According to recent clinical practice guidelines (links below), Canadian maternal health centres are providing service to an increasing number of women living with higher weights. These guidelines have become the focus of a community of practice (CoP), based out of the IWK Health Centre and Kingston Health Science Centre, that has been formed to determine the best ways to support women (and their family) during the pre-, peri- and post-natal period(s).
A recent article, written by members of this CoP, asks clinicians and scientists whether “weight management” is the best approach to treating diabetes during pregnancy. The article is part of a larger integrative knowledge translation (iKT) initiative, led by Dr. Erna Snelgrove-Clarke (a Registered Nurse) and Dr. Shannan Grant (a Registered Dietitian). The initiative aims to create, synthesize, and share knowledge about pre-, peri- and post-natal care of women living with obesity.
“Pregnancy is a short and busy period for patients to engage in behaviour change”, says Grant. “It is clear that weight, especially gestational weight gain, has a role to play in prevention and treatment of diabetes, but we are skeptical that ‘weight management’ is the approach we should be taking in prenatal care.” She also highlighted that in March 2020 (Nutrition Month) Dietitians of Canada endorsed an International consensus statement against weight stigma.
Gestational diabetes occurs in three to 20 per cent of pregnant women, during the second or third trimester of pregnancy, depending on various risk factors. In most cases, women with gestational diabetes do not have diabetes before their pregnancy and, after giving birth, the diabetes usually goes away.
“As female clinicians, researchers, women, and mothers, we have a deep interest in this topic”, says Snelgrove-Clarke. “It is time for clinicians to commit to person-centred care when it comes to weight, which includes challenging unjustified norms and bias within and outside of our professions.”
A long-time member of the IWK and Dalhousie University research and maternal health community, Snelgrove-Clarke recently took on the role of Vice-Dean (Health Sciences) & Director, School of Nursing, Queen’s University.
“I was thrilled when Shannan agreed to oversee Atlantic Canada TeemOB research and outreach,” says Snelgrove-Clarke. “She is a well-trained, precocious, early career researcher with strong work ethic and understanding of the population the IWK serves. She is also a skilled clinician with ten to 15 years practical experience in women’s health, bariatrics, pediatrics, and chronic disease management.”
“I am grateful for Erna’s sponsorship and collegiality, and to IWK and Canadian Institutes of Health Research funding,” says Grant. “This project marries various topics I explore in my research program and it is an honour to oversee the IWK site. The IWK Research, Administrative and Clinical Staff (and Public Relations Team) have been an amazing support in getting this work off the ground and we look forward to sharing our findings with the larger community. We already have a Masters of Science Student, Department of Applied Human Nutrition, Mount Saint Vincent University working on this project and will be hiring a new Research Coordinator in the coming weeks.”
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- Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Guidelines for (No. 239) Obesity in Pregnancy Part 1.
- Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Guidelines for (No. 392) Pregnancy and Maternal Obesity Part 2: Team Planning for Delivery and Postpartum Care
- Diabetes Canada (DC) Clinical Practice Guidelines for Prevention and Management of Diabetes. Diabetes and Pregnancy