Reducing Pregnancy Issues in Obese Women: An Educational Program

This report investigates the challenges faced by obese women during pregnancy and proposes an educational program to mitigate complications. It begins with an introduction highlighting the risks associated with obesity, such as miscarriage, gestational diabetes, and preeclampsia, and emphasizes the negative impact on both the mother and the child. The literature review defines obesity, explores its pathophysiology, and discusses the symptoms and causes, emphasizing the role of an educational program in reducing complications, enhancing health outcomes, and lowering miscarriage rates. The research methodology outlines the research paradigm, philosophy, methods, approach, and design, including data collection tools, sampling techniques, and ethical considerations. The results and findings section presents data from interviews and observations. The report concludes with a discussion, reflection, and recommendations for future research and interventions. The report aims to improve the quality of life for obese pregnant women by providing timely interventions and promoting regular monitoring of complications. The report emphasizes on the importance of understanding the issues and complexities obese women face during pregnancy and focuses on creating educational programs to address these challenges.

To reduce the
difficulties of
overweight women
the during
pregnancy
childbirth through
educational
program

Contents
1. Introduction................................................................................................................................1
Aim.........................................................................................................................................2
Objective...............................................................................................................................2
Research questions.............................................................................................................2
Rationale...............................................................................................................................3
Statement of Intention.........................................................................................................3
Background...........................................................................................................................4
2. LITERATURE REVIEW...........................................................................................................4
Definition of Obesity and its impact on pregnant women..............................................4
Pathophysiology of Obesity................................................................................................5
Obesity symptoms and causes..........................................................................................5
Reduction in complications faced by obese women during pregnancy through
educational program............................................................................................................7
Enhance the health outcomes pregnant women face due to obesity.........................8
Reduction in miscarriages in obese women through an educational program..........9
3. Research Methodology..........................................................................................................10
Research Paradigm...........................................................................................................10
Research philosophy.........................................................................................................10
Research Methods............................................................................................................11
Research Approach...........................................................................................................11
Research Design...............................................................................................................11
Data Collection Tools........................................................................................................12
Data Sampling....................................................................................................................13
Ethical Consideration........................................................................................................14
4. RESULTS AND FINDINGS...................................................................................................14
Interview:.............................................................................................................................14
Observation technique:.....................................................................................................18
5. DISCUSSION..........................................................................................................................20
6. Reflection.................................................................................................................................22
7. Conclusion and Recommendations.....................................................................................23

Conclusion..........................................................................................................................23
Recommendations.............................................................................................................25
8. REFERENCES........................................................................................................................27

1. Introduction
There are various kind of issues which are faced by the women's while pregnancy.
Some of these issues are due to pre pregnancy weights, this is because there are
various kind of risk related to miscarriage, gestational diabetes, preeclampsia, venous
thromboembolism. In current time obesity can be defined as a major problem which
leads to various kind of disadvantage at the time of pregnancy. in relation to the
women's who are generally placed at the time of pregnancy has to face different
difficulty related to gastric problems diabetes and many other which can directly impact
on their pregnancy as well as their child (Hanson and et. al., 2017). It is seen that there
are various kind of negative impacts on the health of child who is in the womb of women
giving birth. Weight is dangerous for a woman who is going to give a birth to baby
because it can reduce their fertility rate as well as their immunity which can impact on
the stress level as well as directly effect on the health of baby and can lead to the
depression in a mother. From various kinds of studies it can be analysed that there are
more chances of miscarriage as well as failure of operation while giving birth because of
obesity. In current time, it is a biggest issue which is faced by the world and also making
it worse for chronic pregnancy outcomes. This is also impacting on the quality life of the
woman in a current time where it is directly reduces the chances of success.
Miscarriage is a major risk which is directly related to the obesity within the woman
who is giving birth to a baby. There are various kind of health related problems and one
of the major issue is diabetes and cardiovascular problems. Inequality life of women's
will directly impacted by this and major issues related to ill health and unhealthy lifestyle
can be seen. From the studied this can be seen that obesity will impact on the physical
and mental development of the child inside a woman (Ma and et. al., 2016). Also
decrease the pregnancy rate where women chances miscarriage was more than normal
and fit women. In a recent study conducted by United Kingdom’s health care centre it
was found that it point 20% women suffering from obesity the chances to face problem
of miscarriage at the time of delivery. The whole research is conducted on hundred
women’s where it is also analysed as miscarriage can lead to several other problems in
future on a women which are related to the bone density as well as fast aging. Anxiety
and depression are also causes which can be seen in a woman who suffer from
1

miscarriage due to obesity. in this current report there is a discussion about the
reduction complications related to the pregnancy which are faced by different
movements were suffering from the obesity at the time of pregnancy (Stephenson and
et. al., 2018). There is description about the various incidents and knowledge which are
related to marriage in the pregnancy effectively so that chances of miscarriage can be
reduced within the pregnant woman's as well as early symptoms will be identified so
that problem faced by obese women related to pregnancy will be identified.
Aim
In present investigating research former researcher has formulated the aim which
is “To deal with the issues and complexities a women go through who is obese and
pregnant through an instructive program.” The task likewise targets improving the
personal satisfaction by giving ease to indications and advancing customary checking of
inconveniences identified with pregnant women dealing with obesity. It helps with
lessening wellbeing entanglements by conveying opportune interventions developed by
government.
Objective
• To reduce the complications faced by obese women during pregnancy
through educational program.
• To enhance the health outcome of obese women facing problems during
pregnancy.
• To reduce the miscarriage rate in obese women through an educational
program.
Research questions
• What are the complications faced by obese women during pregnancy?
• How to reduce the complications faced by obese women during pregnancy
through an educational program?
• How to enhance health outcome of obese women facing problem during
pregnancy?
• How to reduce the miscarriage rate in obese women through an educational
program?
2

Rationale
Major reason behind conducting investigation on the chosen topic is because the
quantity of issues dealt by healthy pregnant women are being rising ceaselessly. They
are fundamentally confronting high number of inconveniences during the hour of
pregnancy coming about into unfavourable pregnancy results for the most part
miscarriage. It has been examined that miscarriage rate among healthy or obese
females 25% in a range of week (Stang and Huffman, 2016). The most elevated danger
of miscarriage that can be looked by fat females is between 0 a month and a half. It has
been examined that obese or fat women can experience premature delivery during the
underlying long stretches of pregnancy without even them understanding of being
pregnant. There are different kinds of inconveniences that can be looked by
heavyweight woman, for example, they can experience issue of asthma. Other serious
issue that can be looked by them remembers contamination for wound. They can
likewise confront issue in starting breastfeeding. This can lay antagonistic effect on
improvement capacities of kid. The significant explanation of this investigation is to
decrease the measure of intricacies faced by women who are heavyweight and giving
them information and instruction identified with compelling administration of pregnancy
(Withers, Kharazmi and Lim, 2018). This can help social insurance experts in lessening
the pace of unsuccessful labour in over-weight pregnant females. They will likewise
attempt to lessen the hazard identified with other wellbeing related issue in overweight
females.
Statement of Intention
The reason for this dissertation is to upgrade information for women who are
obese or overweight through an instructive program with the goal that they don't
confronted any inconveniences identified with pregnancy. In these medicinal services
experts will utilize different administration methodologies with the goal that hazard
identified with medical issues of pregnant females can be diminished. They will be
occupied with improving personal satisfaction of pregnant large females through
instructive program. They will be engaged with making them mindful about early signs
and manifestations of entanglements looked by overweight women (Flenady and et. al.,
2016).
3

Background
Over the years, it has been analysed to that many investigations were performed
on the difficulties which are faced by pregnant women while giving birth to the child or
during the pregnancy period of time. But, there are only a few investigations were done
on the particular problem which is obesity that has majorly raised a number of risks for a
pregnant woman like delivering a child who is premature and so on (Redsell and et. al.,
2016). Including this, it has been analysed to that at the time of pregnancy and
overweight woman specifically deals with more issues than a woman who is fit. In the
past, there were a less number of educational programs that were generated by
governments in order to study the different risks that an overweight woman carries
when she gets pregnant or while spending the time of pregnancy. But now it has
become impossible to understand the different issues coma risks and cons that main
directly impact on life of the woman who is overweight and her child as well. Mostly,
there are a few common issues that majorly takes place and these are cardiovascular
problem, wound infection, diabetes, cardio vascular problem, asthma, wound infection
or they can even face problem during the time of breast feeding. Away with this, it can
be said that the major or serious issue which is majorly being faced by overweight
females in pregnancy incorporates actuate work, cesarean segments. This can lay
serious negative effect on wellbeing result of stout females and furthermore can lay
other effect on child’s development as well. Basically, it can be said that there are
various elements be decreased by human services experts to rouse women to take an
interest in different sort of multimodal exercises and giving training on same (Poston
and et. al., 2016).
2. LITERATURE REVIEW
Definition of Obesity and its impact on pregnant women
Obesity can be defined as medical conditions where an individual carries excess
body fat that specifically impact negatively on health. On the other hand, Body mass
index (BMI) is one of the crucial tool that is being utilised to evaluate in terms of fat
distribution via the waist–hip ratio and total cardiovascular risk factors. Including this,
the major impact over pregnant women that can be seen of obesity is directly linking
4

towards miscarriage, premature baby, and it may also affect health conditions as well of
women going through the difficulties (Alkema and et. al., 2016).
Pathophysiology of Obesity
In human body, obesity occurs when imbalance takes place among energy
expenditure and caloric intake. Basically, it is considered to be the imbalance that
majorly takes place within genetic and environmental influence. On the other hand,
mostly in human body discovery of immunologic abnormalities can be considered as
obesity and these specifically stays linked with leptin-proopiomelanocortin system and
elevated tumour necrosis factor alpha (TNF-α) brought a new perspective to the
understanding of obesity. It has been analysed that these are said to be some of the
crucial elements that specifically impacts negatively on a woman when she is pregnant
(Hawkes and et. al., 2020).
Leptin is a hormone made primarily in adipocytes. The circulating leptin levels
reflect the amount of stored body fat. Leptin is a negative feedback signal that acts on
the hypothalamus to alter the expression of several neuroendocrine peptides that
regulate energy intake and expenditure. Central resistance to leptin is a prominent
feature of obesity. In other words, obesity is said to be a sickness including an over the
top measure of muscle versus fat. Obesity isn't only a corrective concern. It is a clinical
issue that expands danger for pregnant women of different sicknesses and medical
issues, for example, coronary illness, diabetes, hypertension and certain malignant
growths.
Obesity symptoms and causes
Symptoms:
Obesity is specifically being diagnosed in an individual when the body mass
index (BMI) is 30 or higher. In order to identify body mass index pregnant women can
effectively divide her weight in pounds by considering her height in inches squared and
multiply it by 703 (Devlieger and et. al., 2016). Or divide the weight in kilograms by a
pregnant women's height in meters squared.
Causes:
Human science has found ample number of causes of obesity and these are
genetic, behavioural, metabolic and hormonal influences on body weight, obesity occurs
5

when an individual take in more calories than it is required for him or her to burn through
exercise and normal daily activities. It has been found that, human body specifically
stores excess of calories as fat because, most of Individuals diets in United Kingdom
are too high in calories often from fast food and high-calorie beverages (Cahill and et.
al., 2018). Over the years, women dealing with obesity whether she is pregnant or not
carries a habit of eating more calories before feeling full and also do not performs any
sort of exercise or daily activities to burn them and continuation of this routine may
excessively impact on different situations like she may feel hungry, or eat more due to
stress or anxiety. Some of causes are presented underneath:
 Genetic influences: Genetic solutions of women plays an important role of a
person to deal with obesity or becoming obese. It is may be possible that a
woman may specifically maintain most of the control to carry a particular weight
but it has been found that rare genetic diseases make it almost impossible to
avoid obesity (Vir, 2016).
 Physiological influences: A few analysts accept that each individual has a
foreordained weight that the body opposes moving endlessly from (Obese).
Additionally, individuals of a similar age, sex and body size regularly have
diverse metabolic rates. This implies their bodies consume food in an
unexpected way. Somebody with a low metabolic rate may require less calories
to keep up roughly a similar load as somebody whose metabolic rate is high.
 Food intake and eating disorders: If a women who is pregnant eat a lot, then it
is may be possible that she may consume foods that are high in fat and calories.
This situation may increase chances for her to become obese. Obesity also can
result from eating disorders, such as a tendency to binge (Fernández‐Barrés and
et. al., 2016).
 Lifestyle: Following sedentary lifestyle, it is may be possible that women who is
pregnant may start dealing with higher risk of becoming obese. This is why, it is
much needed for pregnant women to specifically follow a healthy diet in order to
reduce the chances of getting obese because, it is maybe possible that it may
lead her to go through different range of health conditions which may also affect
her child and herself as well.
6

 Weight history: This is also said to be effective reason behind increasing the
chances of person to get obese. Including this, weight as a child or adolescent,
individuals are more likely to be obese as an adult (Hill and et. al., 2017).
 Pregnancy: Pregnancy can also be taken as an effective contribution towards
being obese and it has been analysed that many women weigh more after each
pregnancy. Therefore, it is also considered to be the cause of getting caught by
different range of cardiovascular diseases which may negatively impact on a
women in near future.
 Drugs: Including this, it is also considered to be the cause of obesity where
some of the drugs might react. In present context, steroid hormones along with
some of the other drugs which are being utilised to treat psychiatric conditions
and some of the other situations may effectively cause obesity (Peaceman and
et. al., 2018).
Reduction in complications faced by obese women during pregnancy through
educational program
Based on the information given by Carolan-Olah, (2016), women who are
pregnant and are also dealing with overweight conditions holds maternal complications
more than healthy and fit women. In present context, issues can be anything from
preeclampsia, preterm birth, gestational hypertension, and gestational diabetes and so
on. On the other hand, if it is thought in a different way than it has been contradicted by
various researches who has mentioned that obstetric deliverables would require to keep
their focus over spreading awareness in relation to different range of risks that may
impact negatively on health conditions of an overrated women who is pregnant. It has
also been analysed to that, pregnancy have the expansion in level intricacy with respect
to the more noteworthy degree if a woman is overweight so as to have support in
pathogenies of these antagonistic results. As indicated by the perspectives given by
investigators, where it was mentioned that maternal corpulence may influence long haul
posterity results because of epigenetic changes initiated by dangerous presentation to
expanded degrees of glucose, insulin, lipids, and fiery cytokines.
In present context, in order to support or to spread awareness among women
about how obesity can affect their health conditions, pregnancy span and their child as
7

well to whom they will be giving birth there are a range of educational programs that has
been built by government of different countries in order to reduce the risks linking to
maternity. Basically, there main support for the contribution has been towards
nourishing directions to pregnant women who are overweight by enrolling with the
assistance of dietitian or conduct wellbeing results to guarantees the setting up of eating
regimen (Brennan and et. al., 2017). Also, it has been analysed that there are a less
number of ways from of supervisorial diet for the pregnant lady who is overweight by
regular proposal of diet which are low glycaemic load diet and a Mediterranean eating
routine. Apparatuses, for example, food journals and pedometers may likewise assist
obese women who are pregnant. Doctors ought to energize a slow increment in
physical action up to an objective of 30 minutes of moderate-force practice every day.
Enhance the health outcomes pregnant women face due to obesity.
As per Garner and et. al., (2017), at the time of pregnancy, hypertension is
considered to be the unmistakably have the relationship with the hazard which is being
related with progressively level of negative results towards health conditions, increasing
risks of cardiovascular problems and so on. Kids have a danger of future corpulence
and coronary illness due to obesity, which is considered to be one of the primary issue
that is required to be undertaken. In present context, women dealing with obesity stays
at the risk of getting diabetic. On the other hand there are some of the crucial elements
like technology, economy and social that has majorly impacted and raised unhealthy
habits of eating fast food which can be considered as the primary reason of increasing
numbers of patients dealing with obesity. Basically all the comforts along with the eating
habits has change the way of living because most of the working women majorly eats
fast food through carrying out a small part of their busy schedule. It is also found that
confront wellbeing entanglements, for example, diabetes, cardio vascular issue,
asthma, wound contamination or they can even face issue during the pregnancy (Kavle
and et. al., 2018).
Away with this, it has also been analysed that more degree of extent of the
helplessness or hypertension is also considered as one of the crucial region of women
has started dealing with obesity. There are estimations outline the nutritionists and
obstetricians is that the problems like miscarriage will be reduced to minim if women
8

majorly get in shape through performing different range of exercises and training at the
time when, they get pregnant. Also, it is being measured that pregnant females put on
weight alongside progressively level of issues which can be, for example, toxemia,
rashness, macrosomia, cesarean areas, stillbirths, gestational diabetes, fetal
irregularity. Thus, the educational programmes upheld as pre origination is wellbeing
key which can be a component to diminish their danger of maternal weight by
organizing increasingly level of hazard like activities and critical degree of dietary plans
and procedures.
Reduction in miscarriages in obese women through an educational program.
According to Clifton and et. al., (2016), development of different range of
awareness related educational programs are some of the crucial interventions that may
help both private and governmental agencies to enhance the knowledge of women of
both who are fit and who are already dealing with problems like obesity through
spreading awareness of how negatively obesity can impact on their own health
conditions in near future and of their child as well. Basically education programmes in
present time are impacting positively on mind-set of people, therefore it can easily be
said that developing an effective educational program in relation to how obesity can
affect maternity time and can raise different range of difficulties in relation to pregnancy
of the women who are overweight in nature. Obesity related educational programs
make continuously help pregnant women who are overweight to get the knowledge in
relation to nutritional needs; developing new foods to help achieve caloric balance;
providing nutrition education; conducting behavioural research; and planning,
conducting, and evaluating dietary interventions.
On the other hand, danger of progressively level of premature child birth,
miscarriage and so on are to be found as the 38.1% among women dealing with
obesity, though this rate was 13.3% in patients with BMI (Barker and et. al., 2018). The
females who are over weight and large have the more significant level of hazard for the
conceptive wellbeing which also includes infertility miscarriage rates, conception rates,
along with pregnancy complications that are already increasing continuously among
pregnant women. Therefore considering an effective educational program in relation to
obesity, pregnant women in all over United Kingdom can specifically get the knowledge
9

of how obesity can be reduced to minimal so that no impact can be faced by them
during maternity period and even after they have given birth to the children.
3. Research Methodology
Research methodology is considered as a particular procedure just as method that
is embraced to pick just as recognize the data or information with respect to the specific
theme. It gives the dependable just as substantial data that is valuable in finishing a
specific exploration (Jaacks and et. al., 2017).
Research Paradigm
At the time of conducting an investigation coma the developed objectives are
required to be validated in an appropriate manner so that reliability of the overall
investigation results can easily be improved. Since the report has considered
exploratory, realism philosophy and deductive approach in order to conduct the
investigation on how obesity has impacted on health conditions of pregnant women of
England. While focusing on the particular topic which has been taken into consideration
by a researcher the philosophy which has been proven itself appropriate in relation with
the obesity and its impact on pregnant women. On the other side, in order to enhance
the overall knowledge in a scientific approachable way, it has been analysed that
considering this type of paradigm for example causes and symptoms and its impact on
women who are pregnant will be considered in rightful manner (Zerfu, Umeta and Baye,
2016).
Research philosophy
This is considered to be the phase which focuses around various sort of reasoning
that is critical to think about, for example, positivism, metaphysics just as a lot more so
as to lead the proper exploration so as to finish the specific examination. Accordingly,
here in the agent centres around utilizing interpretivism for gathering or assembling the
essential data with respect to marvel that is imperative to consider. Along these lines
from the few methods of reasoning the specialist centres around one of them so as to
accumulate the essential data for finishing specific exploration. Examination theory is
considered as a conviction with respect to the specific where strategy in this is an
information or data in regards to a specific element or information which must be
10

gathered, surveyed just as valuable. It is important to utilize research theory so as to
order the examination that must be required to be given. It likewise gives conversation
with respect to the exploration methodology that helps in gathering fundamental data by
utilizing distinctive source during the specific timeframe (Bruno and et. al., 2017).
Research Methods
Investigation, which has been taken into consideration is directly linking with
exploration in a proper way by utilizing both quantitative and qualitative strategy and
furthermore utilize collaborative procedure for research. Under this investigation,
researcher has utilised qualitative examination so as to gather vital data which is vital
for finishing the specific venture in pre-chosen timeframe. The explanation behind
embracing qualitative examination is to gain knowledge considering detailed
perceptions and values of society, Individuals and group which will help researcher to
take in-depth knowledge about the topic in leading proper exploration in a specific
timeframe.
Research Approach
There are two kind of approach which is must be considered by the investigator
during the research is deductive and inductive. In current investigation the topic is
completely depend upon the outcomes in which the researcher focus on for gathering
the information in perceptions which is considered as a inductive approach. It is
considered as a more advantages than any other kind of research that is connected
with qualitative research (Dencker and et. al., 2019).
Research Design
Research Design is considered as the blueprint of investigation that is essential or
important to manage by a researcher in order to finish the particular project during the
particular phase of time period it is divided among different kind of process such as
exploratory, experimental as well as preliminary examination procedure. In current
research, the investigator focuses on reduce the difficulties of overweight women the
during pregnancy childbirth through educational program. Therefore, they use the
research in order to use the appropriate data by determining actual fact that providing
actual benefit in future period of time. Thus, the main purpose of investigator is to
11

increase favourable outcomes that are useful for complete a particular research within
pre-decided period of time.
Data Collection Tools
Majorly, it has been analysed that there are two different types of data collection
tools that can be utilised by investigators and these are primary and secondary. Both of
these are presented underneath:
 Primary data collection tool: Primary data collection tool can be anything from
questionnaire, Focus group, interview, and so on. Primary data is specifically
being utilised to collect authentic data from the selected individuals (Fall and
Kumaran, 2019). Including this, it has been analysed that the data which has
been gathered from this type of data collection method specifically do not stays in
a processed format. Therefore, it is much required for the investigator to properly
plan every single activity because it is considered to be both time and cost
consuming approach but the data which has been received or gathered it is
considered to be the information which has never been utilised before by any
other researcher, scholar and so on. In present context, researcher will be
considering in-depth as the primary data collection tool which will be helping in
pulling out favourable information in much effective and in efficient manner.
 Secondary Data Collection Tool: There are a range of secondary data
collection tools like books, online articles, journals and so on which can be
utilised by investigators. This is considered to be the tool which is utilised in
literature review section so that it over all investigation can easily be performed
with authenticity but these are said to be the data collection approaches on which
investigator cannot rely upon but in order to conduct the literature review section
where ideas and perceptions were specifically being taken from the previous
investigations that has been performed by scholars researchers and other
individuals to enhance the overall knowledge in relation to the particular topic
(Yeo and et. al., 2017).
In present context, both primary and secondary data collection tools are utilised
in order to perform the overall investigation on how obesity impacts on pregnant
12

females, where investigator will be directly focusing on different areas that will help him
in understanding the topic in much more detailed manner.
Data Sampling
In present context, data sampling is said to be an effective way of conducting
investigation in rightful manner as it helps the investigator in accumulating the data
which is much more reliable and effective as well. This will be done while incorporating
the Inclusion and Exclusion model. For the current examination the investigation
populace was taken from the maternal information base [BMI (BMI) >30 kg/m 2] females
were contrasted and an age‐matched control bunch with typical BMI (19–24.9 kg/m 2).
The age of the females that was fundamentally remembered for the investigation was
starting from 25 to ending that is 45 (Callaway and et. al., 2019). It was broke down that
in this investigation just females was taken for the examination. This is on the grounds
that with the goal that no further inconvenience is been looked during the hour of
assortment of information.
It was dissected from the study that danger of miss-carriage among hefty females is
more than those with typical females. Females taken for the test has a place with United
Kingdom. There clinical condition was that they were corpulent or over weight. This will
help in distinguishing the pace of intricacies that has been looked by large females
during the hour of pregnancy. The avoidance rules for present investigation
incorporates that no females more than the age of 45 was been taken for study. It has
additionally been investigated that the fundamental focal point of study was on pregnant
females. Likewise the females who were pregnant outside United Kingdom were not
taken for additional investigation. Every one of these viewpoints were taken with the
goal that final products identified with exploration can be distinguished. This were the
prohibition standards that has been taken to direct the current investigation. The size of
test that has been taken so as to lead the examination was 25 pregnant females and
furthermore 25 ordinary females. This was done so as to contrast the difficulties related
with wellbeing looked by them. It has been broke down from the examination that that
the pace of unnatural birth cycle in corpulent females is higher than typical. The
technique for gathering information was through perception, centre gathering and inside
13

and out meeting. This has helped analysts in taking better choices (Barrera and et. al.,
2018).
Ethical Consideration
Concentrating on current assessment, it is to consider all the investigation morals
as to finishing the entire work in right way without confronting in a risky way. As
necessities be, operator would require to help the work by strategies for the reasonable
course of good practices and offer agree to the people concerning displaying their
assent about the undertaking (Hawkins and et. al., 2016). Moreover, needs offer
affirmation to their people concerning the data as it is fundamental to keeping up course
of action of their information which is private. Consequently, these are supposed to be a
portion of the urgent components that insightful would require to remember while
directing examination over such a theme so it may not hurt at all to the general public.
4. RESULTS AND FINDINGS
The two effective data collection tools that are specifically being taken into
consideration are in depth interview and observations. Both of these elements are
presented underneath that will be providing detailed information about how obesity has
impacted on women who are and who were pregnant:
Interview:
Q1. Are the educational programmes developed for pregnant women
dealing with obesity are helpful to them or not?
In regards to the question above a study or research program is formulated and
surveys are conducted. Obesity is a complex disease due to which people gets
excessive amount of body fat which gives other more complex diseases to them
such as blood pressure, diabetes and many others. In the survey there were two
groups of 25 women each. The first group are of those women who are pregnant
suffering from obesity as well. Pregnancy exercise is a very complicated state
where a woman have to face several difficulties on daily basis. The women who
was suffering from obesity and were pregnant as well what asked about the
educational programs provided by government for keeping them aware and
knowledgeable about the changes taking place in the healthcare environment for
14

their benefits. Also these educational programs helps in keeping the meaning
aware about the several different methods they can adopt for managing health by
themselves. From the first group of women 15 candidates who were agreed that
the educational programs provided by government over obesity and pregnancy
both are helpful and knowledgeable enough for their awareness. On the contrary
the remaining 10 respondents states that these educational programs needs
changes and modifications. The next group of 25 women were those who are
normal and are not suffering from obesity and not even pregnant. 10 candidates
stated that these educational programs need to be updated frequently and new
knowledge and information has to be included in it for better health care
procedures. On the other hand remaining 15 women stated that in every three to
six months new educational programs should be introduced by UK government in
order to create awareness and keep all the women specially the ones who are
pregnant and dealing with obesity too.
Q2. What are the different challenges that are faced by women while
pregnancy and dealing with obesity at the same time?
Women has a very important and precious gift provided by God to them that is of
giving birth two babies and bringing new lives into the world. As much this is a gift
it brings a lot of pain and difficulties for females in their day to day lives.
Moreover, while being pregnant and suffering from obesity the pregnancy
becomes more and more complicated. Women face challenges and complexities
in their day to day activities as well as in pregnancy too when they are gaining
weight regularly on their body which becomes unmanageable. The challenges
that are faced by women causes huge harm to their bodies and to the babies as
well. Some of the women loses their child due to miscarriage, some are
diagnosed with sever diseases related to heart like cardiac and respiratory issues,
blood pressure, diabetes and weakening of other body organs. These problems
which are faced by these women have developed real dynamic opinions in their
minds about the educational programs provided as the symptoms and the
problems to all different women are varied and causing large amount of pain and
15

harm.
Q3. Do you think, obesity can impact negatively on overall health of a
pregnant women?
Considering the information given by the group of 25 pregnant women who were
dealing with obesity, where most of them has already experienced the problems
like high heart beat and other cardiovascular problems that it has impacted
negatively on their health conditions. On the other side, a few of them has given
their answers towards no and stated that obesity has no relation with pregnancy.
This statement was given by them because they have to take rest for more than 6
to 7 months and this is why they make get over weight. However, what
information was given by rest of the individuals were specifically not that much
correct because following and effective diet and performing daily activities like
exercises and so on could effectively keep them healthy and fit. On the other
hand, if it is talked about the other 25 women who were not dealing with obesity,
they have also given mixed answers like some of them were in the favour of the
statement that yes obesity can impact negatively on health conditions of pregnant
women. Away with this, a few of the other individuals has stated that pregnancy is
something that they have to handle and just because of taking rest for like whole
day long, it is pretty much obvious that they may get overweight.
Q4. According to you, is it important for overweight pregnant women to first
take advice from healthcare providers and then reach to a conclusion of
taking any certain supplements for reducing weight?
As per the answers, given by the group of 25 pregnant women it can be said that
most of the individuals were in the favour of taking advice before focusing on any
sort of supplements to reduce the weight at the time of pregnancy. The reason
that came in front was, the human body during pregnancy specifically stays weak
in nature and it is may be possible that the supplements may react negatively.
Some of them has given their answers towards yes because, they have
experience the same. Like one of the individual used to keep herself fit and used
16

to take supplements, which impacted negatively in her pregnancy period where
she had to face ample number of difficulties and complications. Away with this, it
has also been analysed that women who were pregnant and dealing with obesity
considering the group of 25 individuals, they have given mixed answers like some
of them has stated that it builds power and generate energy in their body which
helps them in reducing pain and keep them working for whole day long like daily
activities. On the other hand, some of the other women were not in the favour and
stated that intake of healthy diet is much more fruitful than any other supplements
and it is must for an overweight pregnant women to keep on performing different
range of exercises like swimming and so on and follow a healthy diet in order to
reduce the fat from her body.
Q5. Based on your thoughts, do you think if it is necessary for government
of United Kingdom to make alterations among their educational
programmes that they are already providing to pregnant women who are
dealing with obesity in a rapidly changing manner?
As per thoughts of most of the respondents (20 out of 25 respondents) belonging
to Pregnant women group dealing with obesity has stated that, based on the
requirements the educational programs should be changed from time to time. The
reason behind why they have mentioned this is because, health conditions
majorly varies from person to person and because of different outbreak of
diseases like coronavirus and so on, impact can be anything on pregnant women.
Diabetic patients who are already dealing with overweight situation if gets
pregnant then it is must for them to take personal advice from health care
providers or the educational programs should be rightfully made for them. Most of
the individuals were in favour of the same but rest of the 5 out of 25 participants
has stated that bringing too many changes within existing educational programs
may not help up any pregnant women but it may also increase and it for her which
is also considered to be a risk that may impact negatively on overall health
conditions of a pregnant woman who is already dealing with obesity.
17

Q6. Based on your thoughts, what are the ways through which reduction
within miscarriage rate in obese women can be done?
Considering the thoughts given by 15 out of 25 respondents who were coming
under pregnant women group state that it is much needed to spread awareness
about how negatively overall problems like obesity and other health issues may
affect both child and mother to be. They have given their answers towards
educational programmes and stated that this is one of the crucial way through
which knowledge of pregnant women can easily be increased in relation to dietary
plans and a healthy lifestyle that can be used by them during pregnancy. Also,
these educational programmes may effectively help the other group of members
as well because it will help them in taking right decisions before eating anything or
considering a particular diet without any sort of toxic elements that may lead them
to create chances of miscarriage. Apart from that rest of the individuals belonging
to the other group and including the five individuals who were belonging to
pregnant women group has given their answers to words directly consulting with
the doctor before taking any sort of chances that may lead the pregnant women to
go through different range of difficulties.
Observation technique:
Observation research define as a qualitative research methods where
investigators observe the ongoing behaviour of the participants' within a natural
situation. This is one of the most effective but on the other hand lengthy process where
the behaviour and attitude of participants has been observed by the researchers so they
can develop fruitful result (Jacobson and et. al., 2018). In reference to the present
investigation which is on the topic which discusses about the issues as well as
complexities face by a women who is obese and pregnant through an instructive
program. The present research is based on primary data collection where interview as
well as observation methods are used by the researcher. For this, total number of
respondents are 50 wherein 25 women who are pregnant deals with obese whereas
other 25 pregnant women do not have any kind of issues. Before doing observation
research it is required by the investigator that there are some steps which needs to be
18

followed by them. These steps are as follows which needs to be considered by the
researcher while conducting observation method.
1. Identify Objective: In this step, investigator need to be clear about what they want to
observe. In reference to the present investigation, researcher develop an objective
where they examine the issues face by pregnant women. For this normal pregnant
women as well as women who are pregnant and deal with obese are chosen. There
are some reason where women face miscarriage are going to be understood.
2. Establish Recording Method: After deciding the objective, researcher set some
recording instruments so that they can record and observe things faced by both sort
of women’s. This as a result will assist in understanding the behavior, problems faced
by pregnant women. Observing people can help in examining the issues as
sometimes it becomes difficult to express the problems faced by them (Arentz and et.
al., 2017).
3. Develop Questions and Techniques: For this, it is necessary to develop some sort
of questions which are required to be asked by the researcher to the pregnant
women. These questions must be related to their current situation and needs to be
asked by everyone so that their opinion can be understood and draw valid
conclusion.
4. Observe and Take Notes: After completing the above steps and formulate all the
necessary questions so that positive outcome will be developed in an effective
manner. It has been observed that having obesity at the time of pregnancy has some
major influence on the overall health of the women as well as on the baby also.
Therefore, women who have obese have major health issues as compared to those
women who do not have any sort of issues. Along with this, it also affect the health
and wellbeing of the baby in an adverse way (Yeo, Crandell and Jones-Vessey,
2016).
5. Analyze Behaviors and Inferences: The main aim behind adopting observation
method is to gather raw data which is being gathered by observing the behavior and
attitude of participants. In this research, participants are those women who are
pregnant and at the same time some of them faces issues related to obese. Each
19

and every female have different experience which need to be observe by the
investigator so that they can formulate favorable outcome.
All the above stated steps are included in the process of observation which is one
of the method for gathering information related to a specific topic. It has been observed
by the researcher that some women who face obese during their pregnancy have mood
swings and as compared to healthy pregnant women they are less active and healthy. It
has also been observed that there are 50% pregnant women who face obesity where
they eat more due to stress and anxiety. This might increase their weight which affect
their other organs and sometimes these cases of pregnant women who have obesity
leads to miscarriage. Therefore, it has been summarised that there must be some sort
of techniques through which medical professionals reduce the impact of obesity from
the pregnant women. Along with this, they must examine the causes due to which
women are pregnant get this sort of issues and remove the chances of getting such
problems.
5. DISCUSSION
By considering the detailed analysis from both the data collection method it is
analysed that having obesity during pregnancy has major impact on the health of
women and baby as well. For these significant complications recommendations
regarding weight are described in order to promote healthy pregnancy. Obesity is
diagnosed when the body mass index is around 30 or more than that as it leads to
divide the wait in Pounds by the height in inches and squared and multiplies by 703
(Gresham and et. al., 2016). For this, women who regularly ovulate, undertaking higher
obesity has longer to appear to become pregnant. Moreover high obesity at the time of
pregnancy leads to increase the risk for various pregnancy complications including risk
of miscarriage stillbirth and recurrent miscarriage. Higher obesity also leads to generate
gestational diabetes and further complications are characterized by high blood pressure
and the sign of damaging organ system like liver and kidney, cardiac dysfunction, sleep
apnea and risk regarding C-section complications like wound infections. Obesity leads
to impact baby as well as it increased risk regarding various health problems for the
20

baby like birth defects, fetal macrosomia, impaired growth, childhood obesity and
asthma (Einarsson and et. al., 2017).
For this pre pregnancy weight it is important to consider in order to determine that
how much weight is required at the time of pregnancy and also worked on the
Healthcare in order to manage the weight throughout the pregnancy. Moreover if a
woman has the body mass around 30 or more than that and also carry one baby then
the recommended weight gain is around 5 To 9 kilograms and if women carry twins are
multiple babies then the recommended weight gain is about 11 to 19 kilograms. Along
with this the world wide prevalence for the obesity leads to increase substantially over
the past decades as the lifestyle of people changes continuously and leads to create
abundance for high calorie food with decreased physical activity and it become the
evidence for metabolic dysregulation among obese individual that are linked with the
number of significant environmental factors considering contaminants from the modern
industry. Furthermore it is recommended that a woman need to gain specific amount of
weight at the time of pregnancy and also consider the Healthcare advice that leads to
motivate focus for avoiding excessive weight gain at the time of pregnancy. At the time
of pregnancy a pregnant woman need special care regarding the health and consult
with the Healthcare provider in order to closely monitor the pregnancy.
Along with this it is also recommended to a pregnant woman that early testing for
the gestational diabetes is important for the glucose challenge “between” 24 to 28 of
pregnancy and if the body mass index is 30 or more than that then screening test is
recommended at the first prenatal visit. For this the Healthcare provider also advises to
closely monitor and control the blood sugar. Along with these prominent changes for the
fetal ultrasound also done among 18 and 20 weeks of the pregnancy to analyse the
anatomy of baby but the Waves of ultrasound does not penetrate abdominal fat issue. It
leads to interfere with the prominent efficiency of fetal ultrasound and also get
recommendation from the health care provider regarding the best approach in order to
get significant and accurate ultrasound. Effective screening for the obstructive sleep
apnea is considered as the serious sleep disorder that leads to cause breathing to
repeatedly stop and start at the time of sleep. Pregnant woman who has obstructive
sleep apnea are at the increased risk of pre-eclampsia and other considering
21

complications. Obstructive sleep apnea is suspected and also gets recommendation by
the Healthcare providers regarding sleep medicine and also gets possible treatment for
that (Patel and et. al., 2017).
Along with this in order to promote healthy pregnancy the health and other
concerning factors of baby is also considered like scheduling preconception
appointment as if a woman has obesity and considering to get pregnant then she need
to talk to the Healthcare provider and get effective recommendation on the daily basis
for the prenatal vitamin and consult with dietitian that helps in reaching towards the
healthy weight before pregnancy. Furthermore, prenatal visit is useful for the Healthcare
provider in order to closely monitor the health and other condition of baby and also offer
prominent details and instruction recording any medical condition like high blood
pressure diabetes sleep apnea and also discuss in order to manage and overcome
these issues. Despite from this healthy diet is also important in order to avoid excessive
weight gain and keep prominent things in the mind regarding the protein calcium iron
and other important nutrients. Away with this if women consume risky and harmful
substances like alcohol and smoke then she need to stop it at the time of pregnancy as
it leads to put negative impact on the health of a new born child.
6. Reflection
While conducting investigation on the chosen topic “To reduce the difficulties of
overweight women face during pregnancy childbirth through education program,” I have
gone through different range of difficulties that impacted negatively on overall
performance level of my own. Primal problem which I faced was to completely reach to
the point of developing different objectives considering the topic. In this situation, I got
confused because I already developed different range of objectives and it was hard for
me to pick 3 to 4 objectives which were directly connecting to the topic. This is where, I
took help of my lecturers and colleagues in order to reach to the outcome of selecting 4
different objectives soothing the topic. On the other side, I have also so will it my
confidence and enhanced my research skills through considering the particular topic
because it was really very hard to pull out specific information about how overweight
woman at the time of pregnancy faces different range of problems.
22

Including this, I can also say that the overall experience while conducting this
investigation has been really very motivational for me because initially when I just
started the investigation, I was filled with fear because I had no knowledge about the
overall topic that I choose but continuously when I was going through different range of
information, it has helped me out enriching to the ultimate goal of finding out the best
results in much effective and in efficient manner. Another issue that came in front was to
conduct the interview and observation which were the part of primary investigation,
because most of the respondents that I chose where 25 were pregnant women who
were dealing with obesity and 25 the other normal woman. Basically, participants that I
chose were not comfortable to share the information because they thought of I might
leak their personal information. However, I made them understand with the help of
consent form that this information that I was going to gather from them will be only
considered and utilised for research purpose only. Overall experience was effective for
me that would directly help me in conducting any sort of investigation in near future.
Including this, I might also become able to consider the information that I have
gathered in near future to help healthcare organisations to prepare educational
programs for better assistance that can be given to over weighted woman who are
pregnant. Also, with the help of enhancement in my own research skills, time
management, and many other interpersonal skills, I may become able to communicate
the findings and much more improvised way in near future in front of my colleagues,
readers and lecturers. However, the experience that I have experienced while
performing the overall investigation on the chosen topic of how educational program can
help pregnant women who are dealing with obesity, formulating different range of
interventions like spreading awareness in relation to how negatively obesity can affect
health conditions of pregnant women, will directly reduce the number of cases like
miscarriage and premature babies.
7. Conclusion and Recommendations
Conclusion
With the help of above mentioned report, it is concluded that development of
effective educational programmes, a lot of health issues faced by pregnant women
23

dealing with obesity can be reduced to minimum. Including this, it is being also
summarised that ample number of effective interventions developed to effectively
support overweight women who are pregnant. Considering all the evidences which has
been focus in this investigation it is also summarised that it will be required by pregnant
women who are already overweight according to their BMI, to keep on reducing their
wait in much effective and efficient manner through conducting daily activities and
performing different range of exercises.
With the help of this, it can easily be said that problems like miscarriage, giving
birth to pre-mature child, will be reduced to minimal. From the above report it can be
concluded that obesity of a pregnant woman create various kind of issues to the life and
baby who is yet to born. There are various kinds of issues which they face due to the
obesity while they are pregnant like high blood pressure, health issues body pain and
many others. In this report these issues are discussed in detail and regions are also
provided that why the women faces obesity while they are pregnant. There are various
recommendations which are being made for the obesity of pregnant women like eating
healthy food and keeping up their diet plans. For pregnant women it is highly essential
to follow the diet plans in order to expect a healthy child. Another crucial
recommendation that can be given to women who are dealing with complications at the
time of pregnancy, where it has been analysed that education programmes may
effectively deliver information to them about healthy habits and so on. This may
effectively lead pregnant women to reduce their weight during pregnancy period or
before getting pregnant. It is highly essential for pregnant women who have obesity to
take education sessions so that they can easily deal with the complications they are
facing. Along with that, exercises and Yoga sessions can be taken up by pregnant
woman in order to minimise the complications which they face.
Pregnant woman dealing with obesity needs to take regular consultant with
doctors so that every complication can be taken care in effective way. There is
necessity of being active so that obesity can put to limits and woman can live healthy
days while she is pregnant. Conclusion can also be made upon the risky substances
which woman takes likes drinking, smoking and other drugs which she might intake at
the time of pregnancy. Using the above-mentioned article, it is suggested that the
24

implementation of innovative training services will minimize to a minimum certain health
problems experienced by pregnant people struggling with obesity. Despite that, it is also
outlined that a significant range of successful approaches have been implemented to
help women who are pregnant with overweight successfully. In light of all the facts
collected in this case, it is also outlined that pregnant women who are still overweight
according to their BMI would be expected to strive to minimize their waiting successfully
and efficiently by undertaking routine workouts and completing different exercises.
Away with this, in order to encourage healthier parenting, baby's wellbeing and
certain considerations are often known as making preconception visits because though
a individual has hypertension and is contemplating being pregnant, so she has to speak
to the health care practitioner to provide appropriate suggestions for prenatal vitamin on
a regular basis to visit a dietician to better meet the goal. Obstructive sleep apnoea is
reported and provides advice on sleep medications from health care professionals as
well as potential therapy for it. Therefore, for a pregnant lady obesity is a major issue if
proper precautions are not taken care of till the baby is born.
Recommendations
Considering the above mentioned information, there are a range of
recommendations that can be given to women and some of these are presented
underneath:
 Schedule a preconception appointment. This is considered to be the primal
recommendation that can be given to women who are pregnant and dealing with
obesity to test themselves on BMI of 30 or higher at the time of getting BMI done
it is much needed to consult with health care provider about any sort of health
issues which has been faced by them. In present context, healthcare provider
may effectively deliver information in relation to following a daily prenatal vitamin
and may also give suggestions with other health concerns as well, which can be
resolved considering different aspects like registered dietitian, to reach a healthy
weight before pregnancy and so on (Samura and et. al., 2016).
 Attend education programmes: Another crucial recommendation that can be
given to women who are dealing with complications at the time of pregnancy,
where it has been analysed that education programmes may effectively deliver
25

every single information to them about healthy habits and so on. This may
effectively lead pregnant women to reduce their weight during pregnancy period
or before getting pregnant.
 Seek regular prenatal care. Pre-birth visits can enable women who are both
pregnant and overweight to look among different aspects, where healthcare
practitioners could effectively look at the overall health conditions of both mother
to be and foetus as well. On the other side, social insurance supplier regarding
any ailments a pregnant woman have, for example, diabetes, hypertension or
rest apnea and talk about what she can do to oversee them (Karayiannis and et.
al., 2018).
 Eat a healthy diet. In order to reduce situations that may increase the risk to life
of both mother to be who is dealing with obesity and the child, it is much required
to to consult with the health care provider or a registered dietitian to maintain a
healthy diet and avoid excessive weight gain. On the other hand, It will be
required for pregnant women at the time of pregnancy, she'll need more folic
acid, protein, calcium, iron and other essential nutrients.
 Be physically active. Another crucial recommendation that can be given to all
the pregnant women dealing with obesity is to primarily consult their doctors
about different range of procedures through which they can effectively stay active
at the time of pregnancy. In present context, there are a range of ways through
which they can stay active and some of these are swimming coma low impact
aerobics, walking and so on.
 Avoid risky substances. It has been analysed that, some of the women smoke
during the pregnancy and those who are overweight carries high risks half getting
into trouble like rise in chances of getting heart attack or any other cardiovascular
diseases. It is recommended to women who are pregnant to not to consume any
sort of illicit drugs like alcohol. Also, it is must for pregnant women to first consult
to the doctors before starting and stopping any sort of medication that consists
with steroid or any other harmful salts.
Therefore, it can be said that, BMI up to 60 with starting from the age of 30, at
the time of pregnancy may increase the chances of risks that are linked with
26

pregnancy and the reason that came in front was obesity. It is needed that,
healthcare providers may effectively manage the range of risks & promote a healthy
pregnancy with the help of different educational programmes (Blake-Lamb and et.
al., 2016).
27

8. REFERENCES
Books and Journals
Syngelaki H. and et.al., 2016. Metformin versus placebo in obese pregnant women
without diabetes mellitus. New England Journal of Medicine.374(5).pp.434-443.
Wang, C. and et.al., 2017. A randomized clinical trial of exercise during pregnancy to
prevent gestational diabetes mellitus and improve pregnancy outcome in
overweight and obese pregnant women. American journal of obstetrics and
gynecology.216(4). pp.340-351.
Egan, A.M. and et.al., 2017. Epidemiology of gestational diabetes mellitus according to
IADPSG/WHO 2013 criteria among obese pregnant women in
Europe. Diabetologia. 60(10).pp.1913-1921.
Vinter, C.A. and et.al., 2018. Lifestyle intervention in Danish obese pregnant women
with early gestational diabetes mellitus according to WHO 2013 criteria does not
change pregnancy outcomes: results from the LiP (lifestyle in pregnancy)
study. Diabetes care.41(10).pp.2079-2085.
Alkema, L and et. al., 2016. Global, regional, and national levels and trends in maternal
mortality between 1990 and 2015, with scenario-based projections to 2030: a
systematic analysis by the UN Maternal Mortality Estimation Inter-Agency
Group. The Lancet, 387(10017), pp.462-474.
Arentz, S and et. al., 2017. Combined lifestyle and herbal medicine in overweight
women with polycystic ovary syndrome (PCOS): A randomized controlled
trial. Phytotherapy Research, 31(9), pp.1330-1340.
Barker, M and et. al., 2018. Intervention strategies to improve nutrition and health
behaviours before conception. The Lancet, 391(10132), pp.1853-1864.
Barrera, C and et. al., 2018. The impact of maternal diet during pregnancy and lactation
on the fatty acid composition of erythrocytes and breast milk of Chilean
women. Nutrients, 10(7), p.839.
Blake-Lamb, T.L and et. al., 2016. Interventions for childhood obesity in the first 1,000
days a systematic review. American journal of preventive medicine, 50(6),
pp.780-789.
Brennan, L and et. al., 2017. Lifestyle and behavioral management of polycystic ovary
syndrome. Journal of Women's Health, 26(8), pp.836-848.
Bruno, R and et. al., 2017. Adherence to a lifestyle programme in overweight/obese
pregnant women and effect on gestational diabetes mellitus: a randomized
controlled trial. Maternal & child nutrition, 13(3), p.e12333.
Cahill, A.G and et. al., 2018. Weight control program and gestational weight gain in
disadvantaged women with overweight or obesity: a randomized clinical
trial. Obesity, 26(3), pp.485-491.
Callaway, L.K and et. al., 2019. Probiotics for the prevention of gestational diabetes
mellitus in overweight and obese women: findings from the SPRING double-blind
randomized controlled trial. Diabetes Care, 42(3), pp.364-371.
Carolan-Olah, M.C., 2016. Educational and intervention programmes for gestational
diabetes mellitus (GDM) management: An integrative review. Collegian, 23(1),
pp.103-114.
28

Clifton, R.G and et. al., 2016. Design of lifestyle intervention trials to prevent excessive
gestational weight gain in women with overweight or obesity. Obesity, 24(2),
pp.305-313.
Dencker, A and et. al., 2019. Causes and outcomes in studies of fear of childbirth: a
systematic review. Women and Birth, 32(2), pp.99-111.
Devlieger, R and et. al., 2016. Maternal obesity in Europe: where do we stand and how
to move forward?: A scientific paper commissioned by the European Board and
College of Obstetrics and Gynaecology (EBCOG). European Journal of
Obstetrics & Gynecology and Reproductive Biology, 201, pp.203-208.
Einarsson, S and et. al., 2017. Weight reduction intervention for obese infertile women
prior to IVF: a randomized controlled trial. Human Reproduction, 32(8), pp.1621-
1630.
Fall, C.H. and Kumaran, K., 2019. Metabolic programming in early life in
humans. Philosophical Transactions of the Royal Society B, 374(1770),
p.20180123.
Fernández‐Barrés, S and et. al., 2016. Mediterranean dietary pattern in pregnant
women and offspring risk of overweight and abdominal obesity in early childhood:
the INMA birth cohort study. Pediatric obesity, 11(6), pp.491-499.
Flenady, V and et. al., 2016. Stillbirths: recall to action in high-income countries. The
Lancet, 387(10019), pp.691-702.
Garner, C.D and et. al., 2017. Obese women experience multiple challenges with
breastfeeding that are either unique or exacerbated by their obesity: discoveries
from a longitudinal, qualitative study. Maternal & child nutrition, 13(3), p.e12344.
Gresham, E and et. al., 2016. Diet quality before or during pregnancy and the
relationship with pregnancy and birth outcomes: the Australian Longitudinal
Study on Women’s Health. Public health nutrition, 19(16), pp.2975-2983.
Hanson, M and et. al., 2017. Interventions to prevent maternal obesity before
conception, during pregnancy, and post partum. The lancet Diabetes &
endocrinology, 5(1), pp.65-76.
Hawkes, C and et. al., 2020. Double-duty actions: seizing programme and policy
opportunities to address malnutrition in all its forms. The Lancet, 395(10218),
pp.142-155.
Hawkins, J.D and et. al., 2016. Unleashing the power of prevention. American Journal
of Medical Research, 3(1), p.39.
Hill, B and et. al., 2017. Lifestyle intervention to prevent obesity during pregnancy:
Implications and recommendations for research and
implementation. Midwifery, 49, pp.13-18.
Jaacks, L.M and et. al., 2017. Programming maternal and child overweight and obesity
in the context of undernutrition: current evidence and key considerations for low-
and middle-income countries. Public Health Nutrition, 20(7), pp.1286-1296.
Jacobson, S.W and et. al., 2018. Efficacy of maternal choline supplementation during
pregnancy in mitigating adverse effects of prenatal alcohol exposure on growth
and cognitive function: A randomized, double‐blind, placebo‐controlled clinical
trial. Alcoholism: Clinical and Experimental Research, 42(7), pp.1327-1341.
29

Karayiannis, D and et. al., 2018. Adherence to the Mediterranean diet and IVF success
rate among non-obese women attempting fertility. Human Reproduction, 33(3),
pp.494-502.
Kavle, J.A and et. al., 2018. Program considerations for integration of nutrition and
family planning: Beliefs around maternal diet and breastfeeding within the context
of the nutrition transition in Egypt. Maternal & child nutrition, 14(1), p.e12469.
Ma, R.C.W and et. al., 2016. Clinical management of pregnancy in the obese mother:
before conception, during pregnancy, and post partum. The lancet Diabetes &
endocrinology, 4(12), pp.1037-1049.
Patel, N and et. al., 2017. Infant adiposity following a randomised controlled trial of a
behavioural intervention in obese pregnancy. International Journal of
Obesity, 41(7), pp.1018-1026.
Peaceman, A.M and et. al., 2018. Lifestyle interventions limit gestational weight gain in
women with overweight or obesity: LIFE‐Moms prospective Meta‐
Analysis. Obesity, 26(9), pp.1396-1404.
Poston, L and et. al., 2016. Preconceptional and maternal obesity: epidemiology and
health consequences. The lancet Diabetes & endocrinology, 4(12), pp.1025-
1036.
Redsell, S.A and et. al., 2016. Systematic review of randomised controlled trials of
interventions that aim to reduce the risk, either directly or indirectly, of overweight
and obesity in infancy and early childhood. Maternal & child nutrition, 12(1),
pp.24-38.
Samura, T and et. al., 2016. Factors associated with excessive gestational weight gain:
review of current literature. Global advances in health and medicine, 5(1), pp.87-
93.
Stang, J. and Huffman, L.G., 2016. Position of the academy of nutrition and dietetics:
obesity, reproduction, and pregnancy outcomes. Journal of the Academy of
Nutrition and Dietetics, 116(4), pp.677-691.
Stephenson, J and et. al., 2018. Before the beginning: nutrition and lifestyle in the
preconception period and its importance for future health. The
Lancet, 391(10132), pp.1830-1841.
Vir, S.C., 2016. Improving women's nutrition imperative for rapid reduction of childhood
stunting in South Asia: coupling of nutrition specific interventions with nutrition
sensitive measures essential. Maternal & child nutrition, 12, pp.72-90.
Withers, M., Kharazmi, N. and Lim, E., 2018. Traditional beliefs and practices in
pregnancy, childbirth and postpartum: A review of the evidence from Asian
countries. Midwifery, 56, pp.158-170.
Yeo, S and et. al., 2017. What characteristics of nutrition and physical activity
interventions are key to effectively reducing weight gain in obese or overweight
pregnant women? A systematic review and meta‐analysis. Obesity
Reviews, 18(4), pp.385-399.
Yeo, S., Crandell, J.L. and Jones-Vessey, K., 2016. Adequacy of prenatal care and
gestational weight gain. Journal of Women's Health, 25(2), pp.117-123.
Zerfu, T.A., Umeta, M. and Baye, K., 2016. Dietary diversity during pregnancy is
associated with reduced risk of maternal anemia, preterm delivery, and low birth
30

weight in a prospective cohort study in rural Ethiopia. The American journal of
clinical nutrition, 103(6), pp.1482-1488.
31