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Midwives and dietitians' perspectives on an empowerment programme to enhance diet quality in pregnant women: A

Renske M van Lonkhuijzen¹, Jeanne H M de Vries², Susanne Cremers³

¹Health and Society, Department of Social Sciences, Wageningen University & Research, Hollandseweg 1, bode 60, 6706KN Wageningen, the Netherlands.

|October 11, 2025

Background:

Healthy nutrition during pregnancy is essential for mother and child. Midwives, as trusted sources of information, play a key role in supporting maternal health but current nutrition communication remains limited. The Power 4 a Healthy Pregnancy (P4HP) aims to improve the diet quality of pregnant women through four additional empowerment consultations on nutrition (three with midwives, one with a dietitian). The objective of this study was to evaluate the implementation of the P4HP programme from the perspective of healthcare professionals (HCPs), with a focus on interprofessional collaboration, facilitators, and barriers.

Methods:

A mixed-method process evaluation was conducted in the Netherlands, incorporating quantitative data from online surveys (n = 29; 18 midwives, 11 dietitians) using the Measurement Instrument for Determinants of Innovations, along with in-depth interviews (n = 36 HCPs). Survey data were analysed using descriptive statistics, while interview data were analysed through thematic analysis.

Results:

HCPs reported improved understanding of each other's roles in nutritional care and enhanced interprofessional collaboration. While dietitian consultations provided valuable personalized advice that empowered women to make healthier dietary choices, midwives played a crucial role in supporting the maintenance of these changes. Key facilitators included the program's clear procedures, implementation flexibility, and the HCPs' commitment to promoting healthy eating. The main barriers identified were time constraints and limited staff availability among midwives, as well as the financial burden associated with consulting a dietitian.

Conclusion:

The P4HP programme successfully enhanced interprofessional collaboration between midwives and dietitians, offering significant nutritional support to pregnant women. However, addressing the financial barrier of out-of-pocket costs is crucial for facilitating broader integration into routine antenatal care.

Keywords:

Dietitian Interprofessional collaboration Midwifery Nutrition counselling Pregnancy Process evaluation

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