"A Total Paradigm Shift": Interviews With Australian Maternity Care Providers Who Practice Weight-Inclusive Care

Weight stigma is pervasive in maternity care, contributing to negative health outcomes and disengagement among larger-bodied women. To reduce weight stigma and promote respectful, individualized care, a weight-inclusive approach prioritizes overall well-being rather than focusing on weight as a key health indicator. How maternity care providers adopt weight-inclusive approaches remains underexplored. This study aimed to investigate the perspectives and practices of weight-inclusive maternity care providers.

Semi-structured interviews were conducted online with medical, midwifery, and allied health maternity care providers, nominated by consumers or peers for their weight-inclusive practice. Interviews were audio recorded, transcribed, and analyzed thematically.

Twenty-four professionals were interviewed, with three themes generated to describe their weight-inclusive approaches: (1) Time and space for reflection-participants described a gradual shift from weight-centric to weight-inclusive care, often prompted by personal or professional experiences of weight stigma; (2) Questioning weight science-participants questioned the value of body mass index or weight as indicators of individual health, favoring holistic assessments; and (3) Taking action to make change-participants had made specific changes to their practice, including to clinical environments, communication, and in responding to weight-centric systems.

Our findings map how some maternity care providers describe enacting weight-inclusive maternity care. Despite systemic barriers such as weight-centric education and clinical guidelines, maternity care providers made meaningful change through deliberate reflection and compassionate practice. Reform in education and clinical guidelines is needed. Extending existing frameworks, our study describes maternity-specific enactments to address weight stigma and support broader adoption of weight-inclusive approaches.