Alcohol consumption during pregnancy has the potential to cause significant harm to the foetus and the current Australian guidelines state that it is safest not to drink alcohol while pregnant.
Foetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of effects that can occur due to prenatal alcohol consumption. These effects may include physical, mental, behavioural, or learning disabilities with possible lifelong implications. However, conflicting messages often appear in the media and it is unclear if the message to avoid alcohol is being effectively conveyed to pregnant women. It is important to determine what information is being provided, what information may be missing, and the preferred sources of information on this issue.
Knowledge of effects of alcohol during pregnancy
Research was conducted in Adelaide, South Australia, to explore the advice that health professionals provide to pregnant women about alcohol consumption; the knowledge of health professionals regarding the effects of alcohol consumption; and their consistency with following the Australian guidelines. To do this, 10 interviews were conducted with health professionals who regularly provide antenatal care; including midwives, obstetricians, and general practitioners. Additionally, focus groups were conducted to gain insight into the views and experiences of pregnant women, newly delivered mothers and their partners. We sought to understand the knowledge and experiences of pregnant women and their partners regarding the effects of alcohol consumption during pregnancy.
It was found that health professionals displayed adequate knowledge that alcohol can cause physical and mental difficulties that are lifelong; however, knowledge of the term FASD and the broad spectrum of difficulties associated with alcohol consumption during pregnancy was limited. Among women and partners, it was found that the majority of participants knew not to drink alcohol in pregnancy; however, they had limited information on the specific harmful effects. In addition, routine enquiry and the provision of information by health care professionals were seen as lacking. Although health professionals were willing to discuss alcohol with pregnant women, many did not make this a routine part of practice, and several concerning judgements were noted.
Partners’ influence on decisions about alcohol
One of the most important findings of this study was the acknowledgement of the role of the partner in supporting women during pregnancy. Previous research has suggested that the partner may have a significant impact on a woman’s decision to drink during pregnancy, and that encouraging partners to decrease their alcohol use can help to decrease the woman’s alcohol use. In the current study, some partners showed support by cutting back their own drinking, while others continued to drink; however, all women indicated that they were satisfied with the support they received from their partner with regards to alcohol use during pregnancy. Several women felt that the decision not to drink was a family decision as it would have effects on the baby, and that their partner had input on many of the health decisions made during pregnancy.
“It’s a family decision; it’s not just about me.” (pregnant woman #7)
“Ultimately it is their (the men’s) kid…it’s your body but it’s their kid.” (mother #4)
Several recommendations can be made on the basis of these findings. Firstly, public health messages and educational materials need to provide clear and consistent information about the effects of alcohol consumption on the developing baby. Additionally, more thorough and consistent routine enquiry for alcohol consumption in pregnant women needs to occur. It is also important to ensure ongoing education for health professionals on the issue of alcohol consumption during pregnancy. Communication between health professionals and pregnant women needs to be improved to ensure that accurate information about alcohol use in pregnancy is being provided. Further, it is important to ensure that the national guidelines are being supported by health professionals. This study also confirms the importance of shared decision making, and the role of partners and families in prenatal alcohol consumption. Despite an increase in knowledge and awareness of the adverse effects of alcohol consumption in pregnancy, the prevalence of FASD worldwide does not appear to be decreasing. Thus, while women remain central to FASD prevention, the inclusion of partners and families and a deeper understanding of the societal factors that influence a woman’s drinking may play a key role in tackling this important health issue.
Crawford-Williams F, Steen M, Esterman A, Fielder A & Mikocka-Walus A (2015), “My midwife said that having a glass of red wine was actually better for the baby”: a focus group study of women and their partner’s knowledge and experiences relating to alcohol consumption in pregnancy, BMC Pregnancy and Childbirth 15
Crawford-Williams F, Steen M, Esterman A, Fielder A, Mikocka-Walusa A (2015), “If you can have one glass of wine now and then, why are you denying that to a woman with no evidence”: Knowledge and practices of health professionals concerning alcohol consumption during pregnancy, Women and Birth 28
Photo: mightymightymatze. Creative Commons.