Postpartum Weight Self-Management: A Concept Analysis

Aim: The aim of this concept analysis is to create a clear definition and framework to guide weight self-management research and promotion of healthy weight selfmanagement during the postpartum period. Background: A woman's ability to manage her weight through the postpartum transition has lifelong implications for her weight status. Methods: This concept analysis was guided by Walker and Avant (2005). A broad search of sources was performed, yielding 56 articles in which postpartum weight self-management was the main focus. Results: From consideration of the attributes of postpartum weight self-management, a descriptive, situation-specific theory emerged: Postpartum weight self-management is a process by which the transition to motherhood is viewed by the woman as an opportunity to intentionally engage in healthy weight self-management behaviors by minimizing the salient inhibitors and maximizing the salient facilitators to action. Conclusion: This analysis provides a clarification of the process concept of postpartum weight self-management and its consequences, giving direction for measurement, clinical application, and further research. Future nursing interventions and research should be aimed at helping women to view the postpartum period as a normative transition in which they have the opportunity to take charge of their own health and the health of their family.Keywords: concept analysis; postpartum; weight self-management; health promotionWeight management among childbearing women is an important problem that has been widely studied, but conceptual problems remain as researchers and providers work to incorporate this concept within health promotion for postpartum women. The current body of literature reveals that the responsibility for achieving the desired health outcome of weight loss can lie with women, with providers, or with both. There is currently no consistent description of the process by which women manage their weight during this period or when loss of gestational weight should be measured. The aim of this concept analysis is to create a clear definition and framework to guide weight self-management research and promotion of healthy weight during the postpartum period.BACKGROUNDOverweight and obesity are worldwide problems for women's health. Countries on every continent have an overweight prevalence of between 65% and 80% for adult females, and an obesity prevalence of between 35% and 50% (World Health Organization, 2011). Overweight and obesity are significant concerns for women and for their health care providers because women exceeding normal weight parameters are at higher risk for health problems such as heart disease, stroke, type 2 diabetes, gallbladder disease, and some cancers as well as increasing severity of hypertension and musculoskeletal problems (Manson, Skerrett, Greenland, & VanItallie, 2004). Women who are overweight or obese are also at risk for adverse reproductive outcomes, including infertility, hypertensive disorders of pregnancy, gestational diabetes, and increased risk of delivery by cesarean section. A mother's overweight or obese status can also increase the risk of fetal complications such as macrosomia, intrauterine fetal death, and increased neonatal admission to a neonatal intensive care unit (Arendas, Qui, & Gruslin, 2008).The postpartum period is a unique time of developmental and physical change for women. As women navigate the postpartum transition, they are faced with many challenges within the context of their new or expanded motherhood role (Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000; Mercer 2004). Childbearing and postpartum weight retention have been identified as important contributors to obesity (Johnson, Gerstein, Evans, & Woodward-Lopez, 2006). If women retain weight gained during pregnancy past the postpartum period, they are more likely to be overweight or obese later in life than women who return to prepregnancy weight (Amorim, Linne, & Lourenco, 2008; Linne, Dye, Barkeling, & Rossner, 2004; Rooney, Schauberger, & Mathiason, 2005; Walker & Avant, 2005). …