Narrative analysis of birth stories blogged by women who self-identified as obese or plus-size

In the United States, approximately one in three pregnant women are obese. Obesity in pregnancy affects both maternal and fetal health. In addition to physiological risks, there are also risks for psychosocial burdens placed upon the pregnant woman. It is crucial to address any potential psychosocial issues along with physiological programs, which can affect maternity care and childbirth experiences. Healthcare providers should understand the perception of maternity care and childbirth experienced by plus-size women. This qualitative study aimed to describe maternity care and childbirth experiences that women who self-identify as obese or plus-size presented in online blogs. This study uses narrative inquiry, following Clandinin and Connelly’s framework of the three-dimensional space of temporality, sociality and situation. The study retrospectively collected birth stories posted in blogs by women self-identified as obese or plus-size. A total of 32 blogs were analyzed by employing the thematic narrative analysis mode and following the three-dimensional framework Five major themes and 15 sub-themes emerged, including Struggles and negative feelings: a) Self-blame, fears, and guilt related to pregnancy; b) Social bias and stigmatization; c) Plus-size attributed to polycystic ovarian syndrome; c) Weight loss motivation and struggles for a healthy pregnancy. Participation in decision making: a) Birth plan; b) Involve me in decision making related to my plan of care; c) Keeping the best interests of my baby first. Empowerment: a) Pregnancy motivates; b) Empowerment by other plus-size women’s blogs; c) Reassurance, support, and encouragement by healthcare providers. Respectful care appreciated: a) Don’t treat me differently because I’m plus-size; b) Less emphasis on plus-size; c) Finding the healthcare provider and support I deserve. Celebrating the success of the plus-size woman: a) Debunking plus size pregnancy myths; b) Trusting and loving my body. Understanding the perception of the pregnant, plus-size woman will inform healthcare providers on patient-centered care practice, which aims to improve patient/provider relationships, and can contribute to positive maternal fetal outcomes. In order to provide patient-centered care to the obese maternity patient, empathy training, sensitivity training and training in motivational interview techniques for healthcare providers will enhance communication.