Women's experiences of weight bias in maternity care

Background and Significance: Studies have demonstrated negative stereotypes and attitudes toward obese patients by health care providers, suggesting that discrimination in health care delivery may contribute to poor health outcomes among people with high BMI. Women who are overweight during pregnancy are at higher risk for poor birth outcomes than their normal-weight peers. In maternal child health, chronic stress related to gender bias and racism has been implicated as a risk factor for poor birth outcomes in black women. Understanding other forms of bias and discrimination that may occur across the life course (such as that related to weight) is critical to developing interventions to improve quality of care for high-BMI women. Objective/purpose: The purpose of the study was to test an instrument to measure weight bias experienced by childbearing women, and to document women's experiences with obesity stigma in maternity care. Methods: The study used a mixed methods approach to explore weight discrimination in maternity care. One hundred and two women participated in an online survey using a modified Stigmatizing Situations Inventory. Twenty women volunteered for an in-depth interview about their experiences. We tested the reliability of the modified SSI and then analyzed the in-depth interviews using an inductive qualitative approach. Results: The modified SSI was a reliable measure of weight bias in childbearing women. Qualitative analysis yielded themes about weight discrimination in clinical practice. Discussion/conclusions: Implications for further research and clinical practice are discussed.