Concordia researcher is developing a deck of cards to facilitate dialogue between doctors and moms-to-be

Pregnancy can be an overwhelming experience, especially for first-time mothers.

Common questions can include, Am I putting on too much weight or not enough weight? Are my mood changes normal? What about alcohol? But many pregnant women may find them difficult to discuss with a health-care provider.

“I have always been interested in sensitive communication about weight-related issues, including body weight, eating disorders, physical inactivity, sedentary behaviour and weight stigma,” says Angela Alberga, assistant professor in the Department of Health, Kinesiology and Applied Physiology in Concordia’s Faculty of Arts and Science.

About 50 per cent of Canadian women gain more weight than recommended during pregnancy.

“We know from previous studies that talking about weight and other pregnancy-related concerns with health-care providers is not easy and often evokes a lot of shame and guilt. A study in the U.S. showed that about 67 per cent of pregnant and postpartum women experience some form of weight shaming,” Alberga says.

“Pregnancy is a time where family, friends, health-care providers and even strangers comment on body shape and size, and often pregnant women receive criticism or inappropriate comments about weight gain or healthy habits during pregnancy or even ‘losing the baby weight’ after giving birth.”

The birth of an idea

Alberga says when she had her first child, many of her friends were also pregnant and they reported similar frustrations with the medical system.

She wanted to find ways to improve conversations with health-care providers.

Now pregnant with her second child, Alberga is working with a cross-Canada team to develop Conversation Cards for Moms (MomCards), a deck of about 45 cards.

Funded by the Canadian Institutes of Health Research, the research project will recruit pregnant women and maternal health-care providers to participate in virtual focus groups that will determine the sensitive topics that they want to talk about during clinical visits, such as gestational weight gain, health behaviours and mental health.

This deck will then be sent to a large sample of pregnant women and maternal health-care providers to rank the most important statements, allowing the research team to draft a deck of cards.

Finally, the MomCards will be tested with a diverse sample of pregnant women to determine if they are useful in clinical settings and how the cards may improve their confidence in raising difficult topics.

“The card topics will be informed by pregnant women and created for pregnant women,” Alberga explains.

“We envision that pregnant women might want to use the cards to help them discuss topics that might be difficult for them to bring up on their own. Or the cards may serve as talking points to empower women to choose what they want to discuss during their clinical appointments.”

A national project

This cross-Canada project will bring together partners in exercise, nutrition, pregnancy, weight management, maternal–fetal health, mental health and first-time moms. Co-leader Tamara Cohen comes from the University of British Columbia and is affiliated with Concordia’s PERFORM Centre.

“I have been a member of Obesity Canada since I was a master’s student. I have been very fortunate to collaborate with many health professionals and researchers in all aspects of weight management, including maternity care and pediatrics,” Alberga notes.

It is thanks to these networks that she was able to reach out to key leaders in maternity and obesity care in Canada and develop her proposal.

Eventually, Alberga’s team plans to distribute the cards widely across Canada with our national partners, in English and French.

”Our hope is that this research could help make conversations about body weight changes and healthy habits like nutrition, physical activity, reduction of stress, smoking and alcohol during pregnancy and postpartum health easier, without judgment and more readily discussed,” she says.

”We hope that this could reduce shame and discomfort associated with all the physical and mental health changes that go along with pregnancy and the postpartum period.”

Learn more about Concordia’s Department of Health, Kinesiology and Applied Physiology.