Pregnant Women's Experiences With a Collaborative Midwife-Dietitian Empowerment Programme to Improve Diet Quality

Background: Pregnancy is a crucial period prompting increased intentions for lifestyle changes. Suboptimal diet quality during pregnancy can cause adverse health outcomes for both mother and child. The Power 4 a Healthy Pregnancy (P4HP) programme aims to improve the diet quality of pregnant women through empowerment, by providing four additional consultations to discuss nutrition with a midwife and dietitian. This research aimed to study the experiences of pregnant women engaged in the P4HP programme. Methods: A qualitative study using in-depth interviews was conducted. Participants were recruited through purposive sampling from women who completed the P4HP programme. Semi-structured interviews were conducted using time-lining as an explorative tool. Interview transcripts underwent thematic analysis following Braun and Clarke's six-phase process, combining inductive and deductive coding approaches. Results: Twenty-two interviews were conducted with women from eight midwifery practices. Four main themes emerged: (1) women report various dietary improvements, influenced by diverse factors, (2) most pregnant women evaluate the P4HP programme positively, (3) the dietitian plays a key role in empowering pregnant women towards healthy dietary intakes and (4) midwives support pregnant women in maintaining dietary improvements. Participants viewed the P4HP consultations favourably, which facilitated empowerment through personalized guidance, reassurance, and increased awareness and confidence levels. Motivated by their desire to ensure optimal nutrition for their babies, women made multiple improvements in their diet quality. While the guidance of the midwife served as a motivational factor to sustain these changes, it was the personalized nutritional guidance provided by the dietitian that women found instrumental in achieving actual dietary changes. Conclusion: Our outcomes emphasize the importance of integrating dietitian consultations in standard antenatal care to promote enhancements in the diet quality of pregnant women.