Nutritional counseling in midwifery and obstetric practice

Area of Science:

• Maternal Health
• Nutrition Science
• Healthcare Provider Practices

Background:

• Pregnancy nutrition guidelines have evolved, challenging the traditional "eating for two" concept.
• Understanding how current research informs provider recommendations is crucial for maternal health outcomes.

Purpose of the Study:

• To explore how obstetricians and midwives (certified nurse midwives and direct-entry midwives) integrate pregnancy nutrition research into patient care.
• To identify provider perspectives on dietary practices and barriers to effective nutritional counseling during pregnancy.

Main Methods:

• Grounded theory approach utilizing interviews with obstetricians and midwives.
• Analysis of five emergent themes: food/exercise interplay, food dichotomies, holistic prevention, counseling barriers, and obesity concerns.

Main Results:

• Providers view food and exercise as interconnected, categorizing foods as "good" or "harmful."
• Nutrition is perceived as a holistic preventive measure, yet institutional barriers hinder effective counseling.
• Concerns about the obesity epidemic influence provider approaches to pregnancy nutrition.

Conclusions:

• Provider type influences the integration of nutrition research, potentially perpetuating specific medical or midwifery models of care.
• These models may impact provider-associated effects on nutrition-related pregnancy complications.
• Addressing institutional barriers is key to improving nutritional counseling for pregnant individuals.