Societal constructions of weight stigma against preconception, pregnant, and postpartum women from community members' perspectives: a qualitative story completion study.

BACKGROUND

Weight stigma involves prejudiced attitudes directed towards larger-bodied people. Preconception, pregnant, and postpartum (PPP) women are particularly vulnerable to weight stigma due to societal expectations and prescriptive norms around women's bodies, along with body weight changes during these periods. However, there is limited understanding of the prevailing societal discourse and constructions driving this phenomenon. Therefore, we aimed to explore community members' perspectives to identify constructions of weight stigma towards PPP women living in larger bodies.

METHODS

We conducted a qualitative story completion study. Adult community members residing in Australia were invited to complete three story stems. Each story stem featured a larger-bodied preconception, pregnant, or postpartum protagonist and their interaction with their friends, colleagues, or family. The participants were instructed to complete the story by writing the story about what they think, believe, and do, focusing on the treatment experienced by larger-bodied women. The data were analysed using inductive reflexive thematic analysis, informed by social constructionism.

RESULTS

Eighteen participants took part and completed 48 stories (mean word count = 272 words, range 94-708). Three overarching constructions were identified: (1) prevailing assumptions about weight stigma in PPP periods; (2) disguising fatphobia pertaining to PPP women as concern for the mother's and child's health; and (3) healthism pertaining to PPP women living in larger bodies.

CONCLUSIONS

Our study highlights predominant norms and assumptions that drive weight stigma toward PPP women. These insights can inform future research, policy, and health promotion initiatives to identify targeted strategies to address these constructions. Ultimately, such efforts may contribute to creating a society that embraces body diversity and challenges weight stigma, positively impacting the health of PPP women and their children.