Self-care and Health Care in Postpartum Women with Obesity: A Qualitative Study

Abstract

Objective To explore the experiences of women with obesity regarding self-care and the care provided by their families and health team after childbirth.

Methods A clinical qualitative study performed at the Postnatal Outpatient Clinic of Hospital da Mulher, Universidade Estadual de Campinas, Brazil. The sample was selected using the saturation criteria, with 16 women with obesity up to 6 months after childbirth.

Results The analysis comprised three categories: 1) postnatal self-care; 2) family support for woman after childbirth; and 3) postnatal health care service for women with obesity.

Conclusion Women with obesity need support from the health team and from their families after childbirth, when they are overwhelmed by the exhausting care for the newborn. The present study reveals how important it is for health care professionals to broaden their perception and care provided after childbirth for women with obesity so they may experience an improvement in their quality of health and of life.

Resumo

Objetivo Explorar as vivências de mulheres com obesidade sobre o autocuidado e os cuidados recebidos da família e da equipe de saúde após o parto.

Métodos Estudo clínico-qualitativo realizado no Ambulatório de Revisão Puerperal do Hospital da Mulher da Universidade Estadual de Campinas, Brasil. A amostra foi selecionada de acordo com os critérios de saturação, com 16 mulheres com obesidade até 6 meses após o parto.

Resultados A análise de conteúdo compreendeu três categorias: 1) autocuidado pós-natal; 2) apoio familiar para a mulher após o parto; e 3) atenção do serviço de saúde à mulher com obesidade no pós-parto.

Conclusão As mulheres com obesidade necessitam de acolhimento e do apoio da equipe de saúde e de suas famílias após o parto, quando são absorvidas pelo cuidado exaustivo do recém-nascido. Este estudo revela o quão importante é para os profissionais de saúde ampliar sua percepção e cuidado após o parto às mulheres com obesidade para que estas possam melhorar sua qualidade de saúde e de vida.

Keywords

self-care - health care - postpartum - childbirth - obesity - psychologycal issues

Palavras-chave

autocuidado - cuidados de saúde - pós-parto - parto - obesidade - aspectos psicológicos

Contributions

DBFS, ERT and FGS conceived and designed the study. DBFS collect the data. All of the authors were involved in data analysis and interpretation. DBFS, LR, DSMP and FGS were involved in writing. All authors approved the final version of the manuscript.

• References

• 1 Ghiasvand F, Riazi H, Hajian S, Kazemi E, Firoozi A. The effect of a self-care program based on the teach back method on the postpartum quality of life. Electron Physician 2017; 9 (04) 4180-4189 . doi: 10.19082/4180
• 2 Woolhouse H, Gartland D, Perlen S, Donath S, Brown SJ. Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study. Midwifery 2014; 30 (03) 378-384 . doi: 10.1016/j.midw.2013.03.006
• 3 Tully KP, Stuebe AM, Verbiest SB. The fourth trimester: a critical transition period with unmet maternal health needs. Am J Obstet Gynecol 2017; 217 (01) 37-41 . doi: 10.1016/j.ajog.2017.03.032
• 4 Jasienska G, Bribiescas RG, Furberg AS, Helle S, Núñez-de la Mora A. Human reproduction and health: an evolutionary perspective. Lancet 2017; 390 (10093): 510-520 . doi: 10.1016/S0140-6736(17)30573-1
• 5 Simonetta J, Klerman JA, Daley K, Pozniak A. Family and medical leave in 2012: technical report. 2014 [cited 2018 Sep 12]. Available from: https://www.dol.gov/asp/evaluation/fmla/fmla-2012-technical-report.pdf
• 6 Ostbye T, Peterson BL, Krause KM, Swamy GK, Lovelady CA. Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study. J Womens Health (Larchmt) 2012; 21 (02) 215-222 . doi: 10.1089/jwh.2011.2947
• 7 Byrne F, Grace R, Tredoux J, Kemp L. Structured social relationships: a review of volunteer home visiting programs for parents of young children. Aust Health Rev 2016; 40 (03) 262-269 . doi: 10.1071/AH15057
• 8 He H, Zhu L, Chan SWC, Chong YS, Jiao N, Chan YH. , et al. The effectiveness and cost-effectiveness of web-based and home-based postnatal psychoeducational interventions for first-time mothers: randomized controlled trial protocol. JMIR Res Protoc 2018; 7 (01) e35 . doi: 10.2196/resprot.9042
• 9 Coates R, Ayers S, de Visser R. Women's experiences of postnatal distress: a qualitative study. BMC Pregnancy Childbirth 2014; 14: 359 . doi: 10.1186/1471-2393-14-359
• 10 Barkin JL, Wisner KL. The role of maternal self-care in new motherhood. Midwifery 2013; 29 (09) 1050-1055 . doi: 10.1016/j.midw.2012.10.001
• 11 Faria-Schützer DB, Surita FGC, Alves VLP, Vieira CM, Turato ER. Emotional experiences of obese women with adequate gestational weight variation: a qualitative study. PLoS One 2015; 10 (11) e0141879 . doi: 10.1371/journal.pone.0141879
• 12 Turato ER. Tratado da metodologia da pesquisa clínico-qualitativa: construção teórico-epistemológica, discussão comparada e aplicação às áreas da saúde e humanas. 5. ed. Petrópolis: Vozes; 2011
• 13 Glaser BG, Strauss AL. Discovery of grounded theory. New York: Routledge; 1999
• 14 Morse JM, Field PA. Qualitative research methods for health professionals. 2. ed. Thousand Oaks: Sage; 1995
• 15 Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. Women's perceived reasons for their excessive postpartum weight retention: a qualitative interview study. PLoS One 2016; 11 (12) e0167731 . doi: 10.1371/journal.pone.0167731
• 16 Winnicott DW. Through pediatrics to psychoanalysis. London: Hogarth Press; 1958
• 17 Keith L, Gillanders D, Simpson S. An exploration of the main sources of shame in an eating-disordered population. Clin Psychol Psychother 2009; 16 (04) 317-327 . doi: 10.1002/cpp.629
• 18 Brañas-Garza P, Espín AM, Lenkei B. BMI is not related to altruism, fairness, trust or reciprocity: Experimental evidence from the field and the lab. Physiol Behav 2016; 156: 79-93 . doi: 10.1016/j.physbeh.2016.01.008
• 19 Oliver MD, Datta S, Baldwin DR. A sympathetic nervous system evaluation of obesity stigma. PLoS One 2017; 12 (10) e0185703 . doi: 10.1371/journal.pone.0185703
• 20 van der Pligt P, Olander EK, Ball K, Rawford D, Hesketh KD, Teychenne M. , et al. Maternal dietary intake and physical activity habits during the postpartum period: associations with clinician advice in a sample of Australian first time mothers. BMC Pregnancy Childbirth 2016; 16: 27 . doi: 10.1186/s12884-016-0812-4
• 21 Moran LJ, Flynn AC, Louise J, Deussen AR, Dodd JM. The effect of a lifestyle intervention on pregnancy and postpartum dietary patterns determined by factor analysis. Obesity (Silver Spring) 2017; 25 (06) 1022-1032 . doi: 10.1002/oby.21848
• 22 Price SN, McDonald J, Oken E, Haines J, Gillman MW, Taveras EM. Content analysis of motivational counseling calls targeting obesity-related behaviors among postpartum women. Matern Child Health J 2012; 16 (02) 439-447 . doi: 10.1007/s10995-011-0746-4
• 23 Delormier T, Frohlich KL, Potvin L. Food and eating as social practice--understanding eating patterns as social phenomena and implications for public health. Sociol Health Illn 2009; 31 (02) 215-228 . doi: 10.1111/j.1467-9566.2008.01128.x
• 24 Poland B, Krupa G, McCall D. Settings for health promotion: an analytic framework to guide intervention design and implementation. Health Promot Pract 2009; 10 (04) 505-516 . doi: 10.1177/1524839909341025
• 25 Compean-Ortiz LG, Quintero-Valle LM, Del Ángel-Pérez B, Reséndiz-González E, Salazar-González BC, González-González JG. Educación, actividad física y obesidad en adultos con diabetes tipo 2 desde la perspectiva del autocuidado de Orem. Aquichan 2013; 13: 347-362
• 26 Lipsky LM, Strawderman MS, Olson CM. Maternal weight change between 1 and 2 years postpartum: the importance of 1 year weight retention. Obesity (Silver Spring) 2012; 20 (07) 1496-1502 . doi: 10.1038/oby.2012.41
• 27 Klein M. On the sense of loneliness. In: Klein M. Envy and Gratitude: and Other Works, 1946–1963. New York: The Free Press; 1984: 300-313
• 28 Chugh M, Friedman AM, Clemow LP, Ferrante JM. Women weigh in: obese African American and White women's perspectives on physicians' roles in weight management. J Am Board Fam Med 2013; 26 (04) 421-428 . doi: 10.3122/jabfm.2013.04.120350
• 29 Schmied V, Mills A, Kruske S, Kemp L, Fowler C, Homer C. The nature and impact of collaboration and integrated service delivery for pregnant women, children and families. J Clin Nurs 2010; 19 (23-24): 3516-3526 . doi: 10.1111/j.1365-2702.2010.03321.x
• 30 Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Listening to mothers III: new mothers speak out [Internet]. New York (NY): Childbirth Connect; 2013 [cited 2018 Oct 10]. Available from: https://www.nationalpartnership.org/our-work/resources/health-care/maternity/listening-to-mothers-iii-new-mothers-speak-out-2013.pdf
• 31 Montgomery KS, Aniello TD, Phillips JD. , et al. Experiences accompanying postpartum weight loss: benefits, successes, and well-being. Health Care Women Int 2013; 34 (07) 577-591 . doi: 10.1080/07399332.2012.736568