Re-evaluating the nutritional awareness, knowledge and eating behaviours of women attending a tertiary maternity hospital following iterative service redesign

Aim: Since the opening of the new Mater Mothers' Hospital in 2008, innovative initiatives were developed, implemented and evaluated to meet women's nutritional needs. This study evaluated changes in women's nutritional awareness, knowledge and behaviours and compared these data with our baseline survey. Methods: During 2014–2017, 421 postnatal women were surveyed across nine survey periods. Results were compared with those from our 2008 survey (n = 102). Surveys assessed nutrition knowledge, attitudes, behaviour, education preferences, and dietetic service awareness and were distributed on meal trays. Results: A greater proportion of women accessed the nutrition services in 2014–2017 compared with 2008 (19.7% vs 9.9%) and rated the resources favourably (≥3.5 out of 5). A similar proportion rated the importance of eating well postnatally (83.1% vs 92.1%) and returning to their pre-pregnancy weight (62.4% vs 68.3%) as important/very important. In both periods, women had poor diet quality, despite identifying healthy eating as a high priority. A reduction in median gestational weight gain (GWG) approached significance, 13.0 kg (2014–2017) versus 14.0 kg (2008), P = 0.055. There was a significant association between GWG and cohort with an increase in the proportion of women gaining within their correct guidelines (by 15.4%), a reduction of excessive gain (by 24.7%, P < 0.001) over time. Conclusions: Evidence-based service changes made since 2008 have effected positive change in women's GWG, service preferences, and access. However, women still require awareness-raising and behaviour change programs to improve diet quality and GWG to ensure optimal pregnancy outcomes.