During pregnancy, many women gain more weight than is healthy for them and their babies. Researchers in New Zealand are testing a new program where midwives give pregnant women personalized advice about weight gain during pregnancy. The program, called DOT, uses simple conversations and goal-setting to help women stay healthy. This study will involve 150-200 pregnant women and 15-20 midwives to see if the program works, if women like it, and if it helps reduce health problems for both mothers and babies, especially for Māori women who often face greater health challenges.

The Quick Take

  • What they studied: Whether a new weight gain advice program delivered by midwives during pregnancy can help pregnant women gain a healthy amount of weight and improve health outcomes for mothers and babies.
  • Who participated: About 150-200 pregnant women aged 18 and older, and 15-20 midwives in Northland, New Zealand. About half of the pregnant women in this area are Māori (indigenous New Zealanders). Women with serious health conditions that need specialist care were not included.
  • Key finding: This is a new study testing whether the DOT program is acceptable to both midwives and pregnant women, and whether it helps reduce excessive weight gain during pregnancy. The study hasn’t been completed yet, so final results are not available.
  • What it means for you: If successful, this program could help pregnant women gain the right amount of weight, which may reduce risks of gestational diabetes, high blood pressure during pregnancy, and other complications. It may also help babies be born at healthier weights. This is especially important for Māori women who often experience more pregnancy complications.

The Research Details

This is a case study, which means researchers will carefully examine how a new weight gain advice program works in real pregnancy care settings. Unlike a typical experiment that compares two groups, a case study looks at what happens when a program is used in everyday medical practice. Midwives (healthcare providers who specialize in pregnancy and birth) will be trained to deliver the DOT program to pregnant women. The program involves three visits: one before 15 weeks of pregnancy, then visits every 3-4 weeks after that. During these visits, midwives will have conversations with women about their diet and weight gain using a simple questionnaire called “Starting the Conversation: Diet.” The midwives will help women set goals for healthy weight gain based on their individual needs.

Researchers will collect information from regular pregnancy checkups, including weight measurements, blood pressure, blood test results, and information about the baby’s birth weight. They will also ask women and midwives questions about whether they found the program helpful and easy to use. The study takes place in Northland, New Zealand, where about half of the pregnant women are Māori, allowing researchers to see if the program helps reduce health inequalities.

This research approach is important because it tests whether a helpful program developed in research settings can actually work in real-world pregnancy care. Many good ideas from research never make it into everyday medical practice. By studying this in a real setting with actual midwives and pregnant women, researchers can understand what helps and what gets in the way. This is especially important for Māori women, who have historically experienced worse pregnancy outcomes and less access to helpful health programs.

This study is registered with an official clinical trials registry, which means it follows strict scientific standards. The researchers completed a smaller test (feasibility study) before starting this larger study, which shows they planned carefully. The study will collect both numbers (like weight gain amounts) and personal stories (from interviews), which gives a more complete picture than numbers alone. However, because this is a case study rather than a randomized controlled trial, it cannot prove that the program causes better outcomes—it can only show whether the program seems to work and is acceptable to people.

What the Results Show

This study is still in progress, so final results are not yet available. The main goals of the study are to find out how many pregnant women and midwives agree to participate (recruitment and retention rates) and whether they think the program is acceptable and easy to use. These early measures are important because if women and midwives don’t like the program or find it hard to use, it won’t help even if it’s scientifically sound.

Once the study is complete, researchers will measure how much weight pregnant women gained on average, whether this was within healthy ranges, and how many women had complications like gestational diabetes or high blood pressure. They will also look at baby birth weights to see if healthier maternal weight gain leads to healthier babies. The study will also examine whether the program helps reduce health inequalities for Māori women.

The study will also look at the cost of delivering the program to see if it’s affordable for healthcare systems. Researchers will identify what helps the program work well (enablers) and what makes it difficult (barriers) by talking to women and midwives about their experiences. This information will help improve the program if it’s used more widely in the future.

Previous research has shown that lifestyle interventions—programs that help people change their eating and activity habits—can help pregnant women avoid gaining too much weight. However, most of these successful programs were tested in research settings, not in regular pregnancy care. This study is important because it tests whether these helpful programs can actually be delivered by regular midwives in everyday pregnancy care. It also focuses on Māori women, a group that has been underrepresented in previous pregnancy research.

Because this is a case study rather than a randomized controlled trial (where some women get the program and others don’t), researchers cannot prove that the program directly causes better outcomes. The study involves only one region of New Zealand, so results may not apply to other areas with different populations or healthcare systems. The study relies partly on women reporting their own information, which may not always be completely accurate. Additionally, women with serious health conditions were excluded, so results may not apply to pregnant women with complicated medical situations.

The Bottom Line

This study is still being conducted, so specific recommendations cannot be made yet. However, the research suggests that personalized weight gain advice from midwives during pregnancy may help reduce excessive weight gain and related health problems. Once results are available, healthcare providers may be able to offer similar programs to pregnant women. Pregnant women should continue to follow their healthcare provider’s advice about healthy weight gain during pregnancy, which varies based on pre-pregnancy weight.

This research is relevant to pregnant women, especially those concerned about weight gain during pregnancy. It’s particularly important for Māori women and other groups that experience health inequalities. Midwives and other healthcare providers should care about this research because it tests whether they can effectively deliver weight gain advice in their regular practice. Healthcare systems and policymakers should care because the study examines whether the program is affordable and practical to implement widely.

The study is currently ongoing and expected to be completed in the coming years. If the program proves successful, it would likely take additional time to train midwives and implement it more widely. Pregnant women who receive the program would see benefits during their pregnancy and after birth, though some benefits (like reduced childhood obesity) may take years to become apparent.

Want to Apply This Research?

  • Track weekly weight gain during pregnancy by recording weight at the same time each week. Compare actual weight gain to the personalized healthy range recommended by your healthcare provider based on your pre-pregnancy weight. This helps identify if weight gain is on track or if dietary adjustments might help.
  • Use the app to set specific, achievable goals for healthy eating during pregnancy based on conversations with your midwife. For example: “Eat vegetables at lunch and dinner,” “Drink water instead of sugary drinks,” or “Take a 20-minute walk three times per week.” Track completion of these goals weekly to build healthy habits.
  • Create a simple dashboard showing weekly weight trends, goal completion rates, and notes from midwife visits. Review this monthly with your healthcare provider to adjust goals if needed. After pregnancy, continue tracking weight loss progress and healthy habits to prevent long-term weight retention.

This research is still in progress and final results are not yet available. This information is for educational purposes and should not replace advice from your healthcare provider. Pregnant women should work with their doctor or midwife to determine healthy weight gain targets based on their individual health situation. The findings from this study may not apply to all pregnant women or all healthcare settings. Always consult with qualified healthcare professionals before making changes to diet, exercise, or pregnancy care.