A study on current status and influencing factors of pregnant women’s body image in China: A mixed-methods study

BACKGROUND: Recent studies indicate that negative body image adversely affects the physical and psychological well-being of pregnant women and undermines family harmony, thereby jeopardizing maternal and infant health. Despite its significant impact, this issue has received scant scholarly attention in China. Body image is not formed in isolation; according to the socio-cultural model, it is constructed through the dynamic interplay of socio-cultural context, family interactions, media messages, and social comparisons. Therefore, it is imperative to investigate the current status and influencing factors of body image among pregnant women in China to establish an evidence base for developing culturally targeted interventions. METHODS: An exploratory sequential mixed-methods design was employed. Phase 1 involved semi-structured in-depth interviews with 17 pregnant women, analyzed using reflexive thematic analysis to develop themes. Phase 2 consisted of a questionnaire survey with 160 pregnant women, utilizing a self-designed questionnaire, the Chinese version of the Body Image in Pregnancy Scale (BIPS), the Perceived Social Support Scale (PSSS), and the Simplified Coping Style Questionnaire (SCSQ). SPSS 25 was utilized for statistical analysis. The qualitative findings directly informed the focus and variable selection for the quantitative phase. RESULTS: Three qualitative themes emerged: key factors influencing body image, consequences and outcomes of body image, and the desire for recognition and support. Quantitatively, body image dissatisfaction was moderate (BIPS score: 97.78 ± 15.57). Multiple linear regression identified greater gestational weight gain (β = 0.691, p = 0.008), lower family support (β = -0.804, p = 0.015), and parity (β = -6.819, p = 0.022) as significant predictors of poorer body image. Qualitative insights provided contextual depth to these statistical associations. CONCLUSIONS: Body image dissatisfaction was moderate among Chinese pregnant women and is influenced by weight gain, family support, and parity. The exploratory sequential design allowed for a deep understanding of lived experiences before quantitative measurement, ensuring the relevance of the measured constructs. Interventions should focus on weight management education and enhancing family support, particularly for first-time mothers, while also addressing and challenging the broader socio-cultural expectations surrounding unrealistic body ideals during pregnancy and the postpartum period.