Food Insecure Pregnant Women Expect and Are Comfortable With Food Insecurity Screening and Support Within Routine...

Food insecurity during pregnancy has wide-reaching and deleterious impacts on the health of mothers and their offspring. Healthcare-based responses to food insecurity may advance health equity for this priority population group. This study aimed to examine the relationship between women's food security status, socioeconomic characteristics, and their expectations and comfort with the management of food insecurity during pregnancy.

A cross-sectional study was conducted to examine pregnant women's views on food insecurity screening and support within antenatal care. Data were collected using a self-administered, 27-item questionnaire distributed to pregnant women attending antenatal appointments at a large metropolitan maternity hospital in Australia. The survey included items assessing demographic characteristics, food security status, and participants' expectations of and comfort with food insecurity screening and related support. Logistic regression analyses with interaction terms assessed the moderating effects of food security status on the associations between demographic factors and women's expectations and comfort with food insecurity screening and support.

A total of 401 surveys were analysed. Food secure women had 50% lower odds than food insecure women of expecting to be screened (OR = 0.50; 95%CI 0.32, 0.77, p = 0.002). For food insecure women, income above $AUD120,000 was associated with significantly lower odds of feeling comfortable with being offered support (OR = 0.32), whilst for food secure women, higher income increased the odds (OR = 1.38) of feeling comfortable with being offered support (OR = 0.32, Wald χ²(1) = 5.34, p = 0.021). Food insecure women would prefer not to initiate self-disclosure of food insecurity but favoured a trusted clinician to guide assessment of their food security status.

Antenatal healthcare settings must urgently integrate universal food insecurity screening and provide tailored support for food insecure pregnant women. Providing holistic antenatal healthcare that incorporates a food insecurity response will advance health equity during this critical life stage and ensure all women receive comprehensive, dignified healthcare that optimises their health and that of their offspring.