INVESTIGATING THE WEIGHT CHANGE, DIETARY INTAKE AND PHYSICAL ACTIVITY OF BLACK PREGNANT WOMEN IN THE UK: A MIXED METHODS APPROACH

Abstract

Background: Black women in the UK have higher odds of overweight, obesity and adverse pregnancy outcomes, such as gestational diabetes. They also have three times higher the risk of mortality and have more negative than positive reports of maternity care, compared to White women. Despite this, Black pregnant women remain under-represented in weight management interventions and health behaviour studies and have been labelled a ‘hard to engage’ group. Therefore, to inform the development of future interventions, specifically tailored for Black women, this study aimed to investigate the weight change, dietary intake and PA of pregnant Black women and to understand the underlying factors that influence these behaviours and their experiences.
Methods: An observational study that utilized the convergent parallel mixed methods design. Twenty-five Black African pregnant women were recruited from antenatal clinics and Black communities in Liverpool. Women were weighed, completed a pregnancy symptoms checklist, a 4-day food diary and wore an accelerometer for 7 days in trimesters 2 and 3. Semi-structured interviews were conducted with a sub-set of 12 women and data was analysed using thematic analysis, guided by Braun and Clark.
Findings: Sixty-five percent were living with overweight and obesity but were less likely to have excess GWG. Women had high-calorie, nutrient-deficient diets despite their demonstrated knowledge of healthy eating and its benefits. Moderate PA levels were adequate but were accompanied by significantly high sedentary time. The main motivators of healthy behaviours were their knowledge of healthy eating and PA benefits, and social support from family and friends. Barriers included pregnancy symptoms, lack of advice from HCPs and accessibility challenges. Positive experiences of maternity care centred around women being listened to and treated with kindness, care and respect, while negative experiences stemmed from the biases and assumptions that HCPs held about Black women.
Contribution to knowledge: The first UK study to provide insight into the nutritional status and PA habits of Black African pregnant women which can guide the targeted design of interventions and presents potential strategies for improving the behaviours and pregnancy outcomes of Black women. This study is one of the few that explored how the antenatal experiences shaped the overall pregnancy experiences of Black African women.

Date of Award	2025
Original language	English
Awarding Institution	Edge Hill University
Supervisor	JULIE ABAYOMI (Director of Studies), MHAIRI MACDONALD (Supervisor) & Giliane McKelvin (Supervisor)