Marian Marian, Pérez Ramona L, McClain Amanda C, Hurst Samantha, Reed Elizabeth, Barker Kathryn M, Lundgren Rebecka
University of California San Diego.
San Diego State University.
Res Sq. 2024 Oct 14:rs.3.rs-4902977. doi: 10.21203/rs.3.rs-4902977/v1.
Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.
Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.
Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: 1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; 2) Female family members as a primary source of nutritional knowledge and food support; 3) Support from other members of women's social networks; 4) Medical guidance for nutrition during pregnancy; and 5) Quality and gaps in the broader health care system and social services. These themes highlight how women's own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women's nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.
Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future research and programming that use multi-level approaches (considering the individual and the family and other social influences) are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.
充足的饮食摄入对健康怀孕至关重要。墨西哥社会服务的近期变化，再加上高度的粮食不安全状况，让人质疑社会经济地位最低的孕妇在这种不断变化的背景下是否能够满足其饮食和营养需求。本研究的目的是探讨孕期妇女的营养习惯、所接受和运用的营养知识。
在生态系统理论和交叉性框架的指导下，这项定性研究在瓦哈卡州粮食不安全程度较高的瓦哈卡市和埃斯孔迪多港开展。在过去五年中至少育有一个子女且在过去五年里一直居住在瓦哈卡的妇女有资格参与。25名妇女参与了2023年6月至12月期间进行的半结构化深入访谈。采用扎根理论方法进行编码。使用NVivo进行编码和分析。
出现了五个关键主题，这些主题与个人层面的特征以及与瓦哈卡州低收入孕妇营养知识和习惯的社会支持相关的多重社会身份有关：1）影响孕期营养习惯和知识的生活经历、社会人口统计学特征和健康特征；2）女性家庭成员作为营养知识和食物支持的主要来源；3）妇女社交网络中其他成员的支持；4）孕期营养的医学指导；5）更广泛的医疗保健系统和社会服务的质量及差距。这些主题凸显了妇女自身的经历和社会身份以及不同的人际和社区层面环境，特别是母亲、祖母和医疗保健提供者的环境，如何相互作用并塑造妇女的营养知识和习惯，例如孕期所食用的食物和营养补充剂。
孕期的营养知识和习惯受到妇女所拥有的多重社会身份以及个人、群体和结构层面不同因素的影响。需要开展未来的研究和规划，采用多层次方法（考虑个人、家庭和其他社会影响）来解决瓦哈卡州妇女在产前阶段所面临的营养差距问题。
