Best Practice Principles for Weight-inclusive Maternity Care: Outcomes of a national consensus process

Abstract Objective : To co-create nationally agreed Best Practice Principles for Weight‑inclusive Maternity Care in Australia. Design : A multi‑stage consensus study using a modified Delphi process and Nominal Group Technique. Candidate principles were generated from prior qualitative research with women with lived experience of weight stigma, interviews with maternity care providers, and relevant literature. These principles were ranked and shortlisted through two national surveys, followed by a face‑to‑face national consensus workshop. Peak interest-holder organisations were subsequently invited to provide feedback and formally endorse the final principles. Setting : Australia. Participants : Women with recent lived experience of weight stigma in maternity care, maternity care providers across disciplines, and representatives of maternity consumer, medical, and midwifery organisations. Consumers and clinicians contributed equally throughout the process. Results : Five Best Practice Principles for Weight‑inclusive Maternity Care were agreed and endorsed by interest-holder organisations. These focus on acknowledging the impact of weight stigma in maternity care; educating the maternity workforce about weight stigma and weight‑inclusive practice; appropriately resourcing services to provide weight-inclusive care; partnering with women with lived experience in the development of policies, guidelines and service directives; and providing respectful, woman‑centred, trauma‑informed, and strengths- and evidence‑based care. Consensus was readily achieved on principles addressing respect, communication and partnership, while more contested issues highlighted the need for individualised assessment and adequate resourcing rather than categorical exclusions based on weight or body mass index. Conclusions : These nationally endorsed Best Practice Principles provide a shared, evidence‑informed, and consumer‑led framework to guide maternity care practice, education, and policy. By explicitly addressing weight stigma and moving beyond weight‑centric approaches, the Principles offer an essential foundation for improving maternity care experiences and supporting respectful, individualised care for women with larger bodies.