Care by Midwives, Obstetricians, and Dietitians for Pregnant Women Following a Strict Plant-Based Diet: A Cross-Sectional Study

Abstract

With an growing number of people on a strict plant-based diet, its potential effect on pregnancy and lactation becomes increasingly important. It is, however, unclear how obstetric caregivers currently handle and think about a strict plant-based diet in pregnancy. The aim of the study was therefore to evaluate the self-reported knowledge and advice given by Dutch obstetric caregivers and dietitians when treating pregnant women on a strict plant-based diet. A cross-sectional study was performed by sending an online survey to Dutch midwife practices, obstetricians, and dietitian practices. Descriptive statistics are reported. A total of 121 midwives, 179 obstetricians, and 111 dietitians participated in this study. The majority of midwives (80.2%) and obstetricians (93.9%) considered a strict plant-based diet to be a significant risk factor for nutrient deficiency during pregnancy. Maternal dietary preferences, including a potential strict plant-based diet, were discussed at the first prenatal appointment by 59.5% of midwives and 24.1% of obstetricians. A self-reported lack of knowledge concerning the strict plant-based diet was mentioned by 66.1% of midwives and 75.4% of obstetricians. Obstetric caregivers mostly considered the identification of this dietary habit and subsequent referral to a dietitian or a reliable website as optimal care for pregnant women on the strict plant-based diet. However, only 38.7% of dietitians indicated to have sufficient knowledge to counsel these women. Although obstetric caregivers thought that a strict plant-based diet in pregnancy may lead to increased risks of nutritional deficiencies, the majority report to have insufficient knowledge to provide adequate advice. Only a minority referred these women to dietitians, of whom a minority indicated to have adequate knowledge on this specific diet. These results suggest that current care is suboptimal for an increasing number of pregnant women. Women on a strict plant-based diet could benefit from increased knowledge about this topic among obstetric caregivers and dietitians, as well as from clear guidelines regarding this diet during pregnancy.

Knowledge of health professionals about vegetarian diets: integrative review

“…Most included studies were quantitative [14][15][16][17][18][19][20][21][22] . The only one with a qualitative-quantitative approach was McHugh et al 23 .…”

“…Ten studies were conducted with physicians or medical students 13,14,[17][18][19][21][22][23] . Four 15,[21][22][23] also included other health professionals such as nurses, osteopaths, midwives, dentists, and dieticians.…”

“…Ten studies were conducted with physicians or medical students 13,14,[17][18][19][21][22][23] . Four 15,[21][22][23] also included other health professionals such as nurses, osteopaths, midwives, dentists, and dieticians. One 20 included only dietitians or nutritionists, and another 16 was conducted with directors of the US dietetics programs, who were supposed to be nutritionists/dieticians, although the aim was to investigate the curricular practices of the courses regarding vegetarian diets.…”

Mind the B2: Life-Threatening Neonatal Complications of a Strict Vegan Diet during Pregnancy

“…Professionals involved in the care of pregnant women reported awareness of the risks for nutrient deficiencies of a vegan diet during pregnancy as well as a lack of knowledge for adequate counselling. Only 25% of midwives and 14.5% of obstetricians reported referring pregnant women on a vegan diet to a dietician and only 40% of dieticians felt capable to advise pregnant women on a vegan diet [2].…”

“…In a large survey, 6% of US citizens reported following a vegan diet [1]. The majority of vegans is female and of reproductive age [2]. A vegan diet imposes a risk for nutrient deficiencies, especially for pregnant females who have a higher recommended daily intake (RDI).…”