Teaching Nutrition Improves Birth Outcomes — Will You Help?

How Nutrition Impacts Labor, Birth, and Postpartum

As childbirth professionals, we all care about the labor and birth process, and the health of pregnant parents and their babies. We teach comfort techniques, informed decision-making, and other tools to help expectant parents have the kind of birth that they want and is most supportive for their situation.

How often have your students or clients been unable to use what they learned because they developed a genuine medical complication or something biologically didn’t “go right?” In these situations of genuine medical need, we are very grateful for the midwives and obstetricians who can use their medical expertise to intervene and create the best possible outcome for the situation.

What if they didn’t have to intervene so often?

We can influence that.

Before I go on, let me clarify that it is impossible to prevent every complication. Someone can do “everything right” and still have a complication or negative outcome. There are other factors at play — genetics, environment, plain (bad) luck, etc., that can create complications no matter what someone does. It’s the nature of life. A pregnant parent is never at fault for developing a complication, needing a cesarean, or any other “undesirable” outcome. All parents deserve support no matter what their pregnancy and birth journey look like, and whether the circumstances are chosen or happenstance.

We can, however, lower the risk of pregnancy complications and increase the chance of everything going well.

It is generally accepted that good nutrition is a key ingredient in a healthy pregnancy — and inadequate nutrition a key risk factor for pregnancy complications. This means that — at least in some cases — the cascade of interventions does not start with induction of labor or agreeing to an intervention. It often starts long before that with whether or not our bodies have enough of the right nutrients available to support the physiologic processes of pregnancy, labor, and birth.

The strong influence of nutrition applies not only to big complications like gestational diabetes, anemia, and preterm labor, but nutrition also strongly influences these issues and factors:

• PROM (via strength of the bag of waters)
• Cervical ripening
• Large for gestational age/Macrosomia
• Hormone balance (influencing both timing and progression of labor)
• Ability to regulate energy during labor
• Risk of postpartum hemorrhage
• And more

All of these factors can be influenced with changes in eating habits in late pregnancy. Obviously, making changes earlier is better, but even if an expectant parent makes changes just a few weeks before their due date, it can have a positive impact on the areas listed above.

Eating well in late pregnancy also sets pregnant people up for an easier postpartum recovery, replenishing depleted nutrients, and being able to better meet the nutritional needs of lactation.

OK, So What’s The Ideal Pregnancy Diet?

The short answer is: There isn’t one. Stating that there is a perfect pregnancy diet or distributing prenatal meal plans implies that there is one “right way” to eat. This is simply untrue. What we do know is that there are specific patterns of eating that tend to work well for most people, across cultures, all around the world, with some differences for individual needs. Traditional cultures discovered their own ways to be as healthy as possible in their region. Many of those traditional diets (not necessarily their modernized counterparts) share similar eating patterns. More importantly, any recommendations we make to make eating more healthy should be adaptable to different cultures and eating preferences. This makes recommendations of eating patterns (such as more whole foods, a variety of fruits and vegetables, sources of protein, etc.) more usable than set meal plans.

While discussing the “ideal diet”, it is important to acknowledge that the food we eat is more than nourishment to most of us — it is about social connection, emotional fulfillment, family, identity, and much more. Add in factors such as convenience, affordability, religious or cultural rules around food, preferences, food allergies and sensitivities, chronic health conditions, etc., and it is easy to see how different each person’s individual needs are (Tip: We call this bioindividuality). The good news is that we can make healthier choices in how we eat while still honoring all of our unique needs and preferences. Making changes can be more challenging when other people are involved, such as immediate family, but there are ways to work with that as well.

What Can Non-Medical Childbirth Professionals Do?

Childbirth educators, doulas, lactation consultants, and other non-medical childbirth professionals are in an ideal position to help! Your clients trust you as a source of information at a time when they are (generally) very open to making positive changes and typically will see you multiple times.

You don’t need to be a medical or nutrition professional, or even a health coach, to help pregnant (and new) parents improve their health through better nutrition. Sharing something like a healthy plate model and encouraging a few small changes goes a long way in helping people improve their eating habits. Even as a nutrition professional, a few small changes to eating habits is where I begin with about half of my 1:1 clients. In the context of your classes or sessions with expectant parents, you can help initiate positive changes with as little as five minutes of distributing resources, though focusing for 20 minutes on nutrition will have more impact.

Here are some easy ways you can support parents in improving eating habits:

• Give handouts with visual models showing categories of foods to eat.
• Share videos and infographics with healthy eating tips.
• Be respectful of cultural differences. There are many ways to eat healthy, and every culture and ethnic group has healthy ways of eating in their history.
• Always mention resources to assist with food insecurity. You never know who has trouble obtaining enough healthy food, so make resources known to all.
• Help parents choose a few (just 1-3!) habit changes to make at a time.
• Be encouraging! We all fall off the wagon.

A great and very affordable resource for these things is the continuing education presentation I created for Lamaze: “Improving Pregnancy Health and Postpartum Recovery with the Healthy Pregnancy Plate.”

Here is a sampling of what you get from the CEU presentation from Lamaze:

• An understanding of ways that nutrition influences the health of parents and babies during pregnancy, birth, and postpartum.
• The percentage of pregnant people who are not meeting the estimated average requirements for six key nutrients.
• Class segment “in a box” — a simple presentation you can use to educate your students/clients about perinatal nutrition.
• Access to all slides, handouts, and an optional video to support you sharing this information.
• 1.25 Lamaze credit hours/1.25 CNE credit hours (CBRN)

Access to 1:1 nutrition resources is limited, and often not covered by insurance unless a medical condition is present. Childbirth educators, doulas, and other childbirth professionals are in an ideal position to help get the foundations of good nutrition to a population that can benefit immediately — expectant parents.

Part of my mission is to help as many people as possible to improve their health before complications develop. We all need to work together on this to help lower the risk of low- and moderate-risk pregnant parents, so the time and energy of myself and my fellow nutritionists and dietitians can focus on helping the people who really need individualized attention.

Healthier Eating Supports Normal, Healthy Birth. Will You Help?

Whether you spend five minutes of your valuable interaction time with your students/clients or 20, only distribute some handouts or dive deep into nutrition, or simply share posts with helpful nutrition tips on social media, every small encouragement toward healthier eating patterns helps. By all working together, we can shift the trend in pregnancy and postpartum complications to start moving downward, where it belongs.

I hope you will help!

Get access to the CE program “Improving Pregnancy Health & Postpartum Recovery with the Healthy Pregnancy Plate” for 1.25 Lamaze CE or 1.25 CNE credits here.

Melinda Delisle, MS, LCCE, began teaching childbirth classes in 2000 and attended about 30 births as a doula. Melinda observed how nutrition and lifestyle dropped the preterm birth rate of her students and clients from 7.5% to 1%, hooking her on preventing pregnancy complications with these accessible tools. Melinda’s passion for reducing pregnancy complications remained strong through the years, causing her to pursue an MS in Human Nutrition (earned 2020) and certification as a Certified Nutrition Specialist (pending).

In addition to working with 1:1 clients, Melinda is striving to revolutionize the way we do prenatal and mental health care in the United States. She is systematizing what we know in medical, nutrition, and other health research to make more personalized recommendations accessible to a broader reach of people, which will improve health outcomes for all at a lower cost. You can find more information about Melinda and her mental health work at https://melindadelisle.com and her pregnancy nutrition work at https://confidentpregnancy.com/.

References

Amati, F., Hassounah, S., & Swaka, A. (2019). The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health. Nutrients, 11(5), 1098. https://doi.org/10.3390/nu11051098

Blondin, J. H., & LoGiudice, J. A. (2018). Pregnant women’s knowledge and awareness of nutrition. Applied Nursing Research, 39, 167–174. https://doi.org/10.1016/j.apnr.2017.11.020

Brown, J. E. (2017). Nutrition through the life cycle (Sixth edition). Cengage Learning.

De Vito, M., Alameddine, S., Capannolo, G., Mappa, I., Gualtieri, P., Di Renzo, L., De Lorenzo, A., D’ Antonio, F., & Rizzo, G. (2022). Systematic Review and Critical Evaluation of Quality of Clinical Practice Guidelines on Nutrition in Pregnancy. Healthcare, 10(12), 2490. https://doi.org/10.3390/healthcare10122490

Gernand, A. D., Schulze, K. J., Stewart, C. P., West, K. P., & Christian, P. (2016). Micronutrient deficiencies in pregnancy worldwide: Health effects and prevention. Nature Reviews. Endocrinology, 12(5), 274–289. https://doi.org/10.1038/nrendo.2016.37

Gropper, S. A. S., Smith, J. L., & Carr, T. P. (2018). Advanced nutrition and human metabolism (Seventh edition). Cengage Learning.

Lowensohn, R. I., Stadler, D. D., & Naze, C. (2016). Current Concepts of Maternal Nutrition. Obstetrical & Gynecological Survey, 71(7), 413–426. https://doi.org/10.1097/OGX.0000000000000329

Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2022). The importance of nutrition in pregnancy and lactation: Lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035