An Exploration of Mindfulness-Based Concepts, Maternal-Fetal Attachment, Body Image and Health Behaviour in Pregnancy

Pregnancy has been posited as a ‘teachable moment’ for health behaviour change because women may be more motivated to change their health behaviours and have more contact than usual with healthcare professionals, who can impart healthy behaviour messages. Excessive gestational weight gain can impact on pregnancy and birth outcomes for mother and baby. It can also lead to a higher BMI in subsequent pregnancies and other longer-term health conditions, such as diabetes and obesity in later life. The existence of pregnancy interventions is evidence that pregnancy alone for some women is not sufficient to drive behaviour change to help manage weight gain. Clinical interventions can limit excessive weight gain, but they have faced challenges when translating into community-based programmes. Mindfulness-based concepts have a strong association with well-being, body image and weight-related eating behaviours during pregnancy. This thesis investigated mindfulness-based concepts, maternal-fetal-attachment, body image and weight-related eating behaviours to examine their potential application for future intervention development. Chapter 1 provided an overview of the literature regarding the impact of pregnancy on psychological well-being, body image and eating behaviours, and the role mindfulness-based constructs may play in weight-related health behaviours. Chapter 2 covered the methodological approaches used in this PhD project. Chapters 3, 4 and 5 examined the associations between mindfulness-based concepts, maternal-fetal attachment with well-being, eating behaviours and body image, respectively. Chapter 6 investigated women’s pregnancy experiences in relation to body image and eating before, during and after pregnancy. Chapter 7 investigated midwives’ experiences of discussing weight and healthy eating with pregnant women, and what training they have received to support these interactions. Chapter 8 integrated and discussed the current findings from across all five studies. The findings from this thesis conclude that self-compassion may be an effective target for intervention to improve well-being, body image and eating behaviours during pregnancy, especially for women at greater risk of excessive GWG. Whilst women want healthy eating information, midwives are not being provided with adequate training to engage effectively in these discussions. Finally, going beyond BMI, by also assessing women’s history of eating behaviours, weight and body image issues prior to pregnancy, may also provide additional information to identify women in need of additional support during pregnancy.