Promoting healthy lifestyles during pregnancy in Tasmanian public hospitals

HiPPP EMR-C 2021 People’s Choice Award winner Dr Michelle Kilpatrick identifies health promotion gaps in public hospital antenatal settings in her research Promoting Healthy lifestyles in Routine Antenatal Care: experiences of midwives and obstetricians in Tasmania.

With a focus on clinicians at the Royal Hobart Hospital (RHH), Dr Kilpatrick analysed healthcare specialists and their experiences promoting Healthy Lifestyle Behaviours (HLB) during routine pregnancy appointments. 

“Clinicians in public hospital settings are often working with some of our most vulnerable pregnant women in terms of disadvantage and complex health and wellbeing needs,” she said. 

“We must understand what it is like for clinicians…so we can better support clinicians to support the women they are seeing day in and day out.”

According to a recent report by the Tasmanian Council of Obstetric and Paediatric Mortality and Morbidity, 74 per cent of Tasmanian mothers are public healthcare patients, and 3.3 per cent are under the age of 20. 

The report also found that one in two women start their pregnancy with overweight and obesity. 

With this vulnerable population of pregnant women entering the public health care system, Dr Kilpatrick’s work focused on clinicians and their confidence in promoting healthy lifestyles in the public healthcare system.  

Interviews with midwives and obstetricians unfolded a pattern of barriers that hinder healthy lifestyle promotion with this target group.

Insufficient training, low practitioner confidence and lack of referral pathways and appropriate patient resources were the four main barriers identified. 

In terms of training, midwives and obstetricians experience very little pre-clinical or professional training around nutrition, physical activity, weight, or behaviour change strategies in pregnancy, according to the research findings.  

“I think we just need to have a better way and a little better education about how to approach [weight] in a kind way because we want to help them…” said one midwife in her interview. 

“Through our project, we have been able to highlight the need for new locally relevant nutrition resources for women including those who have low literacy or who might be experiencing food insecurity,” said Dr Kilpatrick. 

“We also need appropriate referral pathways for women who need additional or specialised health promotion support.” 

Her research recommends broad, foundational workforce capacity building. 

This includes sourcing “evidence-based clinician training (and) ensuring clinicians and women have access to appropriate printed and online resources.” 

Dr Kilpatrick hopes that these improvements will help practitioners in public hospitals “to act quickly and confidently in routine appointments.” 

Dr Kilpatrick’s research was awarded the 2021 People’s Choice Award at the recent HiPPP EMR-C conference. 

This achievement affirms a general interest in healthy lifestyle promotion in public antenatal care.

“It was such an honour to receive the People’s Choice Award for my presentation,” Dr Kilpatrick said. 

“It shows the importance of our work resonated with a very knowledgeable, experienced group of researchers and clinicians working across a broad area.” 

Next year, Dr Kilpatrick’s team will introduce clinician training by working alongside the Tasmanian Government to develop health literacy resources and referral pathways.

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