Written nutrition communication in midwifery practice: what purpose does it serve?

OBJECTIVE: to obtain an in-depth understanding of verbal and written nutrition communication in Dutch midwifery practice. DESIGN, SETTING AND PARTICIPANTS: data were collected by recording 12 initial antenatal consultations (12 weeks into the pregnancy) with primiparous women from four Dutch midwifery practices spread over The Netherlands, followed by two semi-structured qualitative interviews with the women. The interviews were undertaken on the day after the consultation and two weeks later. FINDINGS: analysis of the recordings revealed that a nutrition brochure was offered in an information pack, but it was not used or referred to by the midwives. Verbally, clients were informed about healthy nutrition in general terms. Specific, personally relevant nutrition-related questions and motivators of nutrition behaviour were rarely clarified and addressed. Midwives tried to create a good relationship with their clients by being friendly, complimentary, confirmative and supportive. Women appreciated talking about nutrition with the midwife because of her expertise. The subsequent interviews with the women revealed, however, that nutrition communication took place relatively late in pregnancy at a point when women were more interested in 'hearing the baby's heart beat'. Furthermore, clients seldom looked through the nutrition brochure at home. KEY CONCLUSION: the provision of a nutrition brochure does not serve any real purpose. IMPLICATIONS FOR PRACTICE: to reach optimal synergy between verbal and written nutrition communication in midwifery practice, midwives should actively refer to a nutrition brochure in addition to verbal communication. Moreover, health organisations should realise that the provision of nutrition brochures to midwives does not mean that these brochures will be used as an integral part of midwives' nutrition communication with clients.

Nutrition-related information-seeking behaviours of women trying to conceive and pregnant women: evidence for the life course perspective.

OBJECTIVES: To examine whether preconception and pregnancy could be an occasion triggering women's interest, search and need for both general and pregnancy-specific nutrition-related information, in order to: (i) provide a greater understanding of the life course perspective (in this case on nutrition behaviours and pregnancy) and (ii) to contribute to the rationale of nutrition interventions aimed at women of child-bearing age. METHODS: Data were collected in a cross-sectional study with the aid of a face-to-face interview. The sample consisted of four groups each of about 100 Dutch nulliparous women each: women trying to conceive and women in the first, second or third trimester of their first pregnancy. RESULTS: Pregnant women were more interested in nutrition information than before preconception and before pregnancy, especially the first-trimester group. The frequency of search for nutrition information differed significantly between the groups: the first-trimester group searched for information most frequently. Women wanting to conceive and women in their third trimester of pregnancy found significantly more pregnancy-specific information topics than women in their first and second trimester of pregnancy. Women wanting to conceive had significantly higher needs for general and specific nutrition-related topics compared to pregnant women. Overall, the Internet, the midwife and books were the favourite information sources. CONCLUSIONS: The study provided indications that preconception and pregnancy are moments in life that lead to an increased interest, need and search for particularly pregnancy-specific nutrition-related information. This should be borne in mind when healthy nutrition promotion activities are being developed.

Nutrition awareness and pregnancy: implications for the life course perspective.

OBJECTIVE: To explore the influence of a life event (pregnancy) on nutrition awareness and the motivations for nutrition behaviour. STUDY DESIGN: In-depth, face-to-face interviews with five groups of 12 women: women wishing to conceive a child, women in the first, second, and third trimesters of their first pregnancy, and women in the first trimester of their second pregnancy. As is common in qualitative research, participants were selected on the basis of diversity together with maximum representativeness within normal populations with respect to socio-demographic characteristics. RESULTS: With respect to nutrition awareness, three groups of women can be distinguished: (1) those who are 'going all the way'; these women try to live precisely by the book, (2) those who are 'taking the flexible way'; these women are more aware of their nutrition, but are more flexible in handling it, and (3) women who 'continue the same way'; these women have a no-nonsense mentality and do not experience essential shifts in their nutrition awareness. The extent and fluctuations in nutrition awareness throughout preconception and pregnancy are based on three types of motivations, the interest of (1) the child, (2) the mother, and (3) the social environment. CONCLUSIONS: This study provides indications that preconception and pregnancy could indeed be a life event leading to increased general nutrition awareness that might influence women's future nutrition-related behaviours.