title: A questioned authority meets well-informed pregnant women--a qualitative study examining how midwives perceive their role in dietary counselling.
abstract: BACKGROUND
  During pregnancy and afterward, a healthy diet is beneficial for the expecting mother and her foetus. Midwives in antenatal care have an ideal position for promoting healthy diets. Dietary counselling is however complex and recommendations can be controversial. While pregnant women struggle with dietary recommendations, midwives struggle with a lack of authority. The aim of the study was therefore to describe how midwives perceive their role and their significance in dietary counselling of pregnant women.
  
  
  METHODS
  An interview study was conducted that involved twenty-one (21) experienced midwives, who worked in the Swedish prenatal health care. A qualitative content analysis was conducted.
  
  
  RESULTS
  Pregnant women were perceived to be well informed, but they needed guidance to interpret information on the Internet. They were described as rigorous and eager information seekers who needed guidance to interpret information as they were worried and emotional. The midwives saw themselves as a questioned authority who lacked support. This meant being informative and directive though not always updated or listened to. Their impact was uncertain and they could also lack sufficient competence to counsel in delicate issues.
  
  
  CONCLUSIONS
  The midwives' directive role may obstruct the women's needs to manage the dietary recommendations and risk evaluation in a women-centred dialogue. Midwives need to acknowledge pregnant women as both well informed and skilled if they are going to develop woman-centred antenatal care. Ongoing training and self-reflection will be needed to make this change.
authors: Department of Public Health and Clinical Medicine, Family Medicine, University Hospital, SE-901 85, Umeå, Sweden. annalena.wennberg@umu.se.|Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden. annalena.wennberg@umu.se.
authors: Anna-Lena
authors: AL
authors: Wennberg
authors: Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden. asa.hornsten@umu.se.
authors: Åsa
authors: Å
authors: Hörnsten
authors: Department of Public Health and Clinical Medicine, Family Medicine, University Hospital, SE-901 85, Umeå, Sweden. katarina.hamberg@umu.se.
authors: Katarina
authors: K
authors: Hamberg
mesh_terms: D001291:Attitude of Health Personnel; D003376:Counseling; D004032:Diet; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D008880:Midwifery; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D013548:Sweden