Providing guidance on foods to avoid or limit during pregnancy by midwives in England

Background The NHS website gives guidance for pregnant women in England on foods and drinks to avoid or limit because of microbiological, toxicological or teratogenic hazards. These include, for example, some types of soft cheeses, fish/seafood and meat products. This website and information provided directly from midwives are trusted sources of information(1) but the ways in which midwives can be supported to provide information are unknown.
Aims The aims were: (1) to identify the ways in which midwives provide this information; (2) to determine midwives’ confidence and knowledge in providing advice.
Methods  Registered Midwives practicing in England completed an online questionnaire. Questions included: (1) demographics; (2) listing the ways they provided information on foods to avoid/limit; (3) what information they provided and their confidence in doing so. Ethics approval was given by the University of Bristol.
Results The questionnaire was completed by 122 midwives. The most usual methods of providing information were verbal (80%, n=96) and signposting to websites (56%, n=67). Midwives were ‘Confident’/‘Very confident’ in providing advice for some food items (>80% for eggs, soft cheese, liver/liver products, alcohol). However, >10% were ‘Not at all confident’ in providing advice about cured meats (12%, n=14), herbal teas (13%, n=16), white fish (12%, n=14), peanuts (11%, n=13) and game meat/gamebirds (39%, n=48). Specifically with regard to fish, only 53% (n=64) correctly recalled the advice on oily fish, and only 38% (n=46) the advice on tinned tuna.
Conclusion Midwives were in general knowledgeable about foods to avoid or limit during pregnancy, but there were some foods for which they were unconfident, and some for which recall was mistaken. Delivery of guidance by midwives on foods to avoid or limit needs to be supported by appropriate training and access to resources. Further research on barriers to the delivery and implementation of the NHS guidance is needed.