"You want to eat healthy, especially when you’re pregnant. But sometimes, it’s just not possible”: Perceptions of facilitators and barriers to healthy food and diet practices during pre-conception and pregnancy

Background Evidence suggests that women should eat a healthy diet during pre-conception and pregnancy as this benefits their own health as well as reducing the risk of non-communicable diseases in offspring (such as obesity, diabetes, hypertension, cardiovascular and mental health problems); however, previous work indicates that the recommendations are not being followed. This study aimed to understand: the facilitators and barriers to healthy food and diet practices during pre-conception and pregnancy; how these barriers could be addressed, and the changes required to facilitate good food practices. Methods The research used a qualitative approach; five online focus groups were undertaken with 19 women living across the UK who were trying to conceive, pregnant or had babies under 6-months old. Data were thematically analysed. Results The findings revealed three main themes (Challenges of trying to eat healthily; Facilitators to eating healthily; Changes required) and six subthemes (Mothers' load; Body sabotage; Food environment; Information not individualised; Planning skills; Family support; Co-creation and investment for the future; Access to professional advice). Participants spoke of internal factors (such as tiredness and nausea) and external influences (e.g., their financial situation) that impacted on their ability to eat healthily. They identified the need to access more effective professional advice. Conclusions This unique study demonstrated a need for clear, consistent, engaging and culturally appropriate dietary information, as well as access to professionals (such as nutritionists and dietitians) who can give both generic and tailored advice to those trying to conceive and those who are already pregnant.