November 11, 2016

Study identifies key nutrition knowledge gaps in Australian midwives

Academics call for better training of Australian midwives to help address nutrition-related issues in pregnancy

Midwives need better support to address the high rates of Australian pregnant women whose diets are not consistent with nutrition guidelines, a new study has found.

The study, conducted by public health researchers at the University of Wollongong (UOW) and Central Queensland University, was published in the journal Women and Birth. It found Australian midwives are well placed to promote nutrition in pregnancy but most have a significant knowledge gap and are not confident discussing nutrition with pregnant women.

The survey of more than 300 members of the Australian College of Midwives found while the majority (86 per cent) of midwives believed nutrition during pregnancy was important, their nutrition knowledge was poor in several areas.

For example, 79 per cent of respondents did not know how much iodine pregnant women needed. Inadequate levels of iodine can lead to abnormal brain development in the unborn baby.

In addition, 73 per cent of respondents did not know how much weight a women of normal weight should gain during pregnancy and 73 per cent did not know the Australian guidelines for how many serves of dairy foods pregnant women need to consume.

The study also found midwives only had moderate to low confidence in discussing nutrition issues.

“This finding is not surprising,” study co-author Professor Heather Yeatman said. “Only half of the midwives reported they received nutrition education during their degree and about the same number (54 per cent) after registration”.

Professor Yeatman is Head of the School of Health and Society at UOW and Vice-President (Development) of the Public Health Association of Australia. She said “this significant knowledge gap needs to be addressed urgently for the sake of health of pregnant women”.

“Pregnancy is a time when women are keen to eat well. They want to ensure their babies have a healthy start in life. Poor diet during pregnancy can result in babies being underweight (or overweight), brain dysfunction, loss of intelligence or risk of chronic disease later in life,” she said.

“Pregnancy is also a time to reinforce healthy eating habits going forward, as women want to regain their pre-pregnancy weight and young children’s eating behaviours sets down eating patterns for life. All health professionals have a role in educating about and reinforcing healthy eating.”

Professor Yeatman said more education is needed, both during midwives’ training and post qualification.

“The Australian Government has released clinical practice guidelines for all health professionals involved in antenatal care, which reinforce the need for nutrition education. However, these guidelines are quite general. They also are yet to be translated into professional accreditation requirements that direct professional education programs.”

Dietician Jamila Arrish, a PhD student at UOW’s School of Health and Society, who led the study, said she also found those who worked in independent midwifery practices were more knowledgeable than those working in public hospitals, with those working in rural hospitals having the least nutrition knowledge.

“If they are expected to provide nutrition advice as current clinical guidelines recommend, practising midwives will need continuing education and support from the national bodies of the profession and their work places to help fill their knowledge gaps and improve their confidence levels,” Jamila said.

Main photo: Professor Heather Yeatman. Inset: PhD student Jamila Arrish. Credit: Paul Jones