Call for clear guidance on healthy weight management in pregnancy

The survey of midwives showed that they also have some concerns about this issue. Almost half (43%) of midwives surveyed said they were not very confident or not at all confident about advising women on their weight management during pregnancy.

A similar number (around 40%) said they were very worried or fairly worried about asking women to be weighed when it is not their first appointment.

Nearly two-thirds of midwives (62%) said they were worried about causing offence if they asked women to be weighed and almost a quarter (24.7%) said they did not have facilities to weigh women in all of the settings in which they provide antenatal care.

Almost four-fifths of midwives (79%) said they would feel more confident talking about weight management with women if they had more training. The vast majority (90%) also said they would feel more confident if they had formal guidance on healthy weight gain in pregnancy.

Carolyn Pallister, Slimming World Public Health Manager and Dietitian, said: “The women who participated in this survey told us that they were more open to talking about a healthy lifestyle when they were pregnant so we need to make sure that midwives feel that they have the right training and resources to support that. As it stands, this is a significant missed opportunity to share healthy lifestyle messages and guidance.

“As part of our partnership with the Royal College of Midwives, Slimming World welcomes pregnant members; however our service is very different for those that are expecting. We do not suggest any significant weight change – gain or loss – during pregnancy. Instead, we support members to eat a healthy, balanced diet and remain physically active where appropriate. Our priority is a happy, healthy, mum-to-be!

“Currently though, in the UK, women aren’t routinely weighed while pregnant and, in fact, not all midwives even have access to weighing scales at their clinic sites. Midwives are further held back by the absence of guidelines on how much weight is safe to gain during pregnancy, and by the lack of training on how to raise the issue of weight with women.

“The current situation is that women are left feeling confused and unsupported at this most important of times and that needs to change.”

Gill Walton, Chief Executive and General Secretary of the Royal College of Midwives, said: “There is strong evidence of the risks of obesity and excess weight gain in pregnancy and yet there are no UK guidelines on what constitutes a safe weight gain, and many midwives have to use their own initiative and refer to American guidance.

“There is a clear need for midwives to have the tools, guidance and training they need so that they can offer women the best possible support and care. This is especially pressing because of the potentially serious complications that can arise in pregnancy as a result of women being overweight or obese. It is a real concern that some midwives do not have access to that most basic piece of equipment, scales.

“We are calling for clear guidance on healthy weight management in pregnancy and will be looking at how we can take this forward so that women and midwives have the information, support and resources needed.”

Liz Evans, a midwife and mum-of-two who lost more than 5st with Slimming World, has a unique understanding of the challenges both mums and midwives face when it comes to maternal obesity.

At her heaviest, Liz weighed more than 14st and found her weight affecting both her work and overall health. She says: “I’d feel like a sweaty, exhausted mess by the end of every shift. I had high blood pressure and palpitations, and I felt more like a 56-year-old than a 26-year-old.

Liz, now 32, from Liverpool, adds: “Also, I was expected as part of my job to advise new mums about nutrition. Nobody ever asked why someone my size felt she was entitled to talk to them about healthy eating – they were too polite. Even so, I felt like the biggest hypocrite in Liverpool.

“I wasn’t a comfort eater, just a disorganised one – with 40 hours a week spent at the hospital and another two days in my admin job, I thought I didn’t have time to cook. Inevitably, I would just grab something high in fat and low in freshness.”

Liz decided to join Slimming World and in 2013 she won the national ‘Miss Slinky’ award after losing 5st in eight months. She went on to marry her husband Fran wearing a size 8-10 dress.

“As I started losing weight steadily, my confidence increased. I lost 2st in my first two months, then settled into a healthy pattern of 1-2lbs a week. For me, it’s all about having a quick solution for when I’m hungry: if I’ve got a hearty meal with me I don’t get tempted by ready meals, sandwich bars or takeaways.

“Once I’d lost the weight, it was no problem dashing around the ward or to the operating theatre for a potential emergency, where when I was bigger I’d be out of breath and have a mad scramble to find scrubs big enough to fit.

“Since then I’ve qualified as a midwife at Liverpool Women’s Hospital and had two beautiful babies of my own. While I’ve gained a little weight since I got married – I’m now 11st – I’m happy, healthy and enjoy being active day to day. It feels amazing to be setting a healthy example to my children. I was so glad to have a healthy weight when carrying my babies. It’s great to be able to talk to mums about their weight with a real understanding and empathy of what it’s like to be overweight and how great it feels to lose weight. I tell them if I can do it, anyone can!"