What is needed to facilitate healthy dietary behaviours in pregnant women: A qualitative study of Dutch midwives’ perceptions of current versus preferred nutrition communication practices in antenatal care

Objective: The aim of this paper was to explore midwives’ perceptions of current and preferred nutrition communication practices in antenatal care, and to identify what is needed to achieve their preferred practices. Design: A qualitative descriptive design was used. Semi-structured interviews were conducted with twenty Dutch midwives working in primary care or secondary care settings across the Netherlands. To create a positive atmosphere, interviews were based on the principles of Appreciative Inquiry. Findings: Opportunities identified in current practices included midwives’ sense of responsibility, their skills and experience, availability of resources, and group consultations. Barriers were the precarity and lack of prioritization of the topic, and the current focus on food safety (risks). Ideally, midwives envisioned nutrition communication as a continuous trajectory, in which not only reliable and consistent information is provided, but also more personalized and positive communication, to empower pregnant women. Key conclusions: Midwives favour nutrition communication practices characterized by continuity of care and woman-centeredness. Opportunities to realize such practices in antenatal care are the use of innovative tools to support nutrition communication, more sustainable collaborations with dietitians, and better nutrition education for midwives. Implications for practice: Midwives could act as facilitators and gatekeepers in nutrition communication, requiring limited time and expertise from midwives, and empowering pregnant women.