Exploring Pregnant Women’s Perceptions and Experiences of Adiposity Measurements in Routine Antenatal Care: A Qualitative Study

TL;DR

This study explores how pregnant women feel about using more detailed body fat measurements instead of BMI in antenatal care.

Contribution

The study introduces a qualitative exploration of pregnant women's perceptions of alternative adiposity measurements in antenatal care.

Findings

Participants viewed BMI as outdated and were generally neutral to positive about detailed adiposity measurements.

Women emphasized the importance of autonomy, informed consent, and clear communication in the measurement process.

Implementation of new adiposity assessments requires staff training and ethical considerations for privacy and emotional safety.

Abstract

Background/objectives: Maternal adiposity is a known risk factor for adverse pregnancy outcomes, yet routine antenatal care primarily relies on body mass index (BMI), which has limitations. This study aimed to explore the acceptability of incorporating a broader range of adiposity measurements into early pregnancy antenatal care, assessing pregnant women’s perceptions to inform implementation strategies. Methods: A qualitative study using semi-structured interviews was conducted with 14 pregnant women purposively sampled to capture variation in BMI, age, and parity. Interviews occurred approximately 4–5 months post-measurement experience. The Theoretical Framework of Acceptability (TFA) guided thematic analysis of transcribed data, with independent coding to ensure rigour. Results: Participants generally viewed the current reliance on BMI as outdated and expressed neutral to positive attitudes toward the use of more detailed adiposity measurements. Most reported little emotional discomfort with the process. However, some reflected likelihood of more body self-consciousness had it been their first pregnancy. Time involved in measurements was not seen as burdensome, however waiting between procedures was a minor inconvenience. Self-assessing body shape was described as difficult. Women emphasised the importance of choice, autonomy, and informed consent, especially in relation to partner involvement, the gender of the anthropometrist, and the nature of the procedures. Clear, advance communication and supportive explanations during appointments were seen as essential to ensuring a positive experience. Conclusions: Expanding adiposity assessments in early pregnancy is acceptable to women if implemented ethically, prioritising consent, privacy, emotional safety, and effective communication. Integration into routine care requires staff training and pre-appointment guidance.