The weight of Obesity. Analysis of Weigh to a Healthy Pregnancy and the Role of the Midwife in Public Health

Holly Hogg, Gail Anderson*

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review


Maternal obesity is a significant public health concern which has considerable bearing on health by increasing morbidity and mortality for women and their babies. This impacts families, communities, and the economy. Maternal obesity contributed to over 50% of maternal deaths. Therefore, obese mothers are vulnerable, and midwives have a professional responsibility to provide information, support and referrals to minimise risk. Within the wider public health agenda, midwives need clear guidelines that support the monitoring and management of weight during pregnancy. WTHP aims to provide a framework which promotes sustained, healthy lifestyle changes.
Intentional weight-loss is not recommended during pregnancy; therefore, it is preferable that women enter pregnancy at a healthy weight. However, as there is no government strategy to provide preconception care and 47% of NI pregnancies are unplanned, the focus must be to limit gestational weight gain (GWG) and promote postnatal weight-loss.
Midwives identify their role of discussing healthy eating and lifestyles choices as challenging, and report feeling unable to provide the education and support women require. WTHP was introduced regionally in 2013 through collaboration by Public Health Agency (PHA), Health and Social Care Trust staff and QUB academia as a multi-disciplinary (Midwives, Dieticians and Physiotherapists) promotion of healthy lifestyle choices to help limit GWG in women with a body mass index (BMI) ≥40 kg/m2. Following evaluation in 2016, which included consultation with women, this was reduced to BMI ≥38kg/m2.
At their booking appointments, over 20% of women in NI are obese - costing 37% more to care for during pregnancy than equivalent women of normal weight. It was determined WTHP was an effective initiative to manage GWG and predicted reduced costs in maternity and neonatal settings. It was recognised a minority of women who participated lost weight during pregnancy; therefore, strengthened protocols alerting obstetric teams to monitor fetal growth throughout pregnancy may be required.
Midwives have a vital public health role which can improve population health and reduce health inequalities for women and their families. With the necessary tools and training, midwives can promote health literacy and changes in health behaviour, which impact throughout the life-course. As a public health initiative, WTHP assists midwives to identify those at greatest risk, refer appropriately, and provide consistent information and support. WTHP limits GWG, and women report that improved lifestyle changes have been extended to the wider family – increasing the impact of positive health messages and reducing risk for subsequent pregnancies. As maternal obesity is an increasing concern across the UK, and having been evaluated positively regionally, WTHP should be considered for use nationally to ensure consistent maternity provision and improved health outcomes.
Original languageEnglish
Publication statusPublished - 30 Nov 0005
EventAll Ireland Annual Midwifery Conference: ‘Midwifery – adaptable and responsive during a crisis’ - online, Ireland
Duration: 05 Nov 202005 Nov 2020


ConferenceAll Ireland Annual Midwifery Conference
Internet address


  • Obesity, Public Health, Midwifery.


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