Medical and Nursing Education

Context: Childbearing women are the second victims for a significant gestational weight retention and weight gain. The gestational weigh retention and weight gain in the postpartal period may primarily contribute to the development of overweight and obesity in midlife and postmenopausal period. Being overweight and obese prior to conception has important implications for long-term persistent weight changes. Although the scientific literature about this subject is growing, what women perceive as reasons for their gestational weight retention, excessive weight gain and their inability to lose weight postpartum, is not yet explored in Indian population. There may be unique reasons to weight management in this period. At a practical level, understanding the holistic perception of women would address the barriers to healthy weight management and move us forward in devising primary preventive strategies to optimize healthy weight management. Aim: The main aim of this study is to explore what women perceive as reasons for their excessive gestational weight retention and weight gain in postpartum period.

Methods: Following the approval of this cross sectional study protocol by ethical committee, purposive sampling was used to select women from diversified culture with different needs and views to explore their perceptions on various reasons for postpartal gestational weight retention and gain. Low risk postpartal women during the first year of postpartum, with BMI of >25 kg/m2 were included. Women with any associated medical, surgical, gynecological, psychological risk factors were excluded. For a significance level of 5%, a statistical power of 80%, and a minimum effect size of 0.5, the minimum sample size calculated was 168 postpartum women. Taking into consideration of missing data and noncompliance by 20%, n=200 women were recruited. Statistical analyses were performed using IBM SPSS Statistics (Version 21.0. Armonk, NY: IBM Corp).

Results: The results indicated that of the n=200 postnatal women who agreed to participate in the study, n=15 of them were excluded from the study as n=06 of them withdrew from the study due to time constraints, n=09 had missing values. Final analyses consisted of n=185 postpartal women in less than a year of postpartum with BMI >25 kg/m2. The participants were between 23 to 37 years old, with mean age of 25.2±5.13 years. Participants perceived that lowered physical activity sedentary life style behavior (98.92%), sleep deprivation and stress (97.84%), lack of knowledge (97.29%), misconceptions that breast feeding automatically leads to weight loss (96.76%), and high caloric intake (97.29% ) as reasons for gestational weight retention and gain in the postpartum period. Misconceptions that weight gain is predetermined by genetic factors (95.68%), lack of support (93.51%) and the use of eating for physical and psychological comfort (82%) were also claimed as reasons for weight gain in the postpartum period.

Conclusion: Obstetric health care personnel should identify women who are susceptible to substantial postpartum weight retention, to becoming obese, or to increased central adiposity after pregnancy. Intensive preventive measures should be devised to raise awareness on risks associated with unhealthy gestational weight retention and weight gain in the postpartal period.