What factors influence the way women perceive and shape their bodies over their reproductive years?

Introduction: As a student nurse keen to promote good public health the concern of a growing obesity epidemic prompted me to explore issue surrounding body size and shape from biomedical and socio-cultural perspectives in women of reproductive age. Methodology: The biomedical perspective is explored from a scientific epistemological stance of an objective reality with measurable variables. I explore quantitative literature relating to associations between BMI, and adverse health outcomes, acknowledging flaws of BMI. The socio-cultural perspective is explored from a naturalistic epistemological stance giving importance to multiple realities of individuals through qualitative research, mainly phenomenological and grounded theory. The biomedical perspective: Associations between pre-pregnancy overweight and obesity, and adverse health and pregnancy outcomes are addressed, followed by adverse outcomes for mother and infant of pre-pregnancy underweight, low maternal weight-gain and low birth-weight. Biomedical solutions of diet and exercise are examined alongside the debate over fitness, exercise and BMI. The socio-cultural perspective: I explore body image including physical appearance evaluation and affective variables. Influences on this including, media, socio-economic status, health promotion and age are examined followed by women’s responses to these through diet and exercise. The perinatal period: In a society where large bodies are heavily stigmatised the perinatal period presents a challenge when women’s bodies change rapidly and relatively out of control. I explore reasons for change in body image and response through exercise and diet, and how pregnancy can be seen as an exemption from socially defined standards. Discussion and Conclusions: I review arguments thus far presented and integrate knowledge gained to examine paradoxes presented by the different perspectives. The importance of thinking from an integrated holistic stance is applied to implications for policy and practice, along with a discussion of what I have learned personally and how this applies to my own practice