This study is being done to assess the feasibility, acceptability, and preliminary impact of a meal delivery intervention designed to improve diet quality and promote appropriate gestational weight gain among predominantly Black and low-income pregnant women with overweight or obesity. This will be done by 1) assessing the feasibility and acceptability of the meal delivery intervention; 2) investigating changes in patient-reported diet quality, barriers to healthy eating, and food security; and 3) exploring the preliminary impact of the meal delivery intervention on gestational weight gain and blood pressure and estimate the effect size of the intervention relative to a de-identified non-randomized control group that will be derived from de-identified hospital records.

Subjects will receive 10 home-delivered meals per week from about 20 weeks gestation until 40 weeks gestation.

Inclusion Criteria:

• Medicaid eligible and/or have a household income at or below 185 percent of the federal poverty line
• 18 years of age or older
• <= 19 weeks gestation
• Currently experiencing a singleton pregnancy
• Receiving prenatal care at a University of Alabama at Birmingham clinic
• Planning to deliver at the University of Alabama at Birmingham
• Residing within the meal company's delivery radius
• Body mass index >= 25
• Willing to consent

Exclusion Criteria:

• Self-reported major health condition (such as renal disease, cancer, or Type 1 or Type 2 diabetes)
• Current treatment for severe psychiatric disorder (such as schizophrenia)
• Current substance abuse
• Self-reported diagnosis of anorexia or bulimia
• Known fetal anomaly
• Current use of medication expected to significantly impact body weight
• Planned termination of the current pregnancy
• Participation in another dietary and/or weight management intervention during the current pregnancy
• Unwilling or unable to understand and communicate in English
• Unwilling or unable to consume study meals

De-identified individual participant data (IPD) that underlie the results reported in a publication will be made available upon request beginning 9 months and ending 36 months following article publication. The research team will keep a record of all individuals and/or research teams who request and receive a copy of the project data. Interested investigators will be asked to submit a document indicating the specific aims of the analyses, the analytic plan, available resources for completing the proposed project, proposed timeline, and goals (i.e., manuscripts, presentations, and/or grant applications). The PI and research team will review these requests to determine whether the proposed analyses constitute an innovative and significant exploration of the data, whether the proposed team has sufficient resources to complete the request, and whether data will be adequately protected and managed.

Data requests can be submitted starting 9 months after publication of results and ending 36 months following article publication.

Access to IPD stripped of all HIPAA identifiers (except age) for this study can be requested by qualified researchers engaging in independent scientific research whose proposed research has received Institutional Review Board approval, and will be provided following review and approval of a research proposal and timeline, statistical analysis plan, and goals (e.g., manuscripts, presentations, grant applications). The Principal Investigator (PI) and research team will review these requests to determine whether the proposed analyses constitute an innovative and significant exploration of the data, whether the proposed team has sufficient resources to complete the request, and whether data will be adequately protected and managed. Based on institutional policies, execution of a Data Sharing Agreement may be required prior to sharing of IPD. IPD requests can be made to the PI at cschneid@uab.edu.

All participants enrolled in the study will receive the meal delivery intervention, so blinding is not possible.