It was therefore often easier to avoid raising weight as a concern during antenatal consultations.
Clinicians asserted that their main concern was to deal with the patients presenting problem, which often restricted the opportunity to raise weight as an additional issue.
Hildingsson and Thomas [ 27] hypothesised that this may be due to midwives' reluctance to raise weight issues throughout pregnancy care, leading to a generally positive experience among higher-BMI women who desire the focus in their maternity care to be placed on their pregnancies and births, and not their weight.
Health professionals have an important role to play in the management of obesity, but may be unsure how to raise weight issues with patients.
One strategy to raise weight awareness was to measure body size or weight and then to move on to presenting facts about the association with ill-health.
Many appeared to respect and trust health professionals' knowledge, expertise and authority, and agreed that they should raise weight issues with patients.
Alternatively, to avoid overlooking potential targets, increased sensitivity can be achieved by raising weight factor to at least 1.0 (sensitivity = 75%).
Although British PNs were more likely to raise weight issues than GPs, only 9% self-reported to present solutions or discuss health promotion [ 38], and weight management seems to be based on brief opportunistic intervention undertaken mainly by PNs [ 39].
Both practitioners [ 16, 19] and parents [ 30] have reported that growth charts can be useful in objectively raising weight related concerns, as long as the terminology used is acceptable.
Furness et al. [ 21] found that midwives often felt uncomfortable raising weight-related issues with women, but that women attending a clinic with specialist midwives (with additional training and experience working with pregnant women with a higher BMI) benefited from clear, non-judgmental advice and support about issues related to their weight and pregnancy.
