived benefits and barriers related to postpartum weight loss of overweight/obese postpartum WIC participants. Top Clin Nutr. 2005;20(1):16–27.
24.
SetseRGroganRCooperLAStrobinoDPoweNRNicholsonW. Weight loss programs for urban-based, postpartum African American women: perceived barriers and preferred components. Matern Child Health J. 2008;12(1):119–127.
25.
PhelanS. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynec. 2010;202(2):135.e1-e8.
26.
MontgomeryKSBusheeTDPhillipsJD, et al.Women’s challenges with postpartum weight loss. Matern Child Health J. 2011;15:1176–1184.
27.
ChristensonAJohanssonEReynisdottirSTorgersonJHemmingssonE. Women’s perceived reasons for their excessive postpartum weight retention: a qualitative interview study. PLoS One. 2016;11(12):e0167731.
MagriplesUBoyntonMHKershawTS, et al.The impact of group prenatal care on pregnancy and postpartum weight trajectories. Am J Obstet Gynec. 2015;213(5):688.e1-e9.
30.
LiuJWilcoxSWhitakerKBlakeCAddyC. Preventing excessive weight gain during pregnancy and promoting postpartum weight loss: a pilot lifestyle intervention for overweight and obese African American women. Matern Child Health J. 2014;19(4):840–849.
31.
GoldsteinNDRogersSEhrenthalDB. The impact of psychosocial stressors on postpartum weight retention. Arch Womens Ment Health. 2016;19(4):691–694.
32.
WhitakerKYoung-HymanDVernonMWilcoxS. Maternal stress predicts postpartum weight retention. Matern Child Health J. 2014;18(9):2209–2217. doi:10.1007/s10995-014-1470-7.
33.
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 757: Screening for perinatal depression.Washington, DC: American College of Obstetricians and Gynecologists2018. 132(5):e208–e212.
34.
WaughLJ. Beliefs associated with Mexican immigrant families’ practice of al cuarentena during postpartum recovery. J Obstet Gynecol Neonatal Nurs. 2011;40(6):732–741.
35.
Martinez-SchallmoserLMacMullenNTelleenS. Social support in Mexican American childbearing women. J Obstet Gynecol Neonatal Nurs. 2005;34(6):755–760.
36.
SternGKruckmanL. Multi-disciplinary perspectives on postpartum depression: an anthropological critique. Soc Sci Med. 1983;17(15):1027–1041.
37.
MorelandJCLloydLBraunSBHeinsJN. A new teaching model to prolong breastfeeding among Latinos. J Hum Lact. 2000;16(4):337–341.
