Background During the first 1,001 days women and their infants are distinctively vulnerable in terms of their susceptibility to food insecurity, and its impact. Food insecurity during this period can have an adverse impact on maternal and foetal health and child development. However, we have a poor understanding of the experiences of this group. Therefore, this research aimed to explore the experiences of food insecurity both during and after pregnancy in relation to the support services they find useful and need.

Methods This study was ethically approved (Ref No: LRS/DP-23/24-39437) and pre-registered on OSF Registries (https://osf.io/9hn6r). Semi-structured mixed format individual interviews were conducted between November 2023 and February 2024. Pregnant individuals, those who had given birth <12 months ago, >18 years old, food insecure, residing in Lambeth, South London with recourse to public funds were recruited through purposive sampling. The topic guide was informed by food insecurity, pregnancy and postpartum related literature and piloted with a nutrition expert and mother. Interviews were audio-recorded and professionally transcribed verbatim. Demographic data was summarised using SPSS. Inductive Thematic Analysis was completed using NVivo.

Results Eleven food insecure participants (2 pregnant, 9 new mothers) participated in this research. Findings are part of ongoing analysis and represented by three themes: 1) Beyond food: Push and Pull, 2) System Soothers, and 3) Creating Coordinated Care. Theme one illustrates how food insecurity sits within societal systems beyond the food system which work against participants to drain and block their household income, thus is conducive to food insecurity around the pregnancy period. Theme two relates to informal and formal support services ‘soothing’ the experience of food insecurity. This theme also provides insight into what’s working well locally whilst revealing an inconsistency in coordination of care across the first 1,001 days. Theme three discusses future solutions to improve the experience of food insecurity during and after pregnancy.

Conclusion This is the first research to provide in-depth qualitative insights into the systematic barriers faced by this vulnerable group experiencing food insecurity. Participants provided policy recommendations to enhance support during the first 1,001 days, including early identification of food insecurity during pregnancy. Further highlighted was the preference of healthcare professional as a route of access to these support services. Future research should consider exploring the experiences of those without recourse to public fund who may have a more severe form of food insecurity, and thus have additional barriers/needs.