Maternal obesity during pregnancy is a major risk factor for difficult pregnancies that harm both mother and baby. Maternal obesity during pregnancy increases the risk of miscarriage, gestational diabetes and hypertensive disorders and is also a significant risk factor for maternal and fetal death. Obesity increases likelihood of medical intervention during labour and longer hospital stay after delivery.
Previous research on interventions to manage women’s weight during pregnancy has demonstrated limited benefit for the health of mothers and babies. There is, however, a local NHS commissioned service in Lincolnshire which is bucking this trend. Bumps and Beyond is a recently established and ongoing antenatal weight management service in Lincolnshire. All pregnant women attending clinics at United Lincolnshire Hospitals NHS Trust sites (Lincoln, Boston, Grantham and Gainsborough) with a BMI ≥35 kg/m2 are currently invited to take part in the intervention, which is delivered on a one-to-one basis by either a midwife or healthy lifestyle advisor at hospital antenatal clinics or local community ‘health shops’. The full intervention comprises seven sessions, beginning when women are around 16 weeks pregnant and continuing every 2-4 weeks until week 36 of pregnancy. The intervention comprises written materials and verbal advice relating to diet and physical activity recommendations
We published the first evaluation of the efficacy of Bumps and Beyond in 2014, showing that women who completed the intervention were significantly less likely to suffer from hypertensive disorders of pregnancy, having gained less than half the weight that women outside the intervention put on during their pregnancy. The current emphasis of our work is to develop an understanding of how and why Bumps and Beyond has been so successful, when the majority of pregnancy weight management interventions have proven to be ineffective. Using a qualitative approach we will be examining the environment in which the intervention takes place, the interactions between the staff and participants and the experiences of women who go through the programme. Developing a detailed understanding of the processes that lead to success will be an essential step if Bumps and Beyond is to be rolled out to a wider community of NHS trusts.
Investigators: Simon Langley-Evans, Judy Swift, Sarah Ellis