Motivating pregnant women to eat healthily and engage in physical activity for weight management: an exploration of routine midwife instruction. An exploration of routine midwife instruction

Background. The importance of antenatal education for supporting and advising women about diet and physical activity for weight management has been highlighted in recent guidelines. However, little is known about how midwives (through routine instruction) aim to influence maternal motivation for healthy behaviours. Aim. To explore the motivational content of routine antenatal instruction provided by midwives relating to diet, physical activity and weight management as a means of identifying any strengths, weaknesses and deficits.Method. A non-participant, semi-structured observation approach was undertaken. All written and verbal instruction relating to diet, physical activity and weight management was collected through a semi-structured observation schedule. Barron and Harackiewicz (2000) conceptualisation of goals was chosen as a framework for analysis. Content and thematic analysis was undertaken to identify key patterns or themes that emerged from the data.Key Findings. The type and frequency of the goals communicated to women about diet and physical activity during pregnancy varied considerably, depending on the individual midwife, with no apparent standardised procedure being followed. There was evidence of midwives strongly communicating the value of these behaviours. However, three motivational deficits were identified: lack of purpose goals within verbal instruction; lack of performance feedback indicators; and target goals often lacked specificity and relevance.Conclusions. Findings suggest that the motivational potential of routine antenatal instruction is yet to be fulfilled. Although a purpose goal and target goal structure was evident, several motivational problems have been identified. Lack of purpose goals in verbal instruction and almost non-existent feedback prevent antenatal education from fulfilling its potential to motivate women.Implications. Now that these critical gaps have been identified, they can be addressed in order to create an optimally motivated environment that supports women in making healthy lifestyle choices. Midwives and other healthcare professionals would benefit from training and sufficient resources in order to empower them with the knowledge and skills that they need to effectively communicate and support women in their care

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