Understanding the perspectives and needs towards midwifery care of women with an eating disorder history during pregnancy and postpartum: A qualitative study

INTRODUCTION: Eating disorders (EDs) can affect pregnancy outcomes in multiple ways. This study aims to contribute to the literature about whether and how midwives can support women with EDs in pregnancy and postpartum, and what they should consider when caring for affected women. METHODS: Mothers and becoming mothers who had experienced midwifery care and had a confirmed ED were invited to participate in this qualitative study. An interview guide was created that covered the needs of women with ED history in midwifery care, the influence of midwifery care on the ED, and support options provided by the midwife. In 2023, in Germany, five semi-structured interviews were conducted. The interviews were analyzed using Mayring's qualitative content analysis. RESULTS: Seven main themes emerged from the thematic analysis: 'Influence of midwifery care' on the ED, 'Addressing ED', 'Nutrition and weight of the woman', 'Nutrition and weight of the child', 'Caring for the woman', 'Negative actions', and 'Midwife characteristics and services'. Women with ED history want midwives to ask them about EDs and remain alert to behaviors that may indicate ED. The topics of nutrition and weight changes, for mother and child, were highly relevant. Midwives should be aware of potential triggers and should continually work to strengthen the woman's body image and their self-efficacy. CONCLUSIONS: Women with a history of ED place special requirements on midwives to ensure a positive impact of midwife care. The categories identified in this study can serve as a starting point to further investigate the needs of affected women to provide adequate support to women with an ED history during midwifery care.