It will be particularly helpful in informing the patients and their practitioners in accessing obesity situations (Thomson, 2012). Chapter 3: Literature review

Originative and current literature on the use of UB-PAP in the management of the gestational weight features in this section. The focus of this paper is the effectiveness of the UB-PAP, but this examination will look at the relationship of the behavior pattern of the obese pregnant women in relation to the respective gestational weight. Books, journal articles, and reports provide a scholarly approach in relation to the problem of the research. Additional material, including conference reports on the risk of obesity and the effectiveness of the UB-PAP tool will feature majorly.

The review focuses on the impact of maternal overweight and obesity. The section covers the behavior of pregnant mothers who are obese, as well as the provision of an intervention plan for the women. A study by Braun (2011) suggested that the rise in the rates of maternal and infant morbidities and mortalities has triggered the curiosity of healthcare providers and researchers. They have strived to ascertain the relationship between gestational weight gains and lifestyle behavior pattern amongst the obese pregnant women (Thomson, 2012). Biomedical studies have forwarded the knowledge on the physical well-being implications obesity and overweight in pregnancy for both mothers and babies like hypertension, hemorrhage, infertility, caesarean delivery and late fetal deaths amongst others.

Little information exists on the psychological and emotional impact of obesity high gestational weights and obesity in pregnancy (Visser & Atkinson, 2012). There is also little information on the how the social context of the obese pregnant women's lives affects their obesity experiences. In general, the increased focus about obesity and high gestational weight has extended into reproductive health. Evidence exists to suggest that obesity and overweight affect conception. Obesity and overweight lead to reduced infertility and lower success probability for assisted reproduction (Visser & Atkinson, 2012).

Kelly (2006) reveals that pregnancy in women suffering from obesity are commonly complicated than pregnancies among women with normal weights. Pregnancy outcomes decline linearly as the BMI increases from normal to overweight. The list of complications for overweight pregnant mothers is evident (Krauss, Winston, Fletcher, & Grundy, 2000). Hypertension disorders, gestational diabetes, infections, blood clots, and preterm delivery are just some of the few. Pregnant women with high levels of BMI are highly likely to suffer from severe forms of hypertensive constraints.

Evidence exists to suggest that obesity and high gestational weights affect the experiences of labor and delivery (Thomson, 2012). Studies suggest that obese pregnant women are more likely to rely on assisted delivery. This includes the use of forceps in the case of normal delivery, and caesarean section. Various sources have recorded elevated occurrences of the caesarean section amongst obese pregnant mothers. The risk of the caesarean delivery is 50% in women who have recorded high gestational weights (Visser & Atkinson, 2012). The rate doubles in the case of obese pregnant mothers. Positive results arising from caesarean section are likely to be compromised for overweight and obese women. Hefti (2009) continues to argue that women with a BMI higher than 35 are at an enhanced risk of anesthesia-related problems. This includes airway control, constraints in the insertion of regional nerve blocks, and incidences of failed intubation.

Chapter 4: Research methodology

4.1 Sampling and design

This section provides evidence to prove the validity of the research. The section connects the statistics collected to the research questions, and offers a statistical conclusion (Krauss, Winston, Fletcher, & Grundy, 2000). The procedures and rules applied feature in this section. The type of research undertaken was a correlation research. This is because it sought to determine the statistical relationship between the lifestyle behaviors of expectant mothers, and the progression of obesity. More closely, the research sought to investigate how negative behaviors among pregnant women lead to high gestational weight. The research relied on quantitative data.

The choice of quantitative analysis favored the type of research because the phenomenon under investigation could be expressed in numerical form (Clarke, 2010). Some aspects of qualitative analysis came in handy in discovering the underlying desires and motives that determine the lifestyle of pregnant women. in-depth Action Plan (UB-PAP) model. The research employed the data collected in enhancing knowledge about the use of the UB-PAP in managing maternal obesity. The respondents were subjected to answering a questionnaire with ten questions. The respondents who involved a group of expectant mothers from the Lowell Community Health Centre responded to the lifestyle questions. Those respondents who scored 7 and above had their personal action plan created.
4.2 Qualitative and quantitative data sampling

Most of the qualitative data was derived from the 10 prenatal visit questions regarding lifestyle changes. The data helped to determine the general trend for pregnant, obese women in respect to behaviors. The qualitative data also helped to determine the economic status of the pregnant, obese women. The qualitative data was also useful in recommending the women suitable for the "Brief Action Motivational Tool." Those women who scored 7 and above had their own action plan created. The tool involved a well designed procedure that offered guidelines toward behavior change. The framework was developed to offer a comprehensive motivational intervention to promote a series of positive behaviors like a balanced diet, physical activity, regular prenatal visits, and other behaviors that help maintain a safer BMI. The research design flowed from the practical problem of obesity facing pregnant women. The aim of the research was to determine the behavior trend among obese pregnant mothers. This would be followed by an analysis of the effectiveness of the "Brief Action Motivational Tool" in maintaining the BMI of obese pregnant mothers. This study developed a list of research questions that further bring the research problem to the fore. The research problem originated from the need to seek for a practical solution to the complications associated with obese pregnancies. Obesity during pregnancy can present major health complications for the baby and the mother.

The quantitative data was employed in the study to investigate the relationship between the behaviors of obese pregnant women, and their Body Mass Index (BMI). Qualitative data helped to explain the reason behind the behavior pattern of the pregnant, obese women. The research methodology entailed gathering data from both primary and secondary sources.

Data from Gym instructors indicated a poor attendance from obese pregnant clients. They either reflected irregular attendance or halted their attendance completely at some point. The daily attendance sheet provided the attendance information of the overweight pregnant clients. The body mass index of the sample population helped to form the connection between effectiveness of the UB-PAP action and the maternal body weight of the obese pregnant women. The initial weights of the women were measured against their current weights. Current and initial weights are operational defined. Current weight refers to the weight of a pregnant, obese mother, while initial represent the weight of the mother during the first prenatal visit. The difference in the two weights represented the weight gains in pounds for the obese mothers.

The general trend showed by the variation demonstrated that the pregnant, obese women gained more than 20 pounds up to the gestation period. The initial weights of the mothers were determined in the first and second trimester period during the first prenatal visit. The trend showed that the gestational weights of the sample population increased significantly. The increase was way past the stipulated 20 pounds for mothers who weight was abnormal before pregnancy. The weight gains of the mothers were compared against their subsequent level of physical exercise. The sample population was carefully picked. The criteria ensured that the sample was registered with a physical fitness centre. This ensured consistency in the data collection process. It was worthy to note that mothers who showed the greatest irregularity in GYM attendance reflected the most weight gain. The relationship between the weight gain of the obese pregnant mothers and the BMI showed a positive correlation.

The electronic records provided historical data. It offered information on birth outcome variables (infant mortality and morbidity). The data were useful in reinforcing the trend obtained from the GYM attendance and BMI. The proportion of deaths resulting from obesity helped the research to achieve its objective. The deaths resulting from obese pregnancy complications also helped in forming the attitude of the research. Infant morbidity data also played the same role, as well as data from Healthy People 2010 Report from the United States department of Health and Human services.

As mentioned earlier, the qualitative data were extracted from the Motivational Interview (MI) questionnaire. The questions centered on offering a collaborative, client-centered, decision-making approach. The questions offered a non-judgmental attitude. Through permitting the clients to develop their own approach toward the problem, the questions aimed at decreasing levels of ambivalence among the obese pregnant women.

The quantitative data greatly informed the construction of the hypotheses. The data provided a descriptive…