Restricted accessResearch articleFirst published online 2022-4
She “didn’t see my weight;she saw me,a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences
Weight stigmatization is related to emotional and psychological distress including low self-esteem, body image dissatisfaction, depression, and anxiety; all linked with suboptimal breastfeeding outcomes. This qualitative descriptive study explored postpartum individuals’ recalled experiences of weight stigma during interactions with perinatal healthcare professionals and its perceived influence on their breastfeeding experiences. Semi-structured phone interviews were conducted with (n= 18) participants. Three themes emerged: (1) “Size Doesn’t Matter: They Looked Beyond the Scale,” (2) “My Self-Confidence and Desire to Breastfeed is More Important than Weight,” and (3) “I Was on My Own”—Limited Social Support not Weight Stigma Influenced Breastfeeding.
AsioduIVWatersCMDaileyDE, et al. (2017) Infant feeding decision-making and the influences of social support persons among first-time African American mothers. Maternal and Child Health Journal21: 863–872.
3.
BengtssonM (2016) How to plan and perform a qualitative study using content analysis. NursingPlus Open2: 8–14.
4.
Bever BabendureJReifsniderEMendiasE, et al. (2015) Reduced breastfeeding rates among obese mothers: A review of contributing factors, clinical considerations and future directions. International Breastfeed Journal10: 21.
5.
CarlinRFMathewsAOdenR, et al. (2019) The influence of social networks and norms on breastfeeding in African American and caucasian mothers: A qualitative study. Breastfeeding Medicine14: 640–647.
DieterichRDemirciJ (2020) Communication practices of healthcare professionals when caring for overweight/obese pregnant women: A scoping review. Patient Education and Counselling103(10): 1902–1912.
8.
Downe-WamboldtB (1992) Content analysis: Method, applications, and issues. Health Care for Women International13: 313–321.
9.
DursoLELatnerJD (2008) Understanding self-directed stigma: Development of the weight bias internalization scale. Obesity (Silver Spring)16(Suppl 2): S80–S86.
10.
FurnessPJMcSevenyKArdenMA, et al. (2011) Maternal obesity support services: A qualitative study of the perspectives of women and midwives. BMC Pregnancy and Childbirth11: 69.
11.
GarnerCDMcKenzieSADevineCM, et al. (2017) Obese women experience multiple challenges with breastfeeding that are either unique or exacerbated by their obesity: Discoveries from a longitudinal, qualitative study. Maternal & Child Nutrition13(3): e12344.
12.
GraneheimUHLundmanB. (2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today24: 105–112.
13.
GubaEGLincolnLS. (2001) Guidelines and checklist for constructivist evaluation. Evaluation Checklist and Project: 1–15.
14.
GundersonEPQuesenberryCPJrNingX, et al. (2015) Lactation duration and midlife atherosclerosis. Obstetrics and Gynecology126: 381–390.
15.
HimmelsteinMSPuhlRMQuinnDM (2017) Intersectionality: An understudied framework for addressing weight stigma. American Journal of Preventive Medicine53: 421–431.
16.
HsiehHFShannonSE (2005) Three approaches to qualitative content analysis. Qualitative Health Research15: 1277–1288.
17.
Incollingo RodriguezACDunkel SchetterCTomiyamaAJ (2020a) Weight stigma among pregnant and postpartum women: A new context of stigmatization. Stigma and Health5: 209–216.
18.
Incollingo RodriguezACSmieszekSMNippertKE, et al. (2020b) Pregnant and postpartum women’s experiences of weight stigma in healthcare. BMC Pregnancy and Childbirth20: 499–499.
19.
KachoriaRMorelandJJCorderoL, et al. (2015) Trends in breastfeeding initiation, continuation, and exclusivity by maternal prepregnancy weight: 2004–2011. Obesity (Silver Spring)23: 1895–1902.
20.
Kelch-OliverKAncisJR (2011) Black women’s body image: An analysis of culture-specific influences. Women & Therapy34: 345–358.
21.
LaugenCMIslamNJanssenPA (2016) Social support and exclusive breast feeding among Canadian women. Paediatric and Perinatal Epidemiology30: 430–438.
22.
LewallenLPStreetDJ (2010) Initiating and sustaining breastfeeding in African American women. Journal of Obstetrics Gynecologic and Neonatal Nursing39: 667–674.
23.
LindhardtCLRubakSMogensenO, et al. (2013) The experience of pregnant women with a body mass index >30 kg/m(2) of their encounters with healthcare professionals. Acta Obstetricia et Gynecologica Scandinavica92: 1101–1107.
24.
Natland FagerhaugTForsmoSJacobsenGW, et al. (2013) A prospective population-based cohort study of lactation and cardiovascular disease mortality: The HUNT study. BMC Public Health13: 1070.
25.
PalinkasLAHorwitzSMGreenCA, et al. (2015) Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health42: 533–544.
26.
ParkerG (2017) Shamed into health? Fat pregnant women’s views on obesity management strategies in maternity care. Women’s Studies Journal31: 22–33.
27.
PattonMQ (2015) Qualitative Research & Evaluation Methods, Thousand Oaks, CA: SAGE Publications, Inc.
28.
PuhlRMBrownellKD (2006) Confronting and coping with weight stigma: An investigation of overweight and obese adults. Obesity (Silver Spring)14: 1802–1815.
29.
QSR International (1999) NVivo12.
30.
RamonienėGMaleckienėLNadišauskienėRJ, et al. (2017) Maternal obesity and obstetric outcomes in a tertiary referral center. Medicina (Kaunas)53: 109–113.
31.
SandelowskiM (2000) Whatever happened to qualitative description?Research in Nursing Health23: 334–340.
32.
SaundersBSimJKingstoneT, et al. (2018) Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity52: 1893–1907.
33.
SharmaAJDeeDLHardenSM (2014) Adherence to breastfeeding guidelines and maternal weight 6 years after delivery. Pediatrics134(Suppl 1): S42–S49.
34.
ShenMJPetersonEBCostas-MuñizR, et al. (2018) The effects of race and racial concordance on patient–physician communication: A systematic review of the literature. Journal of Racial and Ethnic Health Disparities5: 117–140.
35.
SilveiraMLErtelKADoleN, et al. (2015) The role of body image in prenatal and postpartum depression: a critical review of the literature. Archives of Womens Mental Health18: 409–421.
36.
SwansonVKeelyADenisonFC (2017) Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers?British Journal of Health Psychology22: 557–576.
37.
SwordWHeamanMIBrooksS, et al. (2012) Women’s and care providers’ perspectives of quality prenatal care: A qualitative descriptive study. BMC Pregnancy and Childbirth12: 29.
38.
TiggemannM (2011) Body Image: A Handbook of Science, Practice, and Prevention, New York, NY: Guilford Press.
39.
Washington ColeKOGudzuneKABleichSN, et al. (2017) Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight. Patient Education and Counselling100: 1103–1110.
40.
WuYKBerryDC (2018) Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of Advanced Nursing74: 1030–1042.
41.
ZimmermanERodgersRFO’FlynnJ, et al. (2018) Weight-related concerns as barriers to exclusive breastfeeding at 6 months. Journal of Human Lactation35: 284–291.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
