How effectively do midwives manage the care of obese pregnant women? A cross-sectional survey of Australian midwives

Biro, Mary Anne, Cant, Robyn, Hall, Helen, Bailey, Carolyn, Sinni, Suzanne and East, Christine E. (2013) How effectively do midwives manage the care of obese pregnant women? A cross-sectional survey of Australian midwives. Women and Birth, 26 2: 119-124. doi:10.1016/j.wombi.2013.01.006


Author Biro, Mary Anne
Cant, Robyn
Hall, Helen
Bailey, Carolyn
Sinni, Suzanne
East, Christine E.
Title How effectively do midwives manage the care of obese pregnant women? A cross-sectional survey of Australian midwives
Journal name Women and Birth   Check publisher's open access policy
ISSN 1871-5192
1878-1799
Publication date 2013-06
Sub-type Article (original research)
DOI 10.1016/j.wombi.2013.01.006
Volume 26
Issue 2
Start page 119
End page 124
Total pages 6
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2014
Language eng
Formatted abstract
Background Obesity and overweight are common issues for pregnant women and their healthcare providers. Obesity in pregnancy is associated with poorer maternal and perinatal outcomes and presents particular challenges in day-to-day clinical practice.

Question The aim of this study was to examine midwifery clinical practice for obese pregnant women.

Methods We conducted a cross-sectional survey of midwives using an on-line survey distributed to members of the Australian College of Midwives. Midwives were asked about: the extent to which they provided evidence-based care; their use of a clinical guideline; their education and training and confidence to counsel obese pregnant women. Data for the questions about knowledge, clinical practice and views of education and training were summarized using descriptive statistics. Unadjusted analyses were undertaken to examine the association between use of a guideline and provision of evidence-based care and ratings of education, training and counselling.

Results The survey highlighted considerable variations in practice in the care and management of obese pregnant women. Respondents’ clinical knowledge and their views about education and training and counselling skills highlighted some deficits. Those using a clinical guideline were more likely to report that they ‘always’: tell the woman she is overweight or obese (OR 3.5; 95% CI: 1.9, 6.4); recommend a higher dose of folic acid (OR 4.6; 95% CI: 1.9, 6.4); refer to an obstetrician (OR 2.9; 95% CI: 1.2, 3.4); prepare a pregnancy plan (OR 2.0; 95% CI: 1.2, 3.3) and plan to obtain an anaesthetic referral (OR 2.6; 95% CI: 1.5, 4.3). They were also more likely to report adequate/comprehensive education and training and greater confidence to counsel obese pregnant women.

Conclusions Registered midwives need continuing professional development in communication and counselling to more effectively manage the care of obese pregnant women. The universal use of a clinical guideline may have a positive impact by helping midwives to base early care decisions on clinical evidence.
Keyword Obesity
Pregnancy
Midwifery care
Education
Evidence-base care
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 20 Sep 2013, 13:52:18 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work