|dc.description.abstract||This thesis illuminates women’s maternal body experiences to show the meanings that come into being for women labelled as clinically ‘overweight’ and ‘obese’. Phenomenological interviews with 16 women were used to gather data. Using a post-intentional phenomenological design, phenomenology was put into dialogue with theories of pregnant embodiment, distressed embodiment, and salutogenic understandings of health. Crafted stories provided the practical framework to show how contexts produced and provoked women’s experiences.
Women described care as being preoccupied with control and surveillance of maternal bodies. In biomedical contexts, narrow versions of normality existed. Weight-focused advice was received by women in a climate of risk. Women’s stories tell of a patterning of care that led to disconnection from others, creating intense emotional, bodily, and cultural disruption. In restrictive care contexts, women’s bodies and experiences were marginalised. Understandings of wellbeing as holistic and interconnected were neglected, provoking a variety of responses which helped women to re-harmonise a disordered world. Women sought humanised and empathy-based care which reflected their cultural values, social contexts, and clinical needs. For women, health was not only based on weight; rather, it was framed by holistic understandings of wellbeing.
The findings prompt a shift from weight-focused behaviour change approaches and call for more aspirational approaches to wellbeing which are defined by women themselves. They challenge the current paradigm of contemporary maternal health promotion and reveal how the biomedical model lacked relevance—exposing the tensions that women experience when their values are in conflict with maternity’s idealising of specific body weights. Insights generated through this study uncover how trends in public health policy and health promotion practice privilege science and professional knowledges while marginalising women’s embodied knowledge.
Practice shifts are urgently needed to realign care to focus on indigenous perspectives and embodied knowledge to shift the conditions that problematise women in larger maternal bodies. A realistic approach to wellbeing begins by valuing and accepting diversity. The voices in these pages show that transformative innovation is needed to reinvigorate health promotion as a relational practice. The findings represent a body of evidence that prompts new directions for reimagining more equitable, responsive health promotion.||en_NZ