Delivering Optimal weight gain advice To pregnant women study.

This is a feasibility study. It seeks to determine the feasisbility of a Lead Maternity Carer (LMC) midwife delivering a structured dietary intervention to achieve recommended healthy weight gain during pregnancy for the wellbeing of the mother and the development and growth of the foetus. In this feasibility study we will examine the actual time required to comfortably deliver the structured weight management intervention, how best to collect and collate data from the maternity consultations and obtain data to inform sample size calculations for the main trial. We will recruit 8 midwives who will each recruit 3-5 women with a singleton pregnancy at <15 weeks gestation. Midwives will be trained to deliver the structured dietary intervention as part of antenatal care. The training will involve attending a 6 hour workshop delivered by the researchers (public health physician, obstetrician, midwife, nurse and dietitian). The topics covered in the workshop will include the study rationale, nutrition principles and food label reading, familiarisation with the structured dietary advice approach and case studies. The dietary advice will be based on the New Zealand recommendations in the Ministry of Health 'Guidance for Healthy Weight Gain in Pregnancy 2014'. Participating pregnant women will be invited to attend up to 3 additional antenatal appointments before 22 weeks gestation for specific nutritional advice. The first nutrition in pregnancy appointment will be ideally at 10 weeks gestation, but before 15 weeks gestation. This appointment will be 30-45 minutes during which time a dietary assessment will be conducted, 2-3 dietary goals established and appropriate individualised dieary advice given. The dietary advice will be individualised for each woman taking into account their sociocultural context, food likes and dislikes, household budgets and household membership, The second and third nutrition in pregnancy appoinments will be 15-30 minutes, and will be either 'stand alone' separate appointments or an additional component of routine anetnatal care appointments. The second appointment will be 3-4 weeks after the first appointment, ideally be at 14 weeks gestation, but before 18 weeks. The third appointment will be 3-4 weeks after the second appointment, ideally be at 18 weeks duration, but before 22 weeks. The appointments will be conducted at either the LMC midwife's clinic or the participating pregnant woman's home. Appropriate written resources will be provided to participating pregnant women. Each participating pregnant woman will be given a written resource we have developed with pregnant women, 'Healthy food and lifestyle choices in pregnancy', which includes the Ministry of Primary Industries pullout guide to 'Food safety in pregnancy' and the Auckland District Health Board National Women's Health 'Being active during pregnancy' pamphlet.