Talking to patients about healthy pregnancy weight gain

Supporting healthy is a critical topic for antenatal providers due to an increasing trend of excessive weight gain during among women of all Body Mass Index (BMI) categories as well as the associated health risks for the mother and child. Risks to the mother include cesarean birth, gestational diabetes, hypertensive disorders, and premature rupture of membranes. And to the baby: fetal over- or undergrowth, preterm birth, and child obesity, diabetes, and hypertension later in childhood.

To address these issues, the Canadian Obesity Network (CON) formed a national working group of nurses, midwives, primary care physicians, obstetricians, researchers, and policymakers to adapt the network’s 5As of Obesity Management toolkit for pregnancy. The 5As approach takes the provider through a sequence of steps—Ask, Assess, Advise, Agree and Assist—to ensure sensitive, realistic, measurable, and sustainable obesity management strategies that focus on improving health and well-being rather than simply moving numbers on a scale.

Available from the CON website at obesitynetwork.ca/5As, the new 5As of Weight Gain toolkit includes a practitioner guide, practitioner checklist, and presentation and helps primary care providers discuss and manage gestational weight with their patients.

Perinatal Services BC (PSBC) was part of the national working group and led a provincial advisory committee and working group to develop a training strategy on the 5As of Healthy Pregnancy Weight Gain for primary maternity care providers. PSBC worked with the Continuing Professional Development Program at the University of British Columbia’s Faculty of Medicine and engaged family physicians, obstetricians, registered midwives, nurse practitioners, and registered dietitians across the province.

The goals of the training strategy are to:

  1. increase care provider awareness of the Institute of Medicine gestational weight gain guidelines;
  2. increase their awareness of the evidence identifying excessive gestational weight gain as an independent and modifiable risk factor for a range of maternal, obstetrical, infant, and child outcomes; and
  3. increase their confidence and competence to engage women in effective gestational weight gain counselling and healthy behavior change.

The training consists of regional workshops in BC as well as an accredited online education module, which is available to family physicians, midwives, nurse practitioners, and obstetricians across Canada. For more information on training, visit perinatalservicesbc.ca. To join the Canadian Obesity Network, visit obesitynetwork.ca/join.