Midwives’ Role in Providing Nutrition Advice during Pregnancy: Meeting the Challenges? A Qualitative Study

Abstract

This study explored the Australian midwives' role in the provision of nutrition advice. Little is known about their perceptions of this role, the influence of the model of care, and the barriers and facilitators that may influence them providing quality nutrition advice to pregnant women. Semistructured telephone interviews were undertaken with a subsample (n = 16) of the members of the Australian College of Midwives who participated in an online survey about midwives' nutrition knowledge, attitudes, and their confidence in providing nutrition advice during pregnancy. Thematic descriptive analysis was used to analyse the data. Midwives believed they have a vital role in providing nutrition advice to pregnant women in the context of health promotion. However, this was not reflected in the advice many of them provided, which in many accounts was passive and medically directed. The extent and efficacy of their role appear to be challenged by many structural barriers. Midwives suggested facilitators that may assist in overcoming these challenges. Midwives need assistance, support, and guidance to provide holistic nutrition advice that assists women to achieve healthy pregnancies. A collaborative approach between midwifery bodies, nutrition and education experts, and maternity care services may provide an effective way forward.

Qualitative study on public health nurses’ experience and assessment of nutritional and physical activity counseling of women with gestational diabetes

“…It is important that the PHNs also derived positive and successful experiences from the counseling process as the need for counseling is increasing along with the growing number of women diagnosed with GDM 19 . These results are similar to the existing literature describing the lack of training for health professionals related to nutrition [26][27][28][29][30][31] . An inconsistency, between different nutrition and PA guidelines related to the suggested type of physical activity and the content of diet recommendations, was raised and also the pregnant women's view that the counseling was both contradictory and confusing 21,[32][33][34] .…”

How can we best use opportunities provided by routine maternity care to engage women in improving their diets and health?

“…In the United Kingdom, satisfaction with pregnancy services is reportedly high (Henderson & Redshaw, ). In Australia, midwives were described as being in a position of trust with the women in their care, making them ideally placed to deliver a brief intervention (Arrish et al, ). These Australian midwives struggled however to find time within the existing care pathway to have effective conversations about nutrition.…”

“…Opportunistic brief interventions delivered as part of routine primary care appointments have been shown to achieve significant improvements in health behaviours, including weight loss and smoking reduction, particularly if delivered by respected and trusted authorities (Aveyard et al, ; Aveyard, Begh, Parsons, & West, ). Consequently, there have been calls for midwives to use the relationship of trust they have with pregnant women in their care to engage women in improving their diets and nutritional status (Arrish, Yeatman, & Williamson, ). In the United Kingdom, these calls come in the context of Public Health England's agenda for “making every contact count” (NHS Health Education England, ).…”

“…These hubs offer midwifery and obstetric care alongside smoking cessation and weight management services (National Maternity Review, ). An obstacle to the provision of these services is that midwives have expressed a lack of confidence in their skills to broach such topics (Arrish et al, ; Holton, East, & Fisher, ). Recent research suggests that practitioners working in similar centres can be successfully trained to deliver a brief, opportunistic intervention to support behaviour change in their patients and clients (Black et al, ; Lawrence et al, ).…”

Perceived Benefits and Intakes of Protein, Vitamin C and Iron in Preventing Anemia among Pregnant Women

“…A study at Gote Geda Woreda, East Wollega Zone, Ethiopia showed that the information on nutrition had a significant relationship with the knowledge of pregnant mothers about nutrition .That study showed women who had information about nutrition were 3.6 times more likely knowledgeable about nutrition as compared to the pregnant women with no information about nutrition during pregnancy (AOR=3.59) (Fekadu Beyene, 2013).The adequacy of protein, vitamin C, and iron in the daily diet of pregnant mothers needs to be considered because it has a role to prevent anemia (Abdelwahid, 2013;Brown & Shapiro, 1996;Rivera-rodriguez, Rodríguez-rivera, Roman-julia, & Raul, 2016;Sriramanakoppa, Sreenivas, & Jayaram, 2015). Pregnant mothers need to be givena health education about foods that contain of protein, vitamin C, and iron during antenatal care.Midwivesplayan important role to improve the understanding ofpregnant mothers (Arrish, Yeatman, & Williamson, 2017).…”