A new model of care

A service has been created in NSW to assist obese women to limit their weight gain in pregnancy to recommended levels.

The benefits of a new antenatal service for obese women in NSW is being evaulated by the department of health. The project, a collaboration project between UTS and the then Northern Sydney Central Coast and South East Sydney Illawarra Area Health Services, was implemented in 2009/10.

Project Officer and UTS Midwifery academic Jane Raymond says the program developed is a collaborative and sustainable model of antenatal care. “With input from an interdisciplinary team that included dieticians and physiotherapists, we created a service that not only assists obese women to limit their weight gain in pregnancy to recommended levels (5-9Kg) but is cost neutral as well.”

In addition to regular midwifery and obstetric care, the program focused on group-based education, motivation and peer support.

Project member and UTS Professor of Midwifery Maralyn Foureur says: “We combined group based pregnancy care with facilitated discussions, motivational interviewing techniques and a WELL diary to record achievements, strategies and goals. It is an efficient and effective means of providing targeted services to this group of women.”

At the conclusion of the pilot, 40 women had completed the program with all reporting significant benefits and many finding that they weighed less after the birth of their baby than they did when they became pregnant..“It helped to know what other mums were going through. The group helped to encourage me to keep healthy” one said. Another reported “I felt like I was getting better, more informative care than just going through the hospital. Now I am motivated to get even healthier”.

With the success of the pilot and a growing need for this type of targeted care, the project team is expecting NSW Health to approve widespread implementation of the program in due course.

“A facilitator handbook was developed as part of the program to help Local Area Health Networks implement the program easily and efficiently.” says Raymond.

“We are already getting requests for copies; all I need now is the permission to distribute them.”

In the meantime, additional funding has been provided by the Nursing and Midwifery Office at NSW Health and a further 70 midwives have been trained during 2011 in Motivational Interviewing to help them talk to women about their weight.

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