Registered Dietitians’ Experiences and Perceptions in Providing Prenatal Nutrition Care in Canada: A Cross-sectional Study
Publication: Canadian Journal of Dietetic Practice and Research
14 March 2025
Abstract
Purpose: To explore Canadian Registered Dietitians’ (RDs) roles and experiences in prenatal care.
Methods: This cross-sectional study utilized an online, anonymous, original survey. Eligible RDs, who are members of Dietitians of Canada (DC) and provide care for pregnancy, were invited to participate through their publicly available online profiles on the DC website.
Results: Of the 71 RDs who completed the survey, 97.1% provided nutrition care when requested by the client, 68.8% in times of complications, and 60.0% through referrals. RDs most frequently discussed topics on foods to avoid, supplementation, and healthy eating. Only 4.3% of RDs felt that other prenatal healthcare providers (HCPs) are providing adequate nutritional care, while all (100.0%) RDs believed that they should be the ones providing nutrition care for pregnancy, and most (88.6%) thought they should start providing nutrition counselling during preconception. Most (92.9%) respondents acknowledged that barriers exist in accessing RDs for nutrition advice. Recommendations for improving RD accessibility included increased government funding, involvement in standard care and referrals, awareness, and remote access.
Conclusions: Canadian RDs would like to play a larger role in prenatal care through a more integrated approach with other prenatal HCPs and improved access to dietetic services for all pregnant people.
Résumé
Objectif. Explorer les rôles et expériences des diététistes canadiens en soins prénatals.
Méthodes. Cette étude transversale a été basée sur un sondage original et anonyme diffusé en ligne. Des diététistes admissibles membres des Diététistes du Canada (DC) offrant des soins associés à la grossesse ont été invités à participer par l’entremise de leur profil en ligne accessible au public sur le site Web des DC.
Résultats. Sur les 71 diététistes ayant répondu au sondage, 97,1 % offraient des soins nutritionnels à la demande de la cliente, 68,8 % en contexte de complications et 60,0 % à des clientes à qui ils avaient été recommandés. Les diététistes abordaient le plus souvent des sujets tels que les aliments à éviter, la supplémentation et la saine alimentation. Seuls 4,3 % des diététistes estimaient que les autres professionnels de la santé (PS) travaillant en contexte prénatal fournissent des soins nutritionnels adéquats, 100,0 % croyaient que ce sont eux qui devraient fournir des soins nutritionnels liés à la grossesse et la plupart (88,6 %) pensaient qu’ils devraient commencer à offrir du counseling en nutrition avant la conception. La plupart (92,9 %) des répondants ont reconnu qu’il existe des obstacles à l’accès à des conseils sur la nutrition offerts par des diététistes. Les recommandations visant à améliorer l’accessibilité aux diététistes étaient une hausse du financement public, la participation aux soins standards, de même que les recommandations, la sensibilisation et l’accès à distance.
Conclusions. Les diététistes canadiens aimeraient jouer un plus grand rôle dans les soins prénatals grâce à une approche plus intégrée avec les autres PS travaillant en contexte prénatal et à un meilleur accès aux services des diététistes pour toutes les personnes enceintes.
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Financial support: This study was not funded.
Conflicts of interest: The authors declare that they have no competing interests.
REFERENCES
1
Killeen SL, Geraghty AA, O’ Brien EC, O’Reilly SL, Yelverton CA, and McAuliffe FM. Addressing the gaps in nutritional care before and during pregnancy. Proc Nutr Soc. 2022 Mar;81(1):87–98.
2
Martínez García RM, Jiménez Ortega AI, Peral Suárez Á, Bermejo López L, and Rodríguez-Rodríguez E. Importancia de la nutrición durante el embarazo. Impacto en la composición de la leche materna [Importance of nutrition during pregnancy. Impact on the composition of breast milk]. Nutr Hosp. 2021 Jan;37(Spec No2):38–42.
3
Brunner S, Stecher L, Ziebarth S, Nehring I, Rifas-Shiman SL, and Sommer C. Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis. Diabetologia. 2015 Oct;58(10):2229–37.
4
Goldstein RF, Abell SK, Ranasinha S, Misso ML, Boyle JA, Harrison CL, et al. Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women. BMC Med. 2018 Aug;16(1):153.
5
Liu X, Wang H, Yang L, Zhao M, Magnussen CG, and Xi B. Associations between gestational weight gain and adverse birth outcomes: A population-based retrospective cohort study of 9 million mother-infant pairs. Front Nutr. 2022;9:811217.
6
Voerman E, Santos S, Inskip H, Amiano P, Barros H, Charles MA, et al. Association of gestational weight gain with adverse maternal and infant outcomes. JAMA. 2019 May;321(17):1702–15.
7
Killeen SL, Donnellan N, O’Reilly SL, Hanson MA, Rosser ML, Medina VP, et al. Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals. Int J Gynaecol Obstet. 2023 Jan;160(Suppl 1):10–21.
8
World Health Organization. Good maternal nutrition: The best start in life; 2016 [cited 2023 Aug 28]. Available from: https://www.euro.who.int/__data/assets/pdf_file/0008/313667/Good-maternal-nutrition-The-best-start-in-life.pdf
9
Cantor AG, Jungbauer RM, McDonagh M, Blazina I, Marshall NE, Weeks C, et al. Counseling and behavioral interventions for healthy weight and weight gain in pregnancy: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021 May;325(20):2094–109.
10
Teweldemedhin LG, Amanuel HG, Berhe SA, Gebreyohans G, Tsige Z, and Habte E. Effect of nutrition education by health professionals on pregnancy-specific nutrition knowledge and healthy dietary practice among pregnant women in Asmara, Eritrea: a quasi-experimental study. BMJ Nutr Prev Health. 2021 Apr;4(1):181–94.
11
Premji S, McDonald SW, Zaychkowsky C, and Zwicker JD. Supporting healthy pregnancies: Examining variations in nutrition, weight management and substance abuse advice provision by prenatal care providers in Alberta, Canada. A study using the All Our Families cohort. PLoS One. 2019 Jan;14(1):e0210290.
12
Public Health Agency of Canada. Family-centred maternity and newborn care: National guidelines [Internet]. Ottawa: Public Health Agecy of Canada; 2017 [cited 2023 Aug 28]. Available from: https://www.canada.ca/en/public-health/services/maternity-newborn-care-guidelines.html
13
Morris J, Nikolopoulos H, Berry T, Jain V, Vallis M, Piccinini-Vallis H, et al. Healthcare providers’ gestational weight gain counselling practises and the influence of knowledge and attitudes: a cross-sectional mixed methods study. BMJ open. 2017 Nov;7(11):e018527.
14
Johnsen M, Braaten T, Skeie G, Laholt H, and Hansen S. Midwives and public health nurses’ knowledge and clinical practice in securing sufficient iodine status in relation to pregnancy. A cross-sectional study. Nurs Open. 2023 Jul;10(7):4321–35.
15
Killeen SL, Callaghan SL, Jacob CM, Hanson MA, and McAuliffe FM. Examining the use of the FIGO Nutrition Checklist in routine antenatal practice: multistakeholder feedback to implementation. Int J Gynaecol Obstet. 2020 Sep;151(Suppl 1):51–6.
16
Arrish J, Yeatman H, and Williamson M. Midwives and nutrition education during pregnancy: A literature review. Women Birth. 2014 Mar;27(1):2–8.
17
Escañuela Sánchez T, Meaney S, O’Connor C, et al. Facilitators and barriers influencing weight management behaviours during pregnancy: a meta-synthesis of qualitative research. BMC Pregnancy Childbirth. 2022;22(1):682.
18
Snyder A, Neufeld HT, and Forbes L. A mixed-methods investigation of women’s experiences seeking pregnancy-related online nutrition information. BMC Pregnancy Childbirth. 2020;20(1):377.
19
Mackintosh N, Agarwal S, Adcock K, et al. Online resources and apps to aid self-diagnosis and help seeking in the perinatal period: A descriptive survey of women’s experiences. Midwifery. 2020;90:102803.
20
Unlock Food. What is a dietitian?; 2023 [cited 2023 Aug 28]. Available from: https://www.unlockfood.ca/en/Articles/About-Dietitians/What-is-a-Dietitian.aspx
21
College of Dietitans of Ontario. About registered dietitians; 2022 [cited 2023 Aug 28]. Available from: https://www.collegeofdietitians.org/public/about-registered-dietitians.aspx#:∼:text=Registered%20Dietitians%20(RDs)%20in%20Ontario.
22
Hanifi M, Liu W, Twynstra J, and Seabrook JA. Does dietitian involvement during pregnancy improve birth outcomes? A systematic review. Can J Diet Pract Res. 2023 May:1–13.
23
Misita D, Aulakh S, Jain V, Quintanilha M, Ospina MB, and Bell RC. Prenatal nutrition care in Alberta: The perspectives of pregnant women and registered dietitians. Can J Diet Pract Res. 2023 Jun;84(2):77–83.
24
Buckingham-Schutt LM, Ellingson LD, Vazou S, and Campbell CG. The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain. Am J Clin Nutr. 2019 Apr 1;109(4):1071–9.
25
Eysenbach G. Improving the quality of web surveys: the Checklist for reporting results of internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3):e34.
26
Barker D, Barker M, Fleming T, and Lampl M. Developmental biology: Support mothers to secure future public health. Nature. 2013 Dec 12;504(7479):209–11.
27
Zhu Y, Hedderson MM, Brown SD, et al. Healthy preconception and early-pregnancy lifestyle and risk of preterm birth: a prospective cohort study. Am J Clin Nutr. 2021;114(2):813–821.
28
Jarman M, Mathe N, Ramazani F, Pakseresht M, Robson PJ, Johnson ST, et al. Dietary patterns prior to pregnancy and associations with pregnancy complications. Nutrients. 2018 Jul;10(7):914.
29
Stephenson J, Heslehurst N, Hall J, Schoenaker D, Hutchinson J, Cade JE, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet. 2018 May;391(10132):1830–41.
30
Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022 May;226(5):607–632.
31
Mazza D, Chapman A, and Michie S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Serv Res. 2013 Jan;13:36.
32
Mazza D and Chapman A. Improving the uptake of preconception care and periconceptional folate supplementation: what do women think? BMC Public Health. 2010 Dec;10:786.
33
Tough SC, Clarke M, Hicks M, and Cook J. Pre-conception practices among family physicians and obstetrician-gynaecologists: results from a national survey. J Obstet Gynaecol Can. 2006 Sep;28(9):780–8.
34
Town M, Smoliak O, Brauer P, and Forbes L. Prenatal nutrition in team-based care: Current practices and opportunities for optimization of care. Can J Diet Pract Res. 2019 Sep;80(3):96–103.
35
Epstein NE. Multidisciplinary in-hospital teams improve patient outcomes: A review. Surg Neurol Int. 2014 Aug;5(Suppl 7):S295–303.
36
Public Healthy Agency of Canada. Family-centred maternity and newborn care: National guidelines [Internet]. Ottawa: Public Healthy Agency of Canada; 2017 [cited 2023 Aug 28]. Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/maternity-newborn-care-guidelines-chapter-8.html.
37
Alayoub H, Curran S, Coffey M, Hatunic M, and Higgins M. Assessment of the effectiveness of group education on knowledge for women with newly diagnosed gestational diabetes. Ir J Med Sci. 2018 Feb;187(1):65–8.
38
Magee LA, Cote AM, Joseph G, Firoz T, and Sia W. Obstetric medical care in Canada. Obstet Med. 2016 Sep;9(3):117–9.
39
Super S, Beulen YH, Koelen MA, and Wagemakers A. Opportunities for dietitians to promote a healthy dietary intake in pregnant women with a low socio-economic status within antenatal care practices in the Netherlands: a qualitative study. J Health Popul Nutr. 2021 Jul;40(1):35.
40
Mosher L, Seabrook J, and Twynstra J. Identifiable dietary patterns of pregnant women: A Canadian sample. Can J Diet Pract Res. 2022 Sep;83(3):104–11.
41
Brennand EA, Dannenbaum D, and Willows ND. Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain. J Obstet Gynaecol Can. 2005 Oct;27(10):936–44.
42
Dzakpasu S, Fahey J, Kirby RS, Tough SC, Chalmers B, Heaman MI, et al. Contribution of prepregnancy body mass index and gestational weight gain to caesarean birth in Canada. BMC Pregnancy Childbirth. 2014 Mar;14:106.
43
Kolahdooz F, Launier K, Nader F, Yi KJ, Baker PN, McHugh T-L, et al. Canadian Indigenous women’s perspectives of maternal health and health care services: A systematic review. Divers Equal Health Care. 2016;13(5):334–48.
44
Dewing M. Canadian multiculturalism [Internet]. Ottawa: Canada. Library of Parliament. Parliamentary Research Branch. 2009 [cited 2023 Aug 28] 26 p. Available from: https://publications.gc.ca/collections/collection_2010/bdp-lop/prb/prb0920-eng.pdf
45
Nemec K. Cultural awareness of eating patterns in the health care setting. Clin Liver Dis (Hoboken). 2020 Dec;16(5):204–207.
46
Murray-Davis B, Berger H, Melamed N, Mawjee K, Syed M, Barrett J, et al. Gestational weight gain counselling practices among different antenatal health care providers: a qualitative grounded theory study. BMC Pregnancy Childbirth. 2020 Feb;20(1):102.
47
Lieffers JR, Vance VA, and Hanning RM. Use of mobile device applications in Canadian dietetic practice. Can J Diet Pract Res. 2014 Spring;75(1):41–7.
48
Nasser R, Morley C, Cook S, Coleman J, and Berenbaum S. Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training. Can J Diet Pract Res. 2014 Spring;75(1):7–14.
49
Unlock Food. Where do dietitans work and what do they do?; 2024 [cited 2024 June 3]. Available from: https://www.unlockfood.ca/en/Articles/About-Dietitians/Where-do-dietitians-work-and-what-do-they-do.aspx
50
Dietitians of Canada. Building a sustainable organization: Annual report 2022-2023; 2023 [cited 2024 June 3]. Available from: https://www.dietitians.ca/DietitiansOfCanada/media/Documents/AGM%20reports%20and%20financials/AGM%20documents,%20reports%20and%20financials%202023/DC-ANNUAL-REPORT-2022-2023.pdf?ext=.pdf
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Canadian Journal of Dietetic Practice and Research
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Editor: Naomi Cahill
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Version of record online: 14 March 2025
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SarahWildingMScFN RD, JoelleFrancisMScFN RD, Jamie A.SeabrookPhD, and JasnaTwynstraPhD. Registered Dietitians’ Experiences and Perceptions in Providing Prenatal Nutrition Care in Canada: A Cross-sectional Study. Canadian Journal of Dietetic Practice and Research.
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https://doi.org/10.3148/cjdpr-2024-027
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