Written nutrition communication in midwifery practice: What purpose does it serve?

Objective: to obtain an in-depth understanding of verbal and written nutrition communication in Dutch midwifery practice. Design, setting and participants: data were collected by recording 12 initial antenatal consultations (12 weeks into the pregnancy) with primiparous women from four Dutch midwifery practices spread over The Netherlands, followed by two semi-structured qualitative interviews with the women. The interviews were undertaken on the day after the consultation and two weeks later. Findings: analysis of the recordings revealed that a nutrition brochure was offered in an information pack, but it was not used or referred to by the midwives. Verbally, clients were informed about healthy nutrition in general terms. Specific, personally relevant nutrition-related questions and motivators of nutrition behaviour were rarely clarified and addressed. Midwives tried to create a good relationship with their clients by being friendly, complimentary, confirmative and supportive. Women appreciated talking about nutrition with the midwife because of her expertise. The subsequent interviews with the women revealed, however, that nutrition communication took place relatively late in pregnancy at a point when women were more interested in 'hearing the baby's heart beat'. Furthermore, clients seldom looked through the nutrition brochure at home. Key conclusion: the provision of a nutrition brochure does not serve any real purpose. Implications for practice: to reach optimal synergy between verbal and written nutrition communication in midwifery practice, midwives should actively refer to a nutrition brochure in addition to verbal communication. Moreover, health organisations should realise that the provision of nutrition brochures to midwives does not mean that these brochures will be used as an integral part of midwives' nutrition communication with clients. (C) 2007 Elsevier Ltd. All rights reserved.