Article Text
Abstract
Background Food insecurity is a situation of limited access to sufficient healthy food for people to live a healthy life. Pregnancy is a life stage important in which to consider the health impacts of food insecurity, as optimal antenatal nutrition is associated with best outcomes for the mother and offspring. Antenatal clinicians could play a role in identifying food insecurity; however, a food security screening system does not routinely exist across antenatal healthcare settings. The views and preferences of food-insecure pregnant women are required to understand how they wish to be best supported by antenatal clinicians.
Methods This qualitative study employed in-depth, semi-structured interviews to determine the insights of food-insecure pregnant women regarding screening within antenatal healthcare. Participants were food-insecure women receiving antenatal care at a tertiary-level maternity hospital in Melbourne, Australia. An interview guide was developed to explore experiences related to food insecurity and disclosure, particularly in the context of pregnancy, as well as preferences for modes of screening and the types of supportive strategies that may be offered by antenatal clinicians to address food insecurity. Data collection and qualitative content analysis occurred simultaneously, in a constant comparative approach to inductively identify patterns and themes in the data that were representative of participants’ views.
Results Women were accepting of food insecurity screening becoming embedded within routine care and considered screening an indicator of care and support by clinicians. Women identified reasons for non-disclosure of food insecurity, including feelings of shame, concerns of judgement of unfit parenting, and fear of adverse response from their spouse for exposing the household financial situation. Women indicated interest in private methods of screening, such as online assessment, rather than in person with a clinician. Women suggested food vouchers and referral to external support services as potential support strategies.
Conclusion Food-insecure pregnant women are accepting of food security screening within routine antenatal care, despite concerns of potential adverse consequences following disclosure. Antenatal healthcare settings should develop sensitive approaches to screening and support provision. This may necessitate clinician training to encourage a safe environment for women to disclose, and for healthcare settings to establish a suite of strategies to address identified food insecurity.