Below is a lesson plan aiming to clear some common pregnancy myths. Enjoy!
Clearing
the Pregnancy Myths
Katherine
Lanier HS 6453 Summer 2013
Health
Topic and Intended Audience
“Women
should engage in work, leisure, and exercise armed with the knowledge that they
can use their pregnancy as a launching point for good habits and a foundation
for health for both themselves and their children, now and in the future.”
(Ricciotti, 2008). Concepts discussed in this lesson include weight gain,
dietary concerns, physical activity, and weight loss after baby. All of these
concepts affect the health of an infant and their risk of disease later in
life. The balancing act of weight gain during pregnancy is one that needs more
attention, especially for women who are underweight or obese (Ricciotti, 2008).
Weight gain during pregnancy and weight loss after pregnancy are particularly
concerning topics that need to be addressed to better prevent maternal obesity
and child obesity (Heslehurst, Bell, & Rankin, 2011). Covering these
concepts through the format of pregnancy myths will help these women gain a
better understanding of precautions and recommendations for a healthy
pregnancy.
Because
pregnancy is such a vital time in a baby’s life, teaching women about a healthy
pregnancy before they are pregnant is
equally as important, if not more important, than teaching them once they
become pregnant. With nearly 4 million births a year, it is easy to justify
early education for women in America about the importance of a healthy
pregnancy (Center for Disease Control and Prevention, 2013). Half of all pregnancies
in America are unplanned, which further proves a great need for preconception
education (Office on Women’s Health, 2010). Once a woman becomes pregnant, she
may become more motivated to make lifestyle changes regarding nutrition and
exercise that she wouldn’t have made before becoming pregnant. For both of
these reasons, this class can be used for both women of child-bearing age with
the intention of reaching them preconception, and also for women who are
already pregnant. Even if a woman has already had a child, she would be
encouraged to attend this class for education before she becomes pregnant
again.
Setting
A room large enough for your class size is
needed. It is best if the class size is 15 or less, so that discussion is
easier and more intimate. To allow for better and more open conversation,
arrange chairs in a circle or U-shape. If your facility has couches or more
comfortable chairs, feel free to use these in place of chairs but be sure there
are enough seats for 15. Choose a time that works best for the class
participants—night time may be easy for working women, but not as easy for
those who already have children.
Estimated
Time/Length
This can vary,
depending on how involved the participants become in conversation. Allow for
30-45 minutes of class time and 10 minutes of preparation time for the
instructor. The introduction and icebreaker should take about 5 minutes. Each
myth activity will take anywhere between 5-10 minutes. In the procedure
section, you will find an estimated time length for each myth/activity. The length
of time will also be determined by the participants and how involved they are
in conversation. Remember to give 20-30 seconds of silence before deciding to
move on. It can take time for individuals to open up during a group class. This
is why it is important to get them involved and engaged during the icebreaker. The
evaluation should take about 5 minutes.
Materials
Needed
·
Indoor, comfortable room for a
facilitated discussion
·
One round table large enough for 15 or
less (optional)
·
Enough chairs for participants (15 or
less)
·
If you do not have a table, 15 clip
boards for participants to fill out evaluation
·
White board and marker or
·
2 Poster-sized paper with marker
·
15-20 pens for participants to complete
evaluation
·
Printed myths to hang on the wall or
place on the table (attached)
·
Printed handouts:
o
Menu—1 per participant (attached)
o
Celebrity Photos—1 per participant
(attached)
o
Evaluation—1 per participant (attached)
Guiding
Health Education Theory or Model
The
Health Belief Model (HBM) specifically focuses on one’s readiness to change
based on six factors: perceived susceptibility, perceived severity, perceived
benefits, perceived barriers, cues to action, and self-efficacy (Glanz, Rimer,
& Viswanath, 2008). This lesson uses a combination of perceived benefits,
perceived severity, cues to action and self-efficacy. The benefits and consequences
of dietary choices and weight gain are discussed to apply perceived benefits
and perceived severity. Cues to action are applied when we discuss the “how-to”
information of a healthy weight gain, avoiding certain foods during pregnancy,
and safe weight loss after baby is born. Self-efficacy is applied through
activities that allow the participants to practice what they learned and also
through being validated and affirmed through the facilitated discussion. For
behavior change, the participant will need to realize perceived severity of not
making healthy choices during pregnancy, understand the benefit of their
healthy actions, and feel confident to do so through the building of
self-efficacy (Glanz, Rimer, & Viswanath, 2008). This lesson plan will take
the participant through each of these concepts.
Goal
The goal of this lesson plan is for
participants to have a greater understanding of common pregnancy myths, and the
truth behind them. Most of these myths are connected to nutrition during
pregnancy. We want the participants to make the association between the
importance of good nutrition, a healthy weight gain, and a healthy pregnancy.
Objectives
·
75% of participants will be able to
correctly identify unsafe food to eat during pregnancy. (Outcome objective,
cognitive domain)
·
75% of participants will name a physical
activity that they can enjoy while pregnant.
(Outcome
objective, cognitive domain)
·
Participants will have a greater feeling
of confidence when it comes to controlling their weight gain during pregnancy
and weight loss after pregnancy.
(Outcome
objective, affective domain)
·
Instructor will tailor class procedure,
discussion, and activities according to feedback from class evaluation.
(Process
objective, psychomotor domain)
Procedure
1)
Before class begins
set up the chairs around a table. If you do not have a table, arrange chairs in
a circle or U-shape. Post the four pregnancy myths (attached) to either the
wall or place in the center of the table. The participants will be able to
choose the order of the topics based on their interest. Review each of these
myths and activities before class starts because you will not know which order
the participants will want to learn them.
2)
Introduction: Welcome the participants
and thank them for attending. Introduce yourself and give a little background
on why you are teaching the class (maybe you have children, you are a nutrition
expert, you have worked with pregnant women, etc.—anything that will establish
your authority in the subject matter).
3)
Ice breaker: Ask the participants to go
around in a circle and:
o
State their name
o
Share their children’s age, if they have
children
o
Share how far along they are, if they
are pregnant
o
Share one “crazy” or “strange” thing
they have heard about pregnancy from a friend, family member, or the internet
4)
After everyone has had a chance to
share, point out the four myths posted on the wall or sitting in front of them
on the table. Ask them to choose one myth they would like to learn about first
and continue with that activity. Continue this until all of the myths and
corresponding activities have been completed. See each section below for myth
and corresponding activity. Some will require longer activities and
discussions, and others will be a short discussion without an activity.
·
Myth
#1: There are a lot of foods I can’t have when I am pregnant. (Discussion and Activity;
10 minutes)
Ask:
We will start this myth with a question: What foods have you heard that you
cannot eat when pregnant?
Write these foods on the white board or poster
board. Once they have finished listing the foods, read through the true food
recommendations below and when you discuss one that was listed by the
participants, put a check mark next to that food on the board to note that it
is correct. If you discuss a food below that was not listed by the participants,
add it to the board.
Discuss with
them:
Pregnancy Food Safety Recommendations:
o
No alcohol
o
No soft cheese (only if unpasteurized—check
the label. Most in US are pasteurized)
o
No unpasteurized juice or milk
o
No high mercury fish (shark, swordfish,
king mackerel, tilefish)
o
Limit other fish (12 ounces or less, 6
ounces or less of albacore tuna)
o
No raw or undercooked fish or meats
o
Limit caffeine (200 mg of caffeine a day,
which is equal to 12 ounces of coffee—not red bull or espresso)
o
Cold cuts, lunch meats (heat these until
steaming hot to destroy bacteria)
Activity: Now
that you have clarified which foods the class listed as either being a food to
avoid or a food to enjoy, pass out the sample menu (attached). Tell them to
pretend they are pregnant and decide which menu item they need to avoid. Give
them a couple minutes to look it over and ask them to decide. There will be
more than one.
Discuss answer:
The menu items the pregnant woman should avoid are California Salad (has sprouts), Tuna Special (seared tuna means
undercooked), and Texas Club Sandwich (assuming lunch meats are not heated
until steaming hot). Keep note of how many participants identified at least
one menu item to avoid.
·
Myth
#2: Now that I’m pregnant, I need to eat for two. (Discussion only; 5-10
minutes)
Ask:
Who has heard this statement before? Where did you hear it from? Do you think
it is true? Give the participants time to think or answer aloud.
Explain the following:
It is important to gain weight during your pregnancy so that you baby will grow
correctly. The average person only needs to eat 300 more calories a day when
they are pregnant—if you add a healthy snack every day that can add to 300
calories very easily. Eating for two would DOUBLE the amount of calories you
eat a day so it is probably not a good idea to do that, or you may gain too
much weight.
Ask:
Do you know how much weight a woman is recommended to gain during her entire
pregnancy? Give the participants time to answer, or ask them by name to answer.
Remind them that this may be the first time they have thought about this so it
is okay to be wrong.
Discuss weight gain:
For women who start at a normal weight before they are pregnant, 25-35 pounds
is recommended. Women who were underweight or are having twins may need to gain
more. Women who were overweight before being pregnant may need to gain less.
Ask: Is
this different than what you expected? Have you heard of what may happen if a
woman gains TOO MUCH weight during her pregnancy? Give them time to answer.
Discuss risks of excess weight
gain: There are some risks for both mom and baby. Mom may
develop gestational diabetes or high blood pressure. She may then have to be on
a special diet or have to monitor her blood sugar. Baby can gain weight quickly
and need to be born early. Too much weight gain also increases that baby’s risk
for obesity and other diseases later in life. So you have the chance to start
your baby off right by gaining a healthy amount of weight.
Ask:
If mom is gaining too much weight, what would you recommend she do? Talk
through points below.
Discuss slowing weight gain: We
never want a pregnant mom to be on a restrictive “diet”. But there are some
small changes she can try:
o
Drink lots of water in place of soda,
sweet drinks, excess milk, sports drinks, etc.
o
Exercise or walk with doctor’s approval
o
Try reduced/low fat cheese or milk
o
Replace red meat with lean meats like
turkey or chicken (white meat)
o
Load your plate with fruits and
vegetables
o
Go easy on dressings or sauces (this is
what loads calories on a healthy salad!)
o
Avoid high-fat, fried foods
o
Etc. (Allow participants to name more)
Closing reminder
for them: If you feel like you are gaining too much or not
enough weight, be sure to talk to your doctor.
·
Myth
#3: If I don’t lose my “baby weight” by 6 months, I never will. (Discussion and
activity; 5-10 minutes)
Ask:
Do any of you ever see the celebrity pictures after they have their baby in
magazines? Do you have friends or family members who lost their “baby weight”
very quickly? How does this make you feel? Give them time to discuss. Feel free
to add a personal story here of your own to get the discussion going. Some
potential feelings: pressure, frustrated, excited to lose it fast, curious.
Activity:
Pass out the handout with celebrity pictures. This shows the celebrities when
they were pregnant and 6 months after (or sometimes even earlier). Give the
participants time to look it over and comment as desired.
Discussion:
Talk about these pictures. Does the group feel this is realistic? Validate
these women’s feelings by telling them many women feel frustrated or have a
false impression of weight loss after pregnancy when they see these pictures.
It is not “normal” to lose all of the pregnancy weight by 6 months or even 12
months.
Discussion:
Every mom is different. These celebrity moms have nannies to chase around their
children, professional chefs to cook them healthy foods, and trainers to push
them into sometimes extreme exercise. No matter how you lose it, be sure to
wait until your 6 week check up to get the okay from your doctor to begin an
exercise. Enjoy that time with your new baby and get plenty of rest before
worrying about weight loss.
Ask: What
are some healthy ways that we can start losing “baby weight”?
o
Breastfeed! This can burn a LOT of
calories for mom.
o
Drink plenty of water.
o
Eat a healthy diet with lots of fruits
and vegetables, lean meats, and low-fat dairy.
o
Take baby for a walk.
o
Join an exercise class.
o
Ask family to watch baby while you
exercise.
o
Exercise at home with a DVD while baby
is napping.
o
Remind yourself of what a great mom you
are, and that this may take a while. It took over 9 months to gain the weight
and will take that long or longer to lose it.
*Have
the participants give back the handout of celebrity pictures so that you can
use this for the next class.*
·
Myth
#4: When I am pregnant I cannot exercise like I used to because it is dangerous
for the baby. (Discussion only; 5-10 minutes)
Ask: What
have you heard about exercise during pregnancy? Allow the participants to
answer without giving them the answers yet.
Ask: What
are some benefits of staying active during pregnancy? Allow time to answer, and
then follow up with these possible answers:
o
To help with a healthy weight gain.
o
To reduce stress.
o
To help baby stay healthy.
o
To feel good and more energized.
o
It’s fun!
o
Help make delivery easier.
Ask: What
activities are safe for a pregnant woman?
o
Walking, swimming, yoga, playing with
kids, dancing, etc.
o
Anything mom was actively doing before she got pregnant. Now is not the
time to train for a marathon if you have never run.
o
Avoid a lot of jumping, running on
concrete, weight lifting—talk with your doctor about these and other more
intense exercise programs.
Ask:
Think about activities you like to do now. Which ones would you like to
continue to do when you are pregnant? Write these down on poster or white
board.
These are all great activities. Remember that your
life routine doesn’t stop once you are pregnant. Stay active -- this will help
you stay healthy and it’s great for your baby too.
5)
Once you have gone through all four myths,
summarize the highlights of the class and give them information on the
evaluation. Something like “Today we talked about a lot of information that
will help you have a healthier pregnancy, like healthy eating, weight gain,
exercise, and even weight loss after the baby. I am now going to give you a
short evaluation. Your answers are private and will help us improve the class
for others. We appreciate your feedback and time. Feel free to stay after you
have completed the evaluation if you have more questions. Otherwise, when you
are done you are free to leave.” Now is the time to pass out the evaluation,
pen, and clip board (if needed). Be sure to thank them individually as they
leave.
6)
Finally, now that the class is over,
take a few minutes to reflect on the class. Take notes on what went well, what
didn’t go as well, what you could do better, and other feedback for yourself.
Do this before you read through the participants’ evaluations.
Evaluation
The participants
will complete an evaluation (attached) at the end of the class. This evaluation
will help provide feedback for the instructor to fulfill the objective of: Instructor
will tailor class procedure, discussion, and activities according to feedback
from class evaluation. The evaluation will also address (in questions #1-2) if the participant met the objective of: Participants will have a greater feeling of confidence
when it comes to controlling their weight gain during pregnancy and weight loss
after pregnancy. The two other objectives
will be measured during the class
through specific activities. See below for how each objective will be measured.
75%
of participants will be able to correctly identify unsafe food to eat during
pregnancy. This objective is measured during the
activity of Myth #1. The participants are each given a menu and asked to
identify the menu items to avoid during pregnancy. They will be asked to share
their finding and the instructor is prompted to take note of the outcome of
this.
75%
of participants will name a physical activity that they can enjoy while
pregnant. This objective is measured during the activity of
Myth #4. The participants will be asked to think about and name one activity
they enjoy that they will continue to do during pregnancy. A list will be
compiled on the white board or poster so that the instructor can look back at
the number of responses and take note of how many were able to name an activity
for themselves.
Anticipated
Problems and Solutions
·
Lack of time: If you seem to be running
out of time or if you need to make this lesson shorter, you can remove a myth
of your choice. Be aware that if you cut a myth, you will need to update the
learning objectives for the lesson.
·
Improper Facility: If you do not have a
facility with a table and chairs, be sure to use a private room that allows the
participants to face each other. You can use coaches or something more
comfortable that allows participants to feel more “at home”. The most important
aspect of this lesson is the ability to have conversation as a group.
·
Attendance: If the group is much larger
or much smaller, that is okay. Print extra handouts and evaluations to be
prepared for this.
·
Materials: Always have extra markers,
paper, and pens. This will help if attendance is higher than expected or if the
markers malfunction.
References
Centers for Disease Control and Prevention (2013a). Births
and natality. Retrieved from
Glanz, K., Rimer, B.K., and Viswanath, K. (2008). Health Behavior and Health Education.
San
Francisco: Jossey-Bass
Heslehurst, N., Bell, R., and Rankin, J. (2011).
Tackling maternal obesity: the challenge for
public health. Perspective Public Health, 131(4):
161-162
Office on Women’s Health (2010). Preconception Health. Retrieved from
Ricciotti, H.A. (2008). Nutrition and Lifestyle for
a Healthy Pregnancy. American Journal of
Lifestyle
Medicine, 2 (2);
151-157. doi: 10.1177/155982/60/311516
