Antenatal healthcare providers' knowledge, attitudes and practices regarding food insecurity in pregnancy: A qualitative investigation based at a specialist antenatal hospital in Melbourne, Australia

Abstract

Background: Food insecurity exists when accessibility and availability of nutritious food is restricted, increasing the risk of adverse health outcomes. Pregnant women are especially vulnerable to food insecurity, which is concerning as optimal nutrition to support both their own health and the health and growth of their unborn child is critical. Antenatal healthcare providers (AHPs) are central to provision of pregnancy care. We aimed to assess AHPs' knowledge, attitudes and management of food insecurity. Methods: Semi-structured interviews were conducted face-to-face, via telephone or online via Webex with 16 AHPs at the Royal Women's Hospital located in Melbourne, Australia. Interviews were thematically analysed according to Charmaz's constructivist grounded theory approach to ascertain AHPs' knowledge, attitudes and practices regarding food insecurity during pregnancy. Results: AHPs had limited knowledge and awareness of food insecurity in pregnancy. Lack of experience in managing food insecurity and time constraints limit their capacity to support and deliver care to food-insecure women. There was a reported lack of structure and clarity surrounding referral pathways for effective management of food insecurity during pregnancy, as well as a lack of clarity regarding practitioner responsibility in managing this issue. Conclusions: Current assessment and management of food insecurity during pregnancy in the antenatal setting is suboptimal. Professional development strategies targeted to AHPs are urgently needed to assist optimal care of women who are food insecure during pregnancy to assist with supporting best maternal and child health.