Midwives’ engagement in smoking- and alcohol-prevention in prenatal care before and after the introduction of practice guidelines in Switzerland: comparison of survey findings from 2008 and 2018

Lemola, Sakari; Gkiouleka, Anna; Urfer-Maurer, Natalie; Grob, Alexander; Schwarz, Katharina Tritten; Meyer-Leu, Yvonne

doi:10.1186/s12884-019-2706-8

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Indeed, several studies indicate that health professionals give discordant advice to pregnant and breastfeeding women, from strict abstinence to tolerating low occasional consumption [ 22 , 23 ]. Many authors therefore recommend consistent information about the effects of alcohol consumption on the developing baby as well as education for health care professionals to improve their counselling skills [ 14 , 24 – 27 ]. Information and counselling about alcohol consumption seems to be widely accepted by pregnant and non-pregnant women [ 28 ] and there is a clear need to address this topic in routine antenatal and postnatal care [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum

Pehlke-Milde

Radu

Gouilhers

et al. 2022

BMC Pregnancy Childbirth

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Background Alcohol consumption during pregnancy and breastfeeding is associated with a risk for the child’s healthy development. Nevertheless, about 16 to 25% of all women in the European region, including Switzerland, consume alcohol during pregnancy and probably even more during breastfeeding. Little is known about how women perceive this risk and how risk perception changes during the transition to motherhood. The present study aims to explore the subjective transition from the woman’s perspective, focusing on perceptions of alcohol as a risk, changes in alcohol consumption in daily life and experienced support from health professionals in this period. Methods The longitudinal qualitative, semi-structured interview study was jointly designed and conducted by health sociologists and midwifery researchers. Using the theoretical framework of sociocultural risk and life course transition, we interviewed 46 women from the French and German speaking part of Switzerland during pregnancy and until six months after birth. Results In our study, we found that pregnant and breastfeeding women perceive alcohol consumption as a risk to the health of the child. Abstinence is sought especially during pregnancy, but this does not preclude occasional and low-level consumption according to some women. Alcohol consumption and risk perception change during the transition to motherhood. We identified five stages that characterise this transition in terms of alcohol consumption and risk perception. From the women’s perspective, there was a lack of counselling from health professionals, and the women expressed a desire for respectful and more individualised counselling. Conclusion Many women express a need for guidance and counselling by health care professionals at some stages of the transition to motherhood. The stages identified can be used as pointers to address the subject of alcohol consumption in professional practice. The stage around conception and early pregnancy should be taken more into account, as women experience themselves as particularly vulnerable during this time. Low-threshold counselling services should be therefore offered to women before or in the stage around conception and be continued until the end of the breastfeeding period.

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Section: Introductionmentioning

confidence: 99%

Women’s views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum

Pehlke-Milde

Radu

Gouilhers

et al. 2022

BMC Pregnancy Childbirth

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“…Effective smoking cessation treatment requires addressing barriers to quitting and provision of counseling at regular intervals for women who smoke throughout the course of pregnancy and into the postpartum period, as well as support for pharmacotherapy for those with high nicotine dependency or those who are unable to quit with counseling alone. It is important for health care professionals, especially midwives and obstetricians, to be prepared and use the latest evidence‐based treatment for smoking cessation in maternity care settings 53,54 . Moreover, through building trusting and supportive relationships, midwives and other maternity care providers can play an important role in facilitating smoking cessation among pregnant and postpartum women.…”

Section: Discussionmentioning

confidence: 99%

“…It is important for health care professionals, especially midwives and obstetricians, to be prepared and use the latest evidence-based treatment for smoking cessation in maternity care settings. 53,54 Moreover, through building trusting and supportive relationships, midwives and other maternity care providers can play an important role in facilitating smoking cessation among pregnant and postpartum women.…”

Section: Discussionmentioning

confidence: 99%

Smoking Cessation among Pregnant and Postpartum Women from Low‐Income Groups in the United States

Kedia

Ahuja

Carswell

et al. 2021

J Midwife Womens Health

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Introduction Pregnancy creates a unique window of opportunity for smoking cessation. However, pregnant women from underserved groups can face personal, social, and environmental challenges that impede quitting. This study draws upon the socioecological framework to explore perspectives on smoking cessation among pregnant and postpartum women from low‐income groups in the mid‐South of the United States. Methods Semistructured interviews were conducted with 60 women who were pregnant or postpartum. Data were analyzed in Dedoose qualitative software using the directed content analysis approach. Results Findings reveal that at the individual level, motivations for smoking cessation included the fact of being pregnant, risks associated with the infant's health, and desire to breastfeed. However, some pregnant women perceived that slowing down on smoking during pregnancy was adequate to prevent harm to their fetuses. Individual‐level factors that made smoking cessation difficult included nicotine addiction and habit, boredom, stressful life circumstances, fear of weight gain, and perceived lack of willpower. At the interpersonal level, living in a smoke‐free environment where loved ones do not smoke and emotional and practical support from social network members including partners and family members were thought to facilitate smoking cessation. At the organizational level, access to nicotine replacement therapies and counseling aided in their abilities to quit smoking. At the policy level, pregnant women viewed increase in cigarette prices, warning labels on the cigarette pack, and the potential for a ban on cigarette sales as having some effect in helping them quit smoking. Discussion This study offers theoretical insights into factors that function as barriers or facilitators of smoking cessation among pregnant and postpartum women from low‐income groups in the United States. Designing multilevel smoking cessation interventions while considering the interplay of individual, interpersonal, organizational, and policy level factors may lead to better cessation outcomes.

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“…31 A Swiss study further found that while midwives were more aware of the risks of alcohol use in pregnancy following the release of national guidelines, their knowledge and engagement with more extensive prevention strategies remained limited. 32 A Canadian study found that 90.9% of practitioners used of other guidelines related to alcohol use in pregnancy either as a standalone or alongside national guidelines. 28 However, several studies also reported enablers to guideline adherence.…”

Section: Level 2 Preventionmentioning

confidence: 99%

Supportive alcohol policy as a key element of fetal alcohol spectrum disorder prevention

Wolfson

Poole

2023

Womens Health (Lond Engl)

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In Canada, a Four-Part Model of Fetal Alcohol Spectrum Disorder (FASD) Prevention has been developed that describes a continuum of multi-sectoral efforts, including broad awareness campaigns, safe and respectful conversations around pregnancy and alcohol use, and holistic and wraparound support services for pregnant and postpartum women with alcohol, and other health and social concerns. Supportive alcohol policy is at the centre of the four mutually reinforcing levels of prevention. The purpose of this narrative review is to describe alcohol policies related to specific levels of FASD prevention, and to consider the implications of alcohol policies on FASD prevention and women’s and fetal health. The majority of the evidence focused on alcohol in pregnancy guidelines, alcohol warning labels, and knowledge and uptake of national or regional alcohol and pregnancy guidelines. Several US studies described shifts in alcohol and pregnancy policy over the 7-year period, including moves to punitive approaches that criminalize women’s substance use or prompt child apprehension. This review indicates that more attention could be paid to the role of alcohol policy in FASD prevention and in promoting women’s and fetal health, and that policy actions and advocacy could be important catalysts for both FASD prevention and women’s health promotion. Moving forward, it is essential that alcohol policies are rooted in evidence; attend to and promote women’s health including health during pregnancy; and are collaborative in order to prompt a higher standard of care, and more holistically respond to the factors that contribute to women’s alcohol use during pregnancy.

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Midwives’ engagement in smoking- and alcohol-prevention in prenatal care before and after the introduction of practice guidelines in Switzerland: comparison of survey findings from 2008 and 2018

Cited by 7 publications

References 25 publications

Women’s views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum

Women’s views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum

Smoking Cessation among Pregnant and Postpartum Women from Low‐Income Groups in the United States

Supportive alcohol policy as a key element of fetal alcohol spectrum disorder prevention

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