My PhD study is to discover how women in higher weight bodies* experience their UK- based maternity care. I have a particular interest in weight stigma and how this might affect experiences of care. I am also interested in how maternity care should be improved for higher weight women. I used a narrative method in my research and created I-Poems, five of which feature in a short animation to share the experiences recounted to me.
I had previously established that women of a higher weight experience shame, which includes feelings guilt and humiliation as well as those of being judged and blamed. They also face harmful attitudes and preconceptions from healthcare professionals regularly and repeatedly while receiving maternity care (Cunningham, Calestani and Coxon, 2025). The shame was experienced in both acute and chronic ways (Dolezal and Gibson, 2022), with weight being perceived as a “transgression” as well as being falsely linked to character flaws (Puhl, Himmelstein and Pearl, 2020) and “shame anxiety” being felt prior to and during appointments. I also found that weight stigma and negative experiences can be alleviated by individualised supportive care from a healthcare professional.
To support the next stage of my PhD, I created a Research Collective to support and influence my empirical study. The Collective consists of higher weight women who have previously received maternity care in the UK. Their advice and guidance has been really important to me in terms of the trustworthiness of my work. Members of the Collective helped to sense-check findings from the meta-ethnography before publication, ensured I use appropriate language and helped to design my empirical study. They are also helping me in the data analysis.
Using social media, I recruited women and birthing people to my longitudinal study, inviting them to meet me online up to three times; in early pregnancy, late pregnancy and once their baby had been born. The conversations started with an opening question asking about their maternity care. I spoke to nine women from different parts of the UK. Many women told me towards the end of our conversation that their care had been better than expected. This was despite them having told me about the fear and stress they often experienced, the assumptions maternity care professionals made about them and their pregnancies and some truly disrespectful encounters.
I decided to analyse the data using a narrative approach, as this fitted in with the interview style as well as my desire to keep the stories whole and not fragmented into codes. The approach I used was Voice Centred Relational Method (VCRM) which was first described by two psychologists (Brown and Gilligan, 1992) who later expanded the method and developed a ‘listening guide’ (Gilligan et al., 2003). Other researchers have also used this method and advanced its understanding and use (Mauthner and Doucet, 2003). The step that is best known in VCRM is the writing of poetry, called ‘I-Poems’, and I very much enjoyed this process.
These poems are written using the transcript of a participant. In my case, I found sections of a transcript which appeared to be of interest to the research question and/or important to the participant. Any sentences in this piece of transcript with “I” in them were copied and pasted into a Word document. The sentences were kept in the same order and none were removed, so they read chronologically. The decision was then about how much of the context around the text to keep and what to remove. Retaining context impacts on the understanding of the poem by the reader. Finally, when I was happy with the wording, I decided how it should look, in terms of grammar, capitalisation, indents etc. A selection of the final poems was shared with the Research Collective for their thoughts and feedback. They found them impactful and relevant to their experiences, so I knew that I had found a method of illustrating the data in a meaningful way.
Finally, I applied to my institution, Kingston University, for a small amount of money which I was awarded. I was then able to commission an animation to disseminate the poems and the important topic of weight stigma during maternity care. The animation was created by Christina Clement, a graduate of Kingston University. I hope you enjoy the short 7 minute film of five poems: https://youtu.be/G-WglO1lJZk.
Please get in touch if you would like to know more K2030248@kingston.ac.uk
*I use phrases ‘higher weight’ or ‘higher weight bodies’ which Research Collective members identified as less stigmatising than often used terms such as ‘obese’. In clinical terms, this equates to a body mass index (BMI) of ≥30kg/m2.
Jenny Cunningham
PhD student and midwife, Kingston University
24th November 2025
