THEME | FINDING |
---|---|
Existing knowledge | Knowledgeable about risks of excessive GWG: antepartum and intrapartum monitoring, difficult epidural and labour including FHR tracing, dystocia, macrosomia, risk of maternal DM2, risk of childhood obesity |
Interactions with FHC vs SETFHT patients | SETFHT: higher level of education, most pregnancy advice from books and Internet, occasionally bring up weight with provider FHC: lower education and socioeconomic status, receive pregnancy advice from family, typically do not bring up weight concerns |
Counseling practices | Variability in counseling practices across physicians. More directed counseling reported with FHC patients. Many endorse providing handouts and online resources vs verbal instruction |
Provider barriers | Time constraints during short antenatal visits Language barrier with immigrant populations Patient motivation and compliance Sensitivity of topic |
Perceived patient barriers | Time restraints, child care responsibilities Physical symptoms (nausea, vomiting, fatigue) Financial barriers (nutritious food, gym membership) Cultural differences, especially with immigrant or refugee patients (eg, general distrust of health care system, different beliefs about harms in pregnancy) |
DM2—type 2 diabetes, FHC—Flemingdon Health Centre, FHR—fetal heart rate, GWG—gestational weight gain, SETFHT—South East Toronto Family Health Team.