Nutritional care in pregnancy: the patient's view. I. Amount, type, and sources of dietary advice and treatment.

Interviews were conducted with ninety-two pregnant women who attended an out-patient clinic of a major obstetrical teaching hospital. All were between thirty-four and thirty-eight weeks pregnant when interviewed. Information was obtained on the amount, type, and sources of professional dietary advice; current dietary treatments; and the patterns and nature of the patients' contacts with dietitian. The dietitian was the major source of prenatal dietary advice. Only one-third of subjects received additional advice from other professionals, usually the nurse. Physicians were rarely identified as a source of dietary advice. Approximately one-third of subjects reported receiving dietary instructions to restrict intakes of calories and/or sodium. Physicians instituted these restrictions more frequently than did nurses. Few patients were referred to the dietitian for advice on these diets. Multivitamin and iron supplements were prescribed routinely. Three-quarters of subjects made at least one visit to the nutrition service, generally early in their prenatal care. For most subjects, this was their first experience with a dietitian. Nurses made considerably more referrals to the dietitian than did physicians. There would appear to be a need to educate other health professionals, especially physicians, on the advantages of more liberal diets and weight gain in pregnancy and on the special skills of the dietitian in promoting sound nutritional habits.