General practitioners’ perspectives of caring for larger-bodied preconception women: A descriptive qualitative study

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BackgroundHigh-quality preconception care can optimise health and wellbeing and reduce adverse maternal and infant outcomes. Larger-bodied preconception women are more likely to experience weight stigma and discrimination in healthcare due to their body size, and thus receive lower-quality care. General Practitioners (GPs) are key healthcare providers in preconception care, yet there is a limited understanding on their perspectives caring for larger-bodied preconception women.ObjectivesTo better understand the experiences and viewpoints of GPs' caring for larger-bodied preconception women.DesignDescriptive qualitative study design using thematic analysis.MethodsSemi-structed interviews with GPs (N = 15) who provided preconception care in Australia were conducted online via Zoom. Participants were purposively recruited via word of mouth, emailing digital flyers to GP clinics, and posting information on social media platforms. Interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted and themes were continuously refined through collaborative discussions with the research team.ResultsThree overarching themes were identified: 1) narratives and assumptions about larger-bodied preconception women, with a focus on how these can prevail throughout general practice and contribute to weight stigmatising interactions with preconception women; 2) factors influencing GPs' approaches to caring for larger-bodied women, highlighting how approaches to care are impacted by external factors within healthcare; and 3) challenges to providing non-stigmatising care to larger-bodied preconception women, emphasising that significant effort is required to contest common assumptions and narratives associated with higher body weight.ConclusionFindings demonstrated that whilst GPs have a strong desire to provide high-quality preconception care to all women, the pervasiveness of weight stigma in healthcare can impact the care they provide. Supporting GPs to provide non-stigmatising care to larger-bodied preconception women is urgently warranted to improve health outcomes for all women equitably.

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