Australian midwives and provision of nutrition education during pregnancy: A cross sectional survey of nutrition knowledge, attitudes, and confidence.

Maternal nutrition during pregnancy affects the health of the mother and the baby. Midwives are ideally placed to provide nutrition education to pregnant women. There is limited published research evidence of Australian midwives' nutrition knowledge, attitudes and confidence. To investigate Australian midwives' nutrition knowledge, attitudes and confidence in providing nutrition education during pregnancy. Members of the Australian College of Midwives (n=4770) were sent an invitation email to participate in a web-based survey, followed by two reminders. The completion rate was 6.9% (329 of 4770). The majority (86.6% and 75.7%, respectively) highly rated the importance of nutrition during pregnancy and the significance of their role in nutrition education. Midwives' nutrition knowledge was inadequate in several areas such as weight gain, dairy serves and iodine requirements (73.3%, 73.2% and 79.9% incorrect responses, respectively). The level of confidence in discussing general and specific nutrition issues ranged mostly from moderate to low. The majority of the midwives (93%) provided nutrition advice to pregnant women. This advice was mostly described as 'general' and focused on general nutrition topics. Only half of the midwives reported receiving nutrition education during midwifery education (51.1%) or after registration (54.1%). Australian midwives' attitudes towards nutrition during pregnancy and their role in educating pregnant women about it were positive but their knowledge and confidence did not align with these attitudes. This could be due to minimal nutrition education during midwifery education or during practice. Continued education to improve midwives' nutrition knowledge and confidence is essential.

Arrish J ，Yeatman H ，Williamson M 《-》

Midwives and nutrition education during pregnancy: a literature review.

This review explored the extent to which the role of midwives in nutrition education during pregnancy has been reported in the literature and areas requiring further research were identified. A review of the literature was undertaken. Articles included in the review were published in English, in scholarly journals, and provided information about the knowledge, education, and attitudes of midwives towards nutrition during pregnancy. Few studies were identified. The included studies were exploratory and descriptive. Studies had reported that midwives lacked a basic knowledge of nutrition requirements during pregnancy. This might be attributed to inadequate nutrition education provided in both undergraduate and postgraduate midwifery programmes. The nutrition education components of midwifery courses were not identified within the studies reviewed. Limited international or Australian research is available that reports on the role of midwives in nutrition education during pregnancy and the nutrition content of midwifery curricula. This represents an important omission in midwives capacity to support the health of pregnant women and their babies. More research is required to explore the educational needs of midwives to enhance nutritional care for pregnant women.

Arrish J ，Yeatman H ，Williamson M 《-》

Self-Reported Nutrition Education Received by Australian Midwives before and after Registration.

Arrish J ，Yeatman H ，Williamson M 《-》

Certified Nurse-Midwives' Knowledge, Attitudes, and Behaviors About Infant Safe Sleep.

Little is known about the knowledge, attitudes, and behaviors of certified nurse-midwives related to sudden infant death syndrome and infant safe sleep. However, this population is an important and trusted source of information for pregnant women and may provide guidance on infant care. We explored these topics with certified nurse-midwives to identify potential barriers as well as enabling and reinforcing factors associated with providing infant safe sleep education in the prenatal health care environment. Participants in this cross-sectional survey study were certified nurse-midwives who provide prenatal health care to women in Ohio. Surveys were mailed to all certified nurse-midwives listed with the licensing registry of the Ohio Board of Nursing (N = 333). A total of 153 eligible respondents completed the survey for a response rate of 55%. Most participants had at least some knowledge of the infant safe sleep recommendations from the American Academy of Pediatrics, and two-thirds had positive attitudes about providing infant safe sleep education in the prenatal environment. Many participants (61%) perceived that there were barriers to providing prenatal infant safe sleep education, but nearly all (94%) indicated that they were interested in providing this education to their patients. Positive attitudes about providing infant safe sleep education were predictive of whether they discussed this topic with their patients. Certified nurse-midwives routinely provide guidance on infant care, and it is important that they are familiar with current evidence-based recommendations on infant safe sleep. They should be supported in their desire to provide infant safe sleep education to their prenatal patients. In addition, efforts should be made to improve attitudes and social norms related to providing infant safe sleep education in the prenatal environment.

Hodges NL ，Anderson SE ，McKenzie LB ，Katz ML ... -  《-》

How effectively do midwives manage the care of obese pregnant women? A cross-sectional survey of Australian midwives.

Obesity and overweight are common issues for pregnant women and their healthcare providers. Obesity in pregnancy is associated with poorer maternal and perinatal outcomes and presents particular challenges in day-to-day clinical practice. The aim of this study was to examine midwifery clinical practice for obese pregnant women. We conducted a cross-sectional survey of midwives using an on-line survey distributed to members of the Australian College of Midwives. Midwives were asked about: the extent to which they provided evidence-based care; their use of a clinical guideline; their education and training and confidence to counsel obese pregnant women. Data for the questions about knowledge, clinical practice and views of education and training were summarized using descriptive statistics. Unadjusted analyses were undertaken to examine the association between use of a guideline and provision of evidence-based care and ratings of education, training and counselling. The survey highlighted considerable variations in practice in the care and management of obese pregnant women. Respondents' clinical knowledge and their views about education and training and counselling skills highlighted some deficits. Those using a clinical guideline were more likely to report that they 'always': tell the woman she is overweight or obese (OR 3.5; 95% CI: 1.9, 6.4); recommend a higher dose of folic acid (OR 4.6; 95% CI: 1.9, 6.4); refer to an obstetrician (OR 2.9; 95% CI: 1.2, 3.4); prepare a pregnancy plan (OR 2.0; 95% CI: 1.2, 3.3) and plan to obtain an anaesthetic referral (OR 2.6; 95% CI: 1.5, 4.3). They were also more likely to report adequate/comprehensive education and training and greater confidence to counsel obese pregnant women. Registered midwives need continuing professional development in communication and counselling to more effectively manage the care of obese pregnant women. The universal use of a clinical guideline may have a positive impact by helping midwives to base early care decisions on clinical evidence.

Biro MA ，Cant R ，Hall H ，Bailey C ，Sinni S ，East C ... -  《-》