“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

Abstract

Objective To gain an in‐depth understanding of how the FIGO Nutrition Checklist could work in clinical practice, from the perspective of pregnant women. Methods This qualitative study was part of a pilot study of the FIGO Nutrition Checklist in the antenatal department of a tertiary‐level university maternity hospital in Dublin, Ireland. Individual semistructured phone interviews were conducted with pregnant women who had completed the FIGO Nutrition Checklist as part of the pilot. Interviews were transcribed verbatim and analyzed using content analysis after manual coding of transcripts. Themes and subthemes are described. Results Ten interviews were completed. Subthemes related to the FIGO Nutrition Checklist emerged including ease of use and comprehension. Participants discussed how the tool could add value to their appointment by supporting initiation of nutrition conversations and highlighting nutritional issues. The first trimester was identified as the highest priority for using the FIGO Nutrition Checklist. The convenience of having nutrition addressed as part of standard care, rather than a separate appointment, also emerged. Conclusion Women in this study had a desire for nutrition and weight to be addressed by clinicians during routine antenatal appointments. The findings support using the FIGO Nutrition Checklist to address this.

Nutritional challenges during pregnancy

“…Despite the recognized role of nutrition in improving maternal and child health and reducing the global burden of non-communicable diseases, several studies have shown inadequacies within women's dietary intakes in pregnancy worldwide [96][97][98]. The causes of this lack of adherence to recommended healthy dietary intakes for pregnancy are complex and remain, to date, object of debate and partially unexplained.…”

“…Women may not receive nutrition advice during pregnancy [99] or, when received, nutrition advices are often self-sourced, too general, inadequate, impersonalized or limited to addressing specific pregnancy issues (such as anemia and food safety) [100]. This may have a negative effect on behavior change, as demonstrated by previous studies showing that women may be less likely to follow generic advice [96], which moreover overlap with mistaken or false beliefs and conflicting messages, when searching for further advices from other sources then physicians [101]. Patients' craving and nausea, eating disorders, lack of resources, lack of healthcare professionals training and lack of time are other significant barriers to address nutrition changes in clinical practice [102] (Figure 3).…”

“…As single food items and micronutrients, without considering the composite biological interactions between nutrients, have shown inconclusive associations with complex health outcomes [108], measures of the overall diet quality have been developed for adults by different international organizations [109,110], explaining the full complexity of the diet by including both food and nutrient component, with an increasing number of pregnancy-specific dietary adaptations to reflect current nutritional recommendations for pregnancy and different national dietary guidelines [96,109].…”

Addressing the gaps in nutritional care before and during pregnancy

“…The feasibility of a tool for nutrition counselling depends on factors such as practicality, time and provider characteristics such as motivation, skills and knowledge (102) . A follow-on qualitative study with pregnant women further supported its use in practice with some women reporting that completing the checklist increased their awareness of dietary issues, while others valued the checklist's ability to support healthcare provider conversations on nutrition (98) .…”

“…In a recent systematic review, Callaghan et al found obstetricians and midwives had insufficient knowledge of gestational weight gain guidelines (97) . The absence of nutritional care during pregnancy has the potential to leave women reliant on other and perhaps less evidenced-based sources of information such as internet or family and friends (88,98) . In addition, health literacy is an important consideration in pregnancy that may influence how women engage with this health information (99) .…”