PregNut survey: knowledge, attitude, and practices of midwives regarding plant-based diets during pregnancy

Plant-based diets (PBD) are gaining global popularity, yet there is limited research on the experiences of pregnant women adhering to these diets. This study employed the knowledge, attitudes, and practices (KAP) framework to assess midwives' readiness in managing the growing plant-based trend in Aotearoa New Zealand (NZ).

A cross-sectional, online-administered survey was developed in collaboration with midwifery academics, and was presented in three sections: knowledge, attitudes, and practices towards nutrition in general, towards PBD during pregnancy, and practice information. Questions included Likert-style, free text responses, and check boxes. Currently practising lead maternity carer midwives in NZ were invited to participate, primarily via an email newsletter disseminated by the New Zealand College of Midwives. Descriptive statistics, chi-square tests, and content analysis were used to interpret data.

The study received 133 valid responses from a total of 1246 registered midwives in NZ, reflecting a demographic profile similar to the current midwifery workforce. Although respondents demonstrated foundational knowledge of plant-based nutrition, midwives reported feeling significantly less prepared to advise clients following PBD, compared with omnivorous diets (96% vs. 72%, Χ² (1, n = 133) = 29.03, p <.001)). While attitudes towards PBD appeared positive, midwives reported higher expectations of knowledge from plant-based clients, compared with omnivore-based clients. Midwives' practices towards their PBD clients varied considerably, with some inconsistencies attributable to reported barriers including lack of time or feeling unqualified. Respondents' personal dietary patterns were correlated with preparedness, knowledge of emerging concepts, and the belief that PBD are better for mothers and infant development.

This study, conducted within NZ innovative midwifery care system, reveals discrepancies between midwives reported levels of preparedness to manage clients following PBD compared with omnivorous diets, despite a strong foundation of general and plant-based nutrition knowledge. The reported desire to expand midwives understanding of PBD nutrition and improve practices reiterates the importance of access to current research, evidence-based practice protocols, and support avenues to enhance midwives' preparedness in advising the growing number of individuals following PBD.