BOX 2-1
The Power of Goal-Directed Counseling and Motivation

During her first pregnancy, one of Conry’s patients, age 22, gained 60 pounds. She lost 10 pounds after the pregnancy, but then gained another 60 pounds during her second pregnancy 2.5 years later, for a total weight gain of 110 pounds. During the two pregnancies, she and Conry had many discussions about her weight gain.

The following year, the patient came for an appointment, and she had lost all of the weight. She explained that she had had an experience that finally gave her the motivation she needed to put all that she had learned from Conry into practice. She said, “I went in to Kmart to buy some toys for the kids. I went past the women’s section, and I thought, ‘I’m going to try on a pair of pants.’ I went in and tried on elastic-waistband pants. I looked at myself in the mirror and said, ‘Oh, my. I’m 30 years old and I’m wearing elastic-waistband pants. This cannot be.’”

The next morning, the patient got up 15 minutes before her children, got the treadmill out of the garage, and started walking. Over the course of a month, she progressed to half an hour. The following month she was walking an hour a day. Within a year she had set—and achieved—a goal of running a marathon.

The key to the change was that the patient found a powerful motivation, which allowed her to put into action what she had learned from Conry. Conry concluded the story by expressing the belief that many women put their children first, but helping them understand that putting themselves up a notch higher to improve their health does not displace the children. Rather, it is actually an investment in their children.

QUESTION-AND-ANSWER SESSION

Following the keynote addresses, the floor was opened for questions and discussion. The discussion covered three primary topics: time constraints and centered pregnancy, working with the family as a whole, and restructuring the postpartum visit.

Time Constraints and Centered Pregnancy

One participant asked Lu and Conry to comment on the time constraints that many obstetricians experience. As a result of these time constraints, other staff members in the office often are the ones who talk with patients about such issues as weight and exercise. The participant also asked them to comment on the pregnancy-centering programs that Dr. Conry discussed.



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