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Young women’s and midwives’ perspectives on improving nutritional support in pregnancy: the Babies, Eating and LifestyLe in Adolescence (BELLA) Study

Young women’s and midwives’ perspectives on improving nutritional support in pregnancy: the Babies, Eating and LifestyLe in Adolescence (BELLA) Study
Young women’s and midwives’ perspectives on improving nutritional support in pregnancy: the Babies, Eating and LifestyLe in Adolescence (BELLA) Study
Rationale: Teenage pregnancy has a high risk of poor outcomes for both mother and baby. Teenage girls have the poorest diets of any population group in the UK, which compounds the risk of poor pregnancy outcomes. Pregnant teenagers trust advice from their midwives, but midwives feel they do not have time, confidence, or knowledge to discuss nutrition.

Objective: This study examined how the relationship between pregnant teenagers and their midwives could be utilised to deliver support to improve diet quality.

Method: Qualitative interviews were conducted across three urban sites in the UK: Manchester, Doncaster, and Southampton with adolescent mothers and their midwives regarding diet and lifestyle, and what form of support would be helpful. In total, 106 young women and 20 midwives were interviewed. Most of the young mothers were 19 or younger (67%). Half had had their first child in the past year (52%) and 21% were pregnant during the study. Thematic analysis was used to identify ways to better support young mothers to eat well.

Results: Young women found it difficult to prioritise healthy eating; they often felt isolated and not in control of their own lives and wanted support from their midwife. Midwives felt that it was their role to support young mothers with diet in pregnancy but were anxious about initiating conversations and felt they lacked clear guidance.

Conclusions: Pregnant teenagers and their midwives lack reliable resources and strategies for healthy eating support. An effective intervention to improve pregnant teenagers' diet quality must empower, inform, and motivate young mothers and their midwives, and enable connections between young mothers.
Diet, Midwives, Nutrition, Qualitative study, Teenage pregnancy
0277-9536
1-10
Strommer, Sofia
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Weller, Susie
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Morrison, Leanne
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Soltani, Hora
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Stephenson, Judith
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Whitworth, Melissa
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Rundle, Rachel
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Brewin, Jane
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Poston, Lucilla
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Lawrence, Wendy
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Barker, Mary
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Strommer, Sofia
a025047e-effa-4481-9bf4-48da1668649e
Weller, Susie
6ad1e079-1a7c-41bf-8678-bff11c55142b
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
Soltani, Hora
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Stephenson, Judith
b115169f-d010-4c24-8654-222613c3ed5c
Whitworth, Melissa
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Rundle, Rachel
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Brewin, Jane
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Poston, Lucilla
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Lawrence, Wendy
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Barker, Mary
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Strommer, Sofia, Weller, Susie, Morrison, Leanne, Soltani, Hora, Stephenson, Judith, Whitworth, Melissa, Rundle, Rachel, Brewin, Jane, Poston, Lucilla, Lawrence, Wendy and Barker, Mary (2021) Young women’s and midwives’ perspectives on improving nutritional support in pregnancy: the Babies, Eating and LifestyLe in Adolescence (BELLA) Study. Social Science & Medicine, 274, 1-10, [113781]. (doi:10.1016/j.socscimed.2021.113781).

Record type: Article

Abstract

Rationale: Teenage pregnancy has a high risk of poor outcomes for both mother and baby. Teenage girls have the poorest diets of any population group in the UK, which compounds the risk of poor pregnancy outcomes. Pregnant teenagers trust advice from their midwives, but midwives feel they do not have time, confidence, or knowledge to discuss nutrition.

Objective: This study examined how the relationship between pregnant teenagers and their midwives could be utilised to deliver support to improve diet quality.

Method: Qualitative interviews were conducted across three urban sites in the UK: Manchester, Doncaster, and Southampton with adolescent mothers and their midwives regarding diet and lifestyle, and what form of support would be helpful. In total, 106 young women and 20 midwives were interviewed. Most of the young mothers were 19 or younger (67%). Half had had their first child in the past year (52%) and 21% were pregnant during the study. Thematic analysis was used to identify ways to better support young mothers to eat well.

Results: Young women found it difficult to prioritise healthy eating; they often felt isolated and not in control of their own lives and wanted support from their midwife. Midwives felt that it was their role to support young mothers with diet in pregnancy but were anxious about initiating conversations and felt they lacked clear guidance.

Conclusions: Pregnant teenagers and their midwives lack reliable resources and strategies for healthy eating support. An effective intervention to improve pregnant teenagers' diet quality must empower, inform, and motivate young mothers and their midwives, and enable connections between young mothers.

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Accepted/In Press date: 13 February 2021
e-pub ahead of print date: 17 February 2021
Published date: 1 April 2021
Additional Information: Funding Information: In the UK, adolescent mothers have their pregnancy confirmed by their GP, who then refer them to midwifery care, though young mothers are known to present for their first appointment late in their pregnancy ( McDonald et al., 2020 ). It is traditionally considered part of a midwife's or family nurse practitioner's role to provide nutritional support ( Soltani et al., 2017 ). Young women who are underweight or obese are usually referred to specialist care with a doctor. In areas where it is available, specialist teenage pregnancy midwives provide all or some of their care and may offer slightly longer appointment times. The Family Nurse Partnership (FNP) provides comprehensive support for adolescent mothers but only the most vulnerable are eligible and it is not available nationally. Other care models include Mother and Baby Units, a form of supported housing funded by NHS England as part of a national perinatal mental health programme. These units allow expectant and new mothers with mental health needs to be cared for with their babies. Funding Information: JS has received funding from NIHR (senior investigator award, 2019–2023), outside the submitted work. LP is part of an academic consortium that has received research funding from Abbott Nutrition and Danone . WTL and MB report personal fees, consultancy, lecture fees, and honoraria from Danone Nutricia, outside the submitted work. All other authors have no conflicts of interest to declare. Publisher Copyright: © 2021 Elsevier Ltd
Keywords: Diet, Midwives, Nutrition, Qualitative study, Teenage pregnancy

Identifiers

Local EPrints ID: 447387
URI: http://eprints.soton.ac.uk/id/eprint/447387
ISSN: 0277-9536
PURE UUID: a5e20197-4aa9-4dbb-acd3-7abbbd80c406
ORCID for Susie Weller: ORCID iD orcid.org/0000-0002-6839-876X
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217

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Date deposited: 10 Mar 2021 17:41
Last modified: 27 Feb 2024 05:06

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Contributors

Author: Sofia Strommer
Author: Susie Weller ORCID iD
Author: Leanne Morrison ORCID iD
Author: Hora Soltani
Author: Judith Stephenson
Author: Melissa Whitworth
Author: Rachel Rundle
Author: Jane Brewin
Author: Lucilla Poston
Author: Wendy Lawrence ORCID iD
Author: Mary Barker ORCID iD

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