Mitigating Weight Bias in the Clinical Setting: A New Approach to Care.

Weight bias toward patients in larger bodies is pervasive among health care providers and can negatively influence provider-patient communication, as well as patients' behavior and health outcomes. Weight bias has historical roots that perpetuate thinness and Whiteness as the cultural norm. Although weight bias remains socially acceptable in US culture, contributing factors to an individual's body size are complex and multifactorial. Providers and health care systems also consistently use body mass index (BMI) as an indicator of health status, despite its limitations and harmful effects in the clinical setting. This state of the science review presents 8 evidence-based strategies that demonstrate how to mitigate harm from weight bias and improve quality of care and health outcomes for patients living in larger bodies. Person-centered approaches to care include (1) eliminating clinical recommendations to lose weight; (2) shifting from a focus on weight to health; (3) implementing a size and weight-inclusive approach; (4) engaging in weight bias self-evaluation; (5) creating a welcoming environment for patients of all sizes; (6) seeking permission and learning the patient's story; (7) using weight-inclusive language; and (8) re-evaluating clinical guidelines and policies based on BMI. Midwives and other health care providers may benefit from training that re-imagines the delivery of health care to patients in larger bodies.

Establishing a volunteer doula program within a nurse-midwifery education program: a winning situation for both clients and students.

The use of labor doulas is beneficial for mothers and newborns, but availability and cost can be barriers. The Nashville Volunteer Doula Program was formed to provide labor support to clients of a faculty nurse-midwifery practice. The volunteer doula pool is comprised of both nurse-midwifery students who have trained as doulas and community doulas. Training and coordination of volunteers are managed by nurse-midwifery students with faculty support. Students gain valuable exposure to providing supportive care during labor and birth, which augments their nurse-midwifery education. This novel program operates at a low cost and offers benefits to students as well as women who use the doula service. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.