Abstract
BACKGROUND: Weight stigma is commonly enacted by healthcare providers. Midwives are the primary care providers for women during pregnancy, birth and postpartum. Over half of pregnant women are of a higher weight at commencement of care and therefore vulnerable to weight stigma.
METHODS: An integrative review was undertaken. A search of the literature was performed using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Embase, PsycINFO and the Cochrane Library (Wiley) databases. Keywords included the following: “Midwifery”, AND “Obesity”, AND “Weight bias” AND “Attitudes”, “Knowledge” and Beliefs”. Findings were synthesised using the socioecological framework.
RESULTS: Eleven articles were included. At the individual level, themes related to midwives’ attitudes and beliefs and midwives’ own body size. At the interpersonal level, themes related to communication and relationships, while the influence of cultural norms was a theme at the community level. At the organisation/institutional level, themes related to BMI and weight checks, the need for training and education, and the role of healthcare practices and guidelines emerged. Finally, at the policy level, system level factors and a weight inclusive approach were identified.
DISCUSSION: This review highlighted that some midwives and student midwives hold negative views (conscious and unconscious) towards larger bodied women. Midwives are impacted by their own attitudes and beliefs as well as interpersonal, societal, organisational and system level factors. Interventions to increase empathy in midwives towards larger bodied women should be explored as an approach to lessen the impacts of care provider bias.