Midwives' experiences of discussing health behaviour change within routine maternity care: A qualitative systematic review and meta-synthesis.

ABSTRACT

PROBLEM: Behaviours, such as smoking, alcohol use, unhealthy diet, lack of physical activity and vaccination non-adherence may lead to adverse pregnancy outcomes. BACKGROUND: Pregnancy has been identified as an opportune time for midwives to support women to make health behaviour changes. AIM: To synthesise existing qualitative research exploring midwives' experiences of discussing health behaviour change with women within routine care. METHODS: A systematic search was conducted across Maternity and Infant Care, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Applied Social Sciences Index and Abstracts. Thematic analysis was used to synthesise the data. A professional and public advisory group provided feedback during the synthesis stage. FINDINGS: Twenty-two studies, published between 2005 and 2023, which represented findings from eight countries, were included in the review. The meta-synthesis revealed three themes The midwife-woman relationship; Reflective and tailored behaviour change communication; Practical barriers to behaviour change conversations. This led to one overarching theme Although midwives recognised the importance of behaviour change discussions, these conversations were not prioritised in clinical practice. CONCLUSION: Health behaviour change discussions were de-prioritised in midwives' clinical practice. Future research should explore intervention development to support midwives with their health behaviour change communication.