Abstract
Weight stigmatization is related to emotional and psychological distress including low self-esteem, body image dissatisfaction, depression, and anxiety; all linked with suboptimal breastfeeding outcomes. This qualitative descriptive study explored postpartum individuals’ recalled experiences of weight stigma during interactions with perinatal healthcare professionals and its perceived influence on their breastfeeding experiences. Semi-structured phone interviews were conducted with (n= 18) participants. Three themes emerged: (1) “Size Doesn’t Matter: They Looked Beyond the Scale,” (2) “My Self-Confidence and Desire to Breastfeed is More Important than Weight,” and (3) “I Was on My Own”—Limited Social Support not Weight Stigma Influenced Breastfeeding.
Introduction
Individuals with pre-pregnancy overweight and obesity are uniquely susceptible to weight stigmatization during interactions with perinatal healthcare professionals (Dieterich and Demirci, 2020; Furness et al., 2011). This risk is especially probable considering that the perinatal period is marked by an increased frequency of interactions with the healthcare system and is a time of increased body image and weight-related sensitivity, and mood fluctuations (Silveira et al., 2015).
Weight stigmatization has been demonstrated when healthcare providers engage in less patient-centered communication and rapport-building during interactions with heavier pregnant patients as compared to those without overweight or obesity (Washington Cole et al., 2017). When asked about their views regarding obesity management strategies in pregnancy care, individuals reported “fat phobic” encounters with healthcare professionals and felt singled out because of their weight. These participants also described feeling shamed by their healthcare professionals based on development of weight-related obstetric complications (Parker, 2017). Other pregnant individuals reported feeling stigmatized for their weight during interactions with the media, strangers, family members, and society in general (Incollingo Rodriguez et al., 2020a).
The consequences of weight stigma have the potential to influence parental breastfeeding behaviors. In fact, a recent survey-based study examining weight stigma perceptions among pregnant and postpartum individuals found many individuals reported discomfort when seeking breastfeeding help from healthcare professionals (Incollingo Rodriguez et al., 2020b). While other pathways exist, weight stigma and its associated psychological distress has the potential to influence maternal breastfeeding behavior. Individuals who experience weight stigmatization may be at increased risk for emotional and psychological distress including low self-esteem, body image dissatisfaction, depression, and anxiety (Wu and Berry, 2018). The negative sequelae of weight stigma have potential to influence breastfeeding in that postpartum depression symptomology at 1 week postpartum is associated with higher likelihood of breastfeeding cessation at 4 and 8 weeks postpartum, and lower breastfeeding self-efficacy (Dennis and McQueen, 2007). Among individuals with obesity, higher body image dissatisfaction scores were associated with suboptimal breastfeeding outcomes, including lower odds of maintaining any breastfeeding at 6–8 weeks postpartum compared to individuals with lower scores (Swanson et al., 2017). Lower breastfeeding rates among individuals with overweight or obesity are problematic considering breastfeeding’s unique benefits for this population including well-documented cardio-metabolic protective effects (Gunderson et al., 2015; Natland Fagerhaug et al., 2013) and role in reducing gestational weight gain retention (Sharma et al., 2014).
The association between elevated body mass index (BMI) and low breastfeeding rates have been established. However, the experience of pregnant and postpartum individuals with overweight or obesity and their view of weight stigmatization in perinatal care as it relates to their breastfeeding experiences has not been previously explored. Such data has the potential to add to the state of the science on lactation support for individuals across the BMI continuum. Our study objective was to solicit experiences, perspectives, and concerns from postpartum individuals with overweight and obesity who intended to breastfeed and explore if and how they perceived weight stigma impacted their breastfeeding counseling, decisions, and experiences.
Materials and methods
Design overview
We used a qualitative descriptive approach to explore postpartum individuals’ experiences of weight stigma during interactions with perinatal healthcare professionals and its perceived influence on their breastfeeding experiences. Participants were purposively selected from a larger mixed methods study examining the relationship between weight stigma and breastfeeding outcomes among individuals with pre-pregnancy overweight or obesity (N = 103). Qualitative description provides a comprehensive summary of a phenomenon of interest and stays close to the data, allowing participant’s words to be self-evident (Sandelowski, 2000). By not forming a priori hypotheses, this method reduces investigator biases by preventing expected findings from influencing the data collection and analysis process (Patton, 2015).
Recruitment and setting
Participants were recruited from a university-based research registry website and a single prenatal clinic within a hospital in Southwestern Pennsylvania from November 2019 to March 2020. Eligible participants met the following criteria: (1) ⩾18 years of age, (2) 28–40+ weeks pregnant, (3) pre-pregnancy BMI ⩾ 25, (4) planning to breastfeed or express milk for their infant, and (5) able to speak and read English fluently. Pre-pregnancy BMI documented in the medical record at first prenatal visit was used. If BMI was unavailable in the medical record or if the first prenatal visit occurred beyond 12 weeks of pregnancy, BMI was calculated using self-reported pre-pregnancy height and weight. Participants were compensated with a $25 gift card upon completion of the overall study. This study was approved by the University of Pittsburgh Institutional Review Board (IRB). Written informed consent was obtained from each participant.
Interview participants were purposively selected from the larger study (see Table 1) using maximum variation sampling, a form of purposeful sampling that emphasizes breadth of understanding in relation to a concept of interest (Palinkas et al., 2015). Participant characteristics we considered pursuant to achieving maximum variation included prenatal BMI, third-trimester perceived weight stigma scores generated from the Weight Bias Internalization Scale (WBIS), and demographics associated with breastfeeding practices (education level, race). The intent of this study was not to obtain thematic saturation within WBIS score ranges, demographic categories, or across BMI ranges, but rather to provide a broad summary of how individuals experienced perinatal weight stigma and its influence on breastfeeding. Therefore, we chose to interview participants from a wide variety of ethnic and demographic categories. The WBIS measures internalized weight stigma—the degree to which an individual believes negative weight-based stereotypes applies to oneself (Durso and Latner, 2008). Participants completed the WBIS within four months prior to the phone interview.
Demographic characteristics of overall study (N = 103).
Data collection
A semi-structured interview guide was developed in conjunction with co-authors as respective experts in obstetrics, lactation, health communication, and qualitative research methods. The interview guide was piloted with several colleagues who self-identified as having overweight or obesity and breastfeeding experience and modified based on feedback obtained. It was further updated throughout the data collection process to establish consensus and divergence in topics broached by participants and in themes emerging on preliminary review. During the interview participants were queried on perceptions of their weight and weight stigma (in general and during perinatal period) and its relationship with their breastfeeding experience or behaviors. See Supplemental File for final interview guide. All interviews were conducted via telephone at 1–2 months postpartum. This timepoint was chosen to minimize recall bias regarding events and interactions that occurred during pregnancy and early postpartum which may have impacted breastfeeding initiation. Interviews were conducted from January 2020 to June 2020 and were completed by the first author, a doctoral candidate with clinical obstetric experience and extensive training and practice on interviewing strategy.
Interviews were audio-recorded and transcribed verbatim using NVivo’s online transcription platform (QSR International, 1999). During the interviews, probing and summarizing were used to generate further explanation from participants and to confirm mutual understanding during conversation, respectively. Throughout data collection and analysis, the interviewer kept a reflexive journal to track methodological decisions and rationale and to minimize personal biases possibly influencing data collection and analytical decisions. The reflexive journal was used during team discussions to inform sampling decisions, coding, and theme development.
Analysis
We performed content analysis following six phases: familiarizing oneself with the data, initial code development, searching for themes, reviewing themes, defining and naming themes, and reporting analysis of findings. Qualitative content analysis is the strategy of choice for qualitative descriptive studies (Sandelowski, 2000), lends itself to varying depths of interpretation (Graneheim and Lundman, 2004) and examines both manifest and latent content (Downe-Wamboldt, 1992). Data analysis and collection occurred concurrently and iteratively. Interviews were conducted until informational redundancy in interviews was reached, additional data did not generate novel themes and linkages between categories were fully developed (Saunders et al., 2018).
Raw interview data were coded by the first author (RD) and a trained research assistant (CW) using NVivo 12 qualitative analysis software (QSR International, 1999). The first five transcripts were coded separately to develop the initial coding schema. This initial coding included line-by-line review for content broadly pertaining to experiences of weight stigmatization, breastfeeding, and the relationship between the two (Bengtsson, 2016). Memos were used by both coders throughout the initial coding process regarding evolving impressions related to preliminary findings. After the initial coding schema was developed, the coding was refined based on data from subsequent interviews.
RD then selectively coded all transcripts with CW coding a random 50% sample. RD and CW met twice per month during the selective coding phase to settle coding discrepancies, refine codes, and discuss emerging themes. Additional formal and informal debriefing meetings were held with senior authors during data collection and analysis to discuss sampling decisions, interview guide modifications, and theme development.
In developing themes, codes were sorted into broad topical categories (Hsieh and Shannon, 2005) and the relationships among codes using the subsumed codes and supporting quotes were explored. In the final phase of analysis, themes were woven into a succinct story reflective of participants’ experiences.
To enhance trustworthiness during data analysis, an audit trail was maintained to explain decision rules and justifications related to the coding schema, as well as theme refinement and finalization. To preserve participants’ voices and the authenticity of their original interpretations, we sought to use participants’ words in coding, theme development, and in supporting quotes for each theme wherever possible (Guba and Lincoln, 2001; Sandelowski, 2000). Three interview participants were re-contacted to review study results and conclusions. All participants concurred with our interpretation of findings and did not have substantive additions.
Data sharing statement
The current article includes the complete raw data-set collected in the study including the participants’ data set, syntax file and log files for analysis. Pending acceptance for publication, all of the data files will be automatically uploaded to the Figshare repository.
Results
We interviewed 18 participants at 1–2 months postpartum (Table 2). Interviews ranged from 25 to 40 minutes long. The sample consisted primarily of Black, single, multiparous women. Participants interviewed had prenatal WBIS scores ranging from 11 to 56.
Demographic characteristics of sample (N = 18).
WBIS = Weight Bias Internalization Scale.
Three themes emerged that encompassed participants’ perceptions of weight stigma during interactions with healthcare professionals during pregnancy and postpartum and its influence on their breastfeeding experiences: (1) “Size Doesn’t Matter: They Looked Beyond the Scale,” (2) “My Self-Confidence and Desire to Breastfeed is More Important than Weight,” and (3) “I Was on My Own”—Limited Social Support not Weight Stigma Influenced Breastfeeding.
“Size doesn’t matter: They looked beyond the scale”
Participants felt obstetric and postpartum health-care professionals genuinely cared about the health and wellbeing of them and their infants. When asked about experiences communicating with perinatal healthcare professionals in relation to weight, participants specified they did not feel “personally attacked” or “judged” based on weight. Participants felt weight gain monitoring during prenatal visits and discussions about weight, nutrition or exercise were positive, necessary aspects of their prenatal care. As one participant stated, “I didn’t feel discouraged or talked down to when they mentioned weight gain [gestational] because I knew they wanted what’s best for me and baby. . .it was because they want to keep me and baby safe, so I didn’t mind it.”
Participants described healthcare professionals (nurses, obstetricians, pediatricians, lactation consultants) as less concerned about numerical weight or BMI and more focused on other health indicators when delivering prenatal education including nutrition status, physical activity, engagement with routine perinatal testing, mental wellbeing, and social support systems. Ultimately, this engendered a sense of trust that providers were competent and well-intentioned. In at least one case, the capacity to look beyond pregnancy and plan for future health promoting activities, including breastfeeding was described: It made me feel comfortable and less worried or stressed about having the baby so I think that might have helped me to focus on breastfeeding and just being more patient and being able to go with the flow. Knowing they had my and the baby’s best interests in mind helped me relax more, helped me not be so anxious about having the baby. . .learning to breastfeed.
Participants also felt that perinatal healthcare professionals provided education and care, including breastfeeding support, that did not expressly incorporate weight-specific considerations. This was viewed positively: The breastfeeding lady didn’t see my weight, she saw me, a mom who needed help breastfeeding to get her baby to eat better. I don’t feel they should be aware of - I mean that sort of thing [my size]. The only thing they were concerned about me with the breastfeeding was my medication. And I think that’s a good thing.
Participants contrasted their generally positive experiences around weight and weight-related discussions involving perinatal providers with stigmatizing encounters they experienced in other healthcare settings. In these settings, (primary care, specialists) participants recounted feeling “talked down to,” being told “what to do,” and judged. As one participant described: I went to a doctor one time, I guess he was an orthopedic or something like that. It was about my back hurting, I was in a car accident. And I went in about my back hurting and they put a lot of emphasis on saying it’s because of my weight. . .they shouldn’t be looking at my body, you know for my symptoms. They shouldn’t use my appearance as a reason to blame me for my symptoms or health issues.
Another participant similarly shared dislike of how a primary care provider had addressed weight by highlighting BMI: [My primary care office] prints out these reports and it tells you your BMI on it. And its like, how is that number even relevant to my health care and the reason for my visit. That number, BMI, is almost like a standardized test in high school or something, where the visit just becomes all about this number.
“My self-confidence and desire to breastfeed is more important than weight”
In general, participants described themselves as having high self-confidence, especially in relation to weight and body image. They felt weight was not a defining feature of their personal identity. One participant explains the importance of this confidence: It would be hard for someone to take me down because of my size or looks, since I am generally confident about myself that way. I feel good and I think I look just fine, even if I would like, decide to lose a few pounds, I think I would still be just as happy with myself as I am now.
Individuals were more concerned with obtaining necessary breastfeeding information and support from perinatal healthcare providers, versus any potential for weight stigmatizing encounters with the same providers. When asked to imagine interacting with a healthcare professional who engaged in weight-stigmatizing behaviors, participants predicted that such behaviors would have negligible or no impact on breastfeeding behaviors. Participants exhibited self-advocacy in relation to obtaining and accepting breastfeeding support to meet personal breastfeeding goals: I would probably call [the healthcare professional] out for saying something rude or whatever [about my weight or size] but I wouldn’t pay it any mind. Generally, people can’t say or do things to make me feel bad about myself. So, I would still ask whatever breastfeeding type question I had, since if I need the help, I am gonna make sure I get it. Since I am here for my baby, and if I have breastfeeding issues or a question then I would still ask to make sure I get the breastfeeding info I need to help my baby and keep her healthy.
Participants who expressed more discomfort or ambivalence about their body size, however, were not as willing to self-advocate for breastfeeding needs in a hypothetical scenario where a healthcare professional made them feel stigmatized. Rather, participants imagined weight-stigmatizing comments or attitudes from healthcare professionals would lead to an aversion and reluctance to communicate: “I would never ask for help. If they [healthcare professional] made me feel uncomfortable because of my weight or judged me because of my weight, whatever, I wouldn’t ask for help with the breastfeeding stuff. I wouldn’t.”
“I was on my own”: Limited social support not weight stigma influenced breastfeeding
When asked to explain what weight stigma meant to them in terms of breastfeeding, participants recognized the existence of weight stigma and weight discrimination in society, but denied that it had any bearing on their breastfeeding experiences. One participant explained: [Weight stigma is] just like fat phobia in general, which I think comes from society itself. What society thinks is acceptable or desirable. The media seems to prefer smaller women, and people who are fit and in shape. And because weight stigma is on systemic level I think it’s there internally in people within their self-talk and in their families. . .but that [prior weight stigmatization from family] hasn’t stopped me from wanting to breastfeed. Hasn’t gotten in the way of me getting the breastfeeding help I needed.
While current or previous weight stigmatization from family, society, and healthcare professionals did not appear to influence participants’ breastfeeding experiences, participants described lack of social support as a major detractor to their morale to begin and/or continue breastfeeding. Limited breastfeeding support from family members was a recurrent issue for some participants, which led to ambivalence and uncertainty about their initial intention to breastfeed. This participant detailed this negative pressure from others: “People [family] telling me I should not breastfeed since it’s too time consuming, I heard that like a lot. And then people telling me, if you gonna work, you shouldn’t breastfeed. . .That its [breastfeeding] not for everybody.”
Another participant shared similar experiences from close support people: “There are certain people, close relatives of mine, my mom. She doesn’t care for breastfeeding. It was funny because she was completely against it.”
Lack of breastfeeding support became especially apparent during the COVID-19 pandemic and its associated restrictions on social interactions with family, friends, and breastfeeding support personnel. One participant described: Because of COVID-19, there were no lactation consultants available at the hospital. I never felt like I got the social support from others with breastfeeding because of COVID-19. Everyone is just quarantining, so I haven’t been able to see anyone really or get that social support for me breastfeeding.
Another participant echoed that the impact COVID-19 attributed to isolation and decreased in-person services: Weight stigma didn’t bother me with my breastfeeding, like even breastfeeding in public I felt comfortable with that. But I wasn’t able to go to a breastfeeding group in person or to a breastfeeding center since things started closing down due to COVID-19. . .I felt like I was on my own. For me, the [breastfeeding] difficulty I was having with the baby, it wasn’t conducive to talking to someone over the phone about it.
Discussion
This qualitative descriptive study explored postpartum individuals’ recalled experiences of weight stigma during interactions with perinatal healthcare professionals and its perceived influence on their breastfeeding experiences. The perspectives of the 18 participants with overweight or obesity included in this study indicated that their interactions with perinatal healthcare professionals (including, nurses, physicians, lactation consultants, pediatricians) were largely positive and did not focus on weight or BMI. Participants displayed high self-confidence and breastfeeding self-advocacy behaviors and infrequently experienced weight stigmatization during medical encounters in the pregnancy and postpartum period. Participants denied that weight stigma impacted (or had the potential to impact) their confidence in their ability to breastfeed; a lack of social support was noted as a significant barrier to initiating breastfeeding or overcoming breastfeeding challenges, however.
Our findings are in contrast to previous qualitative work suggesting that pregnant individuals with high BMI experience discriminatory and suboptimal communication with obstetric healthcare professionals (Furness et al., 2011). In a Danish study using in-depth interviews with 16 obese pregnant individuals, the participants reported being treated with a lack of respect by healthcare professionals (midwives, primary care physicians, others); participants were met with an accusatorial tone during weight or gestational weight gain conversations, and reported poor communication with healthcare professionals (Lindhardt et al., 2013). Additionally, results from a large, cross-sectional investigation into the sources and experiences of weight stigma among 2449 women discovered physicians (in general) were one of the most commonly reported sources of weight stigmatization (Puhl and Brownell, 2006). Meanwhile, our interview participants did not report similar experiences when interacting with perinatal healthcare professionals. Instead, participants valued lifestyle modification information as integral to a safe and healthy pregnancy.
Participants in our study collectively voiced high self-confidence, which appeared to protect individuals from perceiving or internalizing weight stigma in both the perinatal period and generally. However, participants did acknowledge the existence of weight stigma in society. Societal normalization of weight stigma may have contributed to participants’ denial of weight stigma during interactions with perinatal healthcare professionals. For example, weight stigma experienced or observed in society may desensitize individuals to weight stigma experienced during perinatal healthcare professional interactions.
Innate differences between perinatal-related healthcare encounters and those in other healthcare contexts may exist. For example, pregnancy and the postpartum period is marked by increased frequency and exposure to the healthcare system (American College of Obstetricians and Gynecologists (ACOG), 2012). The consistency and frequency of prenatal appointments may enable perinatal healthcare professionals to foster better relationships with patients. This differs from other healthcare professionals who periodically interact with patients during annual wellness visits or unexpected medical crises. For instance, a qualitative exploration into characteristics of quality prenatal care revealed pregnant individuals reported high levels of personalization, emotional support, and reassurance from prenatal care providers, which contributed to development of meaningful relationships with their care team (Sword et al., 2012). In the current study, interview participants described perinatal healthcare professionals as non-accusatory with a holistic, non-weight centric view of health. Because of this, healthcare professionals can reinforce positive patient-provider relationships - thereby facilitating open breastfeeding-related communication and instilling confidence in lactating parents with regard to their breastfeeding abilities.
Healthcare professionals’ limited focus on weight-related breastfeeding considerations was positively viewed by interview participants. However, there may be tactful ways to incorporate weight considerations that have a documented impact on breastfeeding success. Such considerations include milk supply and breast size as lactating parents with heavier BMI’s are more likely to experience perceived insufficient milk supply (Bever Babendure et al., 2015) and larger breasts can cause positioning difficulties (Garner et al., 2017). Additionally, heavier individuals are more likely to experience obstetric complications (Ramonienė et al., 2017) leading to early separation with the baby, which is known to negatively influence breastfeeding behavior (Kachoria et al., 2015). To promote patient’s best interests, perinatal healthcare professionals may benefit from educating patients on potential weight-related breastfeeding challenges. In doing so, healthcare professionals can help patients reach personal breastfeeding goals by mitigating or preventing foreseeable breastfeeding issues. However, there is no research examining the best methods to broach these conversations or whether anticipatory or post-hoc management of weight-related breastfeeding challenges is more effective.
While social support is one of the most important factors in breastfeeding behavior regardless of body weight (Laugen et al., 2016; Carlin et al., 2019), it may be particularly important for overweight and obese individuals who report limited sources of social support. In fact, according to a qualitative study using semi-structured interviews, breastfeeding parents with obesity experienced more difficulty obtaining tangible breastfeeding social support compared to those without (Garner et al., 2017). Specifically, parents of heavier weight reported fewer sources of available breastfeeding social support and requiring more physical positioning assistance. Social support is particularly important for Black postpartum individuals, like those in our study. Shorter breastfeeding duration has been associated with lack of breastfeeding role models as revealed in an ethnographic investigation describing infant feeding perceptions of Black mothers (Asiodu et al., 2017). Additionally, “lack of support” from family, healthcare professionals and peers contributed to decreased breastfeeding initiation and duration as found in focus groups with 15 Black breastfeeding women (Lewallen and Street, 2010).
The interview data and resulting themes in the present study provided evidence that the social isolation instilled by COVID-19 further complicated participants’ ability to access breastfeeding support. These findings are reflected in the voices of our participants. Future research is necessary to more fully understand not only COVID-19’s influence on breastfeeding outcomes and experiences (especially among individuals with overweight or obesity) but also how other instances of social isolation may influence breastfeeding practices.
Research indicates Black individuals are less likely to report weight stigmatization compared to White individuals (Himmelstein et al., 2017) and cultural differences may exist with regard to aesthetic ideals (Kelch-Oliver and Ancis, 2011; Tiggemann, 2011). This may have influenced participants’ experience of weight stigmatization during the perinatal period and its influence on breastfeeding behavior. For instance, while it is known some individuals with pre-pregnancy overweight or obesity experience discomfort breastfeeding in public due to body image concerns (Zimmerman et al., 2018), this may not be a significant issue for Black individuals, such as those in our study who collectively voiced high self-confidence.
We recognize several limitations to this study. We recognize the limitation of using the BMI scale in determining weight status, especially among pregnant and postpartum individuals. Future qualitative work should consider using self-perceived weight rather than numerical BMI to ensure adequate representation among individuals who self-identify as having overweight or obesity. Additionally, this qualitative study did not measure or query participants on psychological distress related to weight stigma and its influence on infant feeding behavior. Future research should incorporate psychological correlates of weight stigma (such as postpartum depression, other psychological distress) in relation to infant feeding experiences and outcomes. Because participants were recruited in a four-month period from a single prenatal clinic, findings may not be applicable to individuals from other cultural backgrounds, with higher socioeconomic status, or to other settings. Additionally, racial discordance between Black participants and the white interviewer may have prevented participants from sharing information as they would if the participant and interviewer shared a similar cultural identity (Shen et al., 2018). Rapport-building was limited due to the cross-sectional nature of interviews, potentially restricting disclosure of uncomfortable or painful events. Response bias must also be considered when interpreting study findings as interview participants may have provided answers they felt would be viewed “favorably” by researchers. The current study did not seek to nor reach thematic saturation within certain WBIS score ranges. Therefore, potential nuances in weight stigma-related breastfeeding experiences and perceptions among those with high versus low internalized weight stigma remain unknown. Additionally, it is possible for individuals to not internalize weight bias (and have low WBIS score) but still feel others have treated oneself poorly based on body weight. Future qualitative work is needed to better understand how perinatal individuals with overweight or obesity experience, perceive, and internalize weight-based discrimination. Perceptions and experiences of perinatal weight stigma in relation to specific degrees of weight stigma or demographic characteristics also requires further exploration.
Conclusion
While participants in this sample recognized the existence of weight stigma in other settings, they did not perceive it during encounters with perinatal healthcare professionals. Additionally, individuals did not perceive weight stigma in any setting as influential on their breastfeeding experiences or practices. Future research should explore the perception of pregnancy-related weight stigma among other cultural groups and potential care delivery approaches that mitigate weight stigmatization during perinatal healthcare professional encounters.
Research Data
sj-docx-1-hpq-10.1177_1359105320988325 – for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences
sj-docx-1-hpq-10.1177_1359105320988325 for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences by Rachel Dieterich, Judy Chang, Cynthia Danford, Paul W Scott, Caroline Wend and Jill Demirci in Journal of Health Psychology
Research Data
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sj-docx-2-hpq-10.1177_1359105320988325 for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences by Rachel Dieterich, Judy Chang, Cynthia Danford, Paul W Scott, Caroline Wend and Jill Demirci in Journal of Health Psychology
Research Data
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sj-docx-3-hpq-10.1177_1359105320988325 for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences by Rachel Dieterich, Judy Chang, Cynthia Danford, Paul W Scott, Caroline Wend and Jill Demirci in Journal of Health Psychology
Research Data
sj-docx-4-hpq-10.1177_1359105320988325 – for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences
sj-docx-4-hpq-10.1177_1359105320988325 for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences by Rachel Dieterich, Judy Chang, Cynthia Danford, Paul W Scott, Caroline Wend and Jill Demirci in Journal of Health Psychology
Supplemental Material
sj-pdf-5-hpq-10.1177_1359105320988325 – Supplemental material for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences
Supplemental material, sj-pdf-5-hpq-10.1177_1359105320988325 for She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences by Rachel Dieterich, Judy Chang, Cynthia Danford, Paul W Scott, Caroline Wend and Jill Demirci in Journal of Health Psychology
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Robert Wood Johnson Foundation Future of Nursing Scholars Program; the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Every Woman, Every Baby Research Award; and the Swigart-Gold Doctoral Award for Scholarship in Nursing Ethics.
Data sharing statement
Collective, de-identified data in the form of the qualitative codebook, coding matrix, and title naming documents are included with this submission.
Supplemental material
Supplemental material for this article is available online.
References
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