Dietary knowledge, beliefs and taboos affecting pregnancy outcomes: a qualitative study in Jimma, South-West Ethiopia

A balanced diet during pregnancy is essential for optimal maternal and foetal health outcomes. However, food taboos can influence dietary practices among pregnant women, often limiting the intake of nutrient-rich foods and negatively affecting health and pregnancy outcomes. In Ethiopia, like many other low- and middle-income countries where nutritional transitions are underway, evidence remains limited regarding the knowledge, beliefs and practices surrounding food taboos during pregnancy and their potential link to adverse outcomes such as metabolic disorders. This study explored the knowledge, beliefs and practices of pregnant women, relatives, community health workers and specialists regarding dietary habits and food taboos, and examined their implications for pregnancy outcomes in Jimma, South-West Ethiopia. A qualitative study using a generic approach was conducted with 54 purposively selected participants. Data were collected through ten key informant in-depth interviews with health professionals, four in-depth interviews with elderly individuals, and six focus group discussions with pregnant women and husbands/fathers. Data were analysed using the thematic framework analysis method using NVivo 15 software. Four main themes emerged from the analysis: maternal diet and cultural beliefs; dietary patterns during pregnancy and determining factors; perspectives on obesity as an indicator of metabolic disorders and its associated adverse pregnancy outcomes; and health promotion strategies to address the impact of food taboos on maternal and foetal health. The findings show that pregnant women commonly adhere to food taboos, while spouses and elders often play a reinforcing role, encouraging compliance due to fears of pregnancy-related complications. Pregnant women do not change their diets to meet nutritional needs but modify them based on cultural food taboos, aversions, and cravings. These taboos persist through generational transmission and social learning, deeply embedded in traditional beliefs and community norms. This study shows that pregnant women’s diets are often shaped more by cultural taboos and family influence than by nutritional needs. These beliefs, reinforced by husbands and elders, are deeply rooted in tradition and passed down through generations. Addressing this requires community-based nutrition education that respects local values while promoting healthier practices for maternal and foetal wellbeing.