Experiencing weight stigma during childbirth increases the odds of cesarean birth
Abstract Background Weight-biased clinical practices and institutional characteristics can have a wide impact on the quality of care provided to women with obesity. This may substantially increase their risks for poor birth outcomes. The current study assessed experienced weight stigma by women duri...
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| Language: | English |
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BMC
2025-02-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07251-6 |
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| author | Regula A. Schwenk Carmen Wyss Evelyne M. Aubry |
| author_facet | Regula A. Schwenk Carmen Wyss Evelyne M. Aubry |
| author_sort | Regula A. Schwenk |
| collection | DOAJ |
| description | Abstract Background Weight-biased clinical practices and institutional characteristics can have a wide impact on the quality of care provided to women with obesity. This may substantially increase their risks for poor birth outcomes. The current study assessed experienced weight stigma by women during childbirth in maternity care settings in Switzerland. We aimed to identify frequencies, sources, and manifestations of weight-related stigmatization, hypothesizing that such stigma impacts birth outcomes, specifically cesarean birth (CB). Methods Data from a nationwide cross-sectional online survey was used to investigate the frequencies, sources, and manifestations of experienced weight stigma during childbirth. Binomial logistic regression was applied to predict CB from experienced weight stigma. Mediation analysis assessed the role of experienced weight stigma in the association between body mass index (BMI) and CB. Results In a total of 1352 women who gave birth in the last five years, women with obesity (BMI ≥ 30 kg/m2) experienced weight stigma more often than their peers with healthy weight (BMI 18.5–24.9 kg/m2). Obstetricians were identified as a major source of weight stigma, accounting for 77.8% of stigmatization experienced by women, compared to stigmatization perceived from nurses (21.7%) and midwives (23.8%). Overall, weight stigma was mostly experienced in the form of dismissive or critical comments towards a woman’s figure or weight. Significantly more women with obesity indicated being blamed for weight-related risks during childbirth than their healthy-weighted peers (χ²(2) = 22.2, P < 0.001). An increase in the frequency of experienced weight stigma was related to higher odds of intrapartum CB ([aOR], 1.08; 95% CI, 1.02,1.15; P < 0.05), and it partially mediated the relationship between increased pre-pregnancy BMI and CB (b = 0.07, SE = 0.029; P < 0.05). Conclusion Women with obesity reported the highest proportion of weight stigmatization during childbirth, experiencing stigma more frequently than women without obesity. This increased frequency of weight stigma was associated with higher odds of CB. Raising awareness among healthcare providers and reducing potential biases and stigmatization may improve care quality and health outcomes for women with obesity. |
| format | Article |
| id | doaj-art-dc7dce6d496f40e6b56e07b7fc25b017 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-dc7dce6d496f40e6b56e07b7fc25b0172025-08-20T02:15:08ZengBMCBMC Pregnancy and Childbirth1471-23932025-02-0125111010.1186/s12884-025-07251-6Experiencing weight stigma during childbirth increases the odds of cesarean birthRegula A. Schwenk0Carmen Wyss1Evelyne M. Aubry2Department of Health Professions, Bern University of Applied SciencesDepartment of Health Professions, Bern University of Applied SciencesDepartment of Health Professions, Bern University of Applied SciencesAbstract Background Weight-biased clinical practices and institutional characteristics can have a wide impact on the quality of care provided to women with obesity. This may substantially increase their risks for poor birth outcomes. The current study assessed experienced weight stigma by women during childbirth in maternity care settings in Switzerland. We aimed to identify frequencies, sources, and manifestations of weight-related stigmatization, hypothesizing that such stigma impacts birth outcomes, specifically cesarean birth (CB). Methods Data from a nationwide cross-sectional online survey was used to investigate the frequencies, sources, and manifestations of experienced weight stigma during childbirth. Binomial logistic regression was applied to predict CB from experienced weight stigma. Mediation analysis assessed the role of experienced weight stigma in the association between body mass index (BMI) and CB. Results In a total of 1352 women who gave birth in the last five years, women with obesity (BMI ≥ 30 kg/m2) experienced weight stigma more often than their peers with healthy weight (BMI 18.5–24.9 kg/m2). Obstetricians were identified as a major source of weight stigma, accounting for 77.8% of stigmatization experienced by women, compared to stigmatization perceived from nurses (21.7%) and midwives (23.8%). Overall, weight stigma was mostly experienced in the form of dismissive or critical comments towards a woman’s figure or weight. Significantly more women with obesity indicated being blamed for weight-related risks during childbirth than their healthy-weighted peers (χ²(2) = 22.2, P < 0.001). An increase in the frequency of experienced weight stigma was related to higher odds of intrapartum CB ([aOR], 1.08; 95% CI, 1.02,1.15; P < 0.05), and it partially mediated the relationship between increased pre-pregnancy BMI and CB (b = 0.07, SE = 0.029; P < 0.05). Conclusion Women with obesity reported the highest proportion of weight stigmatization during childbirth, experiencing stigma more frequently than women without obesity. This increased frequency of weight stigma was associated with higher odds of CB. Raising awareness among healthcare providers and reducing potential biases and stigmatization may improve care quality and health outcomes for women with obesity.https://doi.org/10.1186/s12884-025-07251-6DeliveryLaborPregnancyBody mass indexSurveyObesity |
| spellingShingle | Regula A. Schwenk Carmen Wyss Evelyne M. Aubry Experiencing weight stigma during childbirth increases the odds of cesarean birth BMC Pregnancy and Childbirth Delivery Labor Pregnancy Body mass index Survey Obesity |
| title | Experiencing weight stigma during childbirth increases the odds of cesarean birth |
| title_full | Experiencing weight stigma during childbirth increases the odds of cesarean birth |
| title_fullStr | Experiencing weight stigma during childbirth increases the odds of cesarean birth |
| title_full_unstemmed | Experiencing weight stigma during childbirth increases the odds of cesarean birth |
| title_short | Experiencing weight stigma during childbirth increases the odds of cesarean birth |
| title_sort | experiencing weight stigma during childbirth increases the odds of cesarean birth |
| topic | Delivery Labor Pregnancy Body mass index Survey Obesity |
| url | https://doi.org/10.1186/s12884-025-07251-6 |
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