Midwives’ perspectives on women's dietary intake during pregnancy: A systems thinking approach

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-03-28 DOI:10.1016/j.midw.2025.104396

Siobhan A O'Halloran , Priya Sunder , Rachael Cusworth , Alison M Hutchinson , Laura Alston , Vidanka Vasilevski , Linda Sweet , Emily Olive , Luba Sominsky , Peter Vuillermin , Samantha L Dawson , Pregnancy Research and Translation Ecosystem Investigator group

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引用次数: 0

Abstract

Background

Prenatal nutrition status and maternal dietary behaviours are known to impact maternal and child health outcomes. Aim: We aimed to inform strategies for improving prenatal diet quality and their integration into pregnancy care.

Method

Group Model Building (GMB) workshops were conducted with midwives from six health services. A Causal Loop Diagram (CLD) was developed to illustrate how the factors contributing to poor nutrition during pregnancy were interconnected and influenced each other and to identify priority action areas. Workshops were recorded and transcripts thematically analysed to provide a deeper understanding of the challenges of dietary advice provision and intervention opportunities.

Results

The GMB process created a CLD that included 51 factors that were perceived to be driving poor dietary intake in pregnancy. These were grouped into five priority areas for action: knowledge and education, food availability and access, personal and family circumstances, health system, and care. Thematic analysis of the workshop transcripts revealed four major themes related to midwives’ perspectives on the challenges associated with delivering dietary advice in pregnancy care: hospital service provision, pregnancy care clinicians, psychosocial factors affecting women, and maternal diet and health. Intervention targets were identified as continuity of care, nutrition education, guidelines and resources, personalised dietary advice, dietary data collection, and dietitian referrals.

Conclusion

Midwives’ perspectives on the drivers of poor prenatal nutritional intake were multifaceted, spanning the personal, environmental and health system levels. Nutrition interventions should consider the health system and service context, along with pregnant women's dietary knowledge and education, access to healthy food, social, cultural, and personal circumstances, and clinical care experience.

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.