Stages of change in the trajectory of postpartum weight self-management.

OBJECTIVE To identify women's patterns of readiness to engage in weight self-management behaviors during the postpartum period. DESIGN Prospective, longitudinal design with repeated measures, guided by the transtheoretical model of behavior change (TTM). SETTING A tertiary perinatal center in an urban setting in the midwestern United States with approximately 3,000 births annually. PARTICIPANTS One hundred ninety-one (191) adult postpartum women. METHODS Participants were surveyed in person during their postpartum hospitalizations, and by telephone at 4 and 8 weeks postpartum using the Stages of Change for Weight Management (SOCWM) and the Decisional Balance for Weight Management (DBWM) tools. RESULTS There was a significant effect of time on stage of change for women in the postpartum period, with women in a higher stage of change at 8 weeks than during the postpartum hospitalization. There were no significant differences in stage of change at any of the three time points by prepregnant weight category or by race. Nearly one half of the sample was in the contemplation stage during the postpartum hospitalization, and more than 80% were in action or maintenance stages by 8 weeks postpartum. CONCLUSIONS The early postpartum period is an opportune time to influence stage of change in women's weight management behaviors. Assessment of readiness to engage in or continue weight management behaviors will allow providers to use stage-matched interventions guided by the TTM to facilitate women's self-management of weight.