Perceptions of obese pregnant and postpartum women regarding healthcare: a qualitative study

Care experiences of women with obesity are often shaped by weight stigma, negatively affecting health outcomes. Research on this issue within Brazilian healthcare remains limited. This study explored how overweight and obese pregnant and postpartum women perceive the care provided by healthcare teams during prenatal, childbirth, and postpartum periods, with emphasis on experiences of prejudice or discrimination (fatphobia).

A qualitative, descriptive, exploratory, and inductive field study was conducted using netnography. Data was collected from the Facebook community 'Gestantes de Alto Risco - Obesas, Hipertensas e etc.' (High-Risk Pregnant Women - Obese, Hypertensive, etc.) through daily virtual immersion and an online survey between August 2021 and December 2023. Participants included pregnant or postpartum women with a body mass index (BMI) >25 kg/m². Thematic analysis was performed using the Discourse of the Collective Subject (DCS) technique.

A total of 149 women completed the survey. Overall, 52.6% reported negative care experiences. Qualitative findings revealed recurrent themes of weight stigma, humiliation, shame, lack of empathy, dismissive attitudes, and structural barriers such as inadequate equipment. Many felt blamed for complications, often encountering judgmental or moralising language. In contrast, 47.4% described positive experiences when interactions involved respect, empathy, and individualised communication, though occasional weight-related criticism persisted.

The study demonstrates a high prevalence of fatphobia among overweight and obese pregnant and postpartum women in Brazil. Findings highlight the need for more respectful, individualised, and humanised obstetric care. Enhancing professional training and institutional practices is essential to reduce stigma and improve health outcomes for this population.