Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive?

Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

“…The questionnaire was based on the review of the literature and adapted from previous surveys conducted with health professionals in WA [67,73–76], and other surveys of health professionals [60,61,68,77–81]. During the questionnaire development we consulted with a WACHS Midwifery Advisor, the Steering Group, and the Midwifery Reference Group.…”

“…Qualitative research with midwives (n = 12) in New South Wales indicated they routinely asked women at the initial antenatal visit about how much and how often they consumed alcohol [60]. These midwives were reluctant to discuss the risks of prenatal alcohol exposure to the fetus because they did not want to distress women and perceived a lack of knowledge and evidence in the area [60].…”

“…Qualitative research with midwives (n = 12) in New South Wales indicated they routinely asked women at the initial antenatal visit about how much and how often they consumed alcohol [60]. These midwives were reluctant to discuss the risks of prenatal alcohol exposure to the fetus because they did not want to distress women and perceived a lack of knowledge and evidence in the area [60]. International research has found midwives to be knowledgeable about the recommended alcohol limits in pregnancy but not fully confident in their ability to advise women [61], not always offering advice [62], nor adhering to alcohol in pregnancy guidelines [63].…”

“…Barriers to practice about preventing alcohol consumption in pregnancy and its consequences may include lack of knowledge, the potential for significant constraints on their time; concerns about client sensitivity, stigmatisation [65,66], and alienation [60]; the need for additional training to enhance their assessment skills; lack of referral resources for adequately dealing with alcohol use problems once identified; and lack of knowledge about the amount of alcohol that is harmful in pregnancy [67] and specific risks associated with alcohol consumption in pregnancy [60]. Midwives have identified factors that may facilitate communication about alcohol consumption in pregnancy.…”

Peri‐Conceptual and Mid‐Pregnancy Alcohol Consumption: A Comparison between Areas of High and Low Deprivation in Scotland

“…Evaluation of alcohol consumption is part of the overall assessment in early pregnancy when a woman seeks professional support, but practitioners may feel uncomfortable doing this (19). One small-scale Australian survey found that while midwives felt confident in this role they lacked knowledge about risk levels (20). A more recent and larger Australian survey found that many midwives did not use the recommended screening tool or offer a brief intervention when indicated (21), suggesting that professional development in this area was needed.…”