Eating down in pregnancy:: Exploring food-related beliefs and practices of pregnancy in rural Nepal

Adequate nutrition during pregnancy, vital for the health of the mother and the newborn, may be influenced by pregnancy-related food beliefs. This study explores food-related beliefs and practices specifically related to reducing food intake in pregnancy in a rural community in Nepal by combining ethnographic and quantitative data collected from pregnant Nepali women. A large proportion (60%) of women reported reducing rice intake during pregnancy but the reduction was related to food aversions and being unwell (66%), rather than the desire to have smaller babies or other cultural beliefs (18%). Only 10-20% reported reducing intakes of other nutrient-rich foods during pregnancy. Such foods were generally consumed in inadequate amounts due to seasonal variation or because of their high cost. In a multivariate analysis, maternal characteristics that were associated with decreasing food intake during pregnancy included literacy, poor appetite, socio-economic status, and presence of night blindness, caused by vitamin A deficiency. We conclude that eating down to prevent difficult deliveries may not be very common in rural Nepal but women may reduce food intake for reasons of aversion to food, lack of appetite, or feeling unwell. A decline in the consumption of foods rich in protein and micronutrients was not evident; such foods appear to be chronically low in the diets of poor women in this setting.