Maternal and Child Health Journal

, Volume 17, Issue 8, pp 1508–1517

A Qualitative Study of Gestational Weight Gain Counseling and Tracking

Authors

    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
  • Karen Switkowski
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
    • Friedman School of Nutrition Science and PolicyTufts University
  • Sarah Price
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
  • Lauren Guthrie
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
  • Elsie M. Taveras
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
  • Matthew Gillman
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and the Harvard Pilgrim Health Care Institute
  • Jonathan Friedes
    • Harvard Vanguard Medical Associates
  • William Callaghan
    • Division of Reproductive HealthCenters for Disease Control and Prevention
  • Patricia Dietz
    • Division of Reproductive HealthCenters for Disease Control and Prevention
Article

DOI: 10.1007/s10995-012-1158-9

Cite this article as:
Oken, E., Switkowski, K., Price, S. et al. Matern Child Health J (2013) 17: 1508. doi:10.1007/s10995-012-1158-9

Abstract

Excessive gestational weight gain (GWG) predicts adverse pregnancy outcomes and later obesity risk for both mother and child. Women who receive GWG advice from their obstetric clinicians are more likely to gain the recommended amount, but many clinicians do not counsel their patients on GWG, pointing to the need for new strategies. Electronic medical records (EMRs) are a useful tool for tracking weight and supporting guideline-concordant care, but their use for care related to GWG has not been evaluated. We performed in-depth interviews with 16 obstetric clinicians from a multi-site group practice in Massachusetts that uses an EMR. We recorded, transcribed, coded, and analyzed the interviews using immersion-crystallization. Many respondents believed that GWG had “a lot” of influence on pregnancy and child health outcomes but that their patients did not consider it important. Most indicated that excessive GWG was a big or moderate problem in their practice, and that inadequate GWG was rarely a problem. All used an EMR feature that calculates total GWG at each visit. Many were enthusiastic about additional EMR-based supports, such as a reference for recommended GWG for each patient based on pre-pregnancy body mass index, a “growth chart” to plot actual and recommended GWG, and an alert to identify out-of-range gains, features which many felt would remind them to counsel patients about excessive weight gain. Additional decision support tools within EMRs would be well received by many clinicians and may help improve the frequency and accuracy of GWG tracking and counseling.

Keywords

Gestational weight gain Obstetrics Electronic medical record Counseling

Copyright information

© Springer Science+Business Media New York 2012