Pregnancy as a transition: First‐time expectant couples′ experience with alcohol consumption

Abstract

Introduction and AimsMost official healthcare guidelines apply the precautionary principle by recommending that pregnant women abstain from any alcohol consumption. However, a number of women continue drinking alcohol while pregnant. The aim of this study was to investigate couples′ experiences of the issue of alcohol consumption during pregnancy as a transitional process.Design and MethodsThirty semi‐directive joint interviews were conducted with couples expecting their first child in Switzerland. Interviews were analysed thematically with the help of ATLAS.ti.ResultsCouples endorsed the imperative of changing drinking habits and all the women reduced their alcohol consumption, although some reported difficulties. First, we identified three themes describing how couples experienced the woman′s change of drinking habits as a smooth transition: Internalisation of risk discourses, abstinence as a social norm and embodiment of alcohol aversion. Second, we emphasised four kinds of difficulties that couples encountered in their everyday lives: burden of risk discourses, conflicting advice, social occasions and desire for alcohol.Discussion and ConclusionsThis paper makes a significant contribution by examining prenatal drinking change as a transition. In this conceptualisation, the change of alcohol consumption is a relational process that is shaped by multiple changes and social norms. Our findings have important implications for practice. First, health professionals should be aware of the difficulties women experience when they abstain from alcohol during pregnancy. Second, our findings suggest the importance of a patient‐centred approach that considers the role of the partner in supporting a pregnant woman′s change of alcohol consumption.

“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy

“…Two articles reported on the same study [ 33 , 34 ] and two articles used the same datasets as previously published research [ 35 , 36 , 37 , 38 ]. Of the 24 unique studies, seven were from Australia [ 29 , 30 , 35 , 39 , 40 , 41 , 42 ], five from the USA [ 33 , 43 , 44 , 45 , 46 ], two from the UK [ 47 , 48 ], two from South Africa [ 28 , 49 ], two from Switzerland [ 37 , 50 ], two from Brazil [ 51 , 52 ], one from France [ 53 ], one from India [ 54 ], one from The Netherlands [ 55 ], and a joint study from the UK and Sweden [ 56 ]. While several studies included partners of pregnant or parenting women, healthcare providers, or community members, this systematic review is only reporting on the pregnant and recently postpartum women who participated.…”

“…Six studies focused on women experiencing low SES ( n = 146 participants) [ 28 , 44 , 46 , 47 , 49 , 54 ], two reported low-to-medium SES (n = 34 participants) [ 43 , 51 ], and seven reported medium-to-high SES ( n = 197 participants) [ 37 , 42 , 48 , 50 , 52 , 55 , 56 ]. SES was not reported in seven studies ( n = 157 participants) [ 29 , 30 , 39 , 40 , 41 , 45 , 53 ] and was unclear in two studies ( n = 23 participants) [ 33 , 35 ].…”

“…SES was not reported in seven studies ( n = 157 participants) [ 29 , 30 , 39 , 40 , 41 , 45 , 53 ] and was unclear in two studies ( n = 23 participants) [ 33 , 35 ]. Ethnicity was not reported in 13 studies ( n = 305 participants) [ 35 , 37 , 39 , 40 , 41 , 44 , 46 , 47 , 48 , 49 , 53 , 55 , 56 ]. The remaining 11 studies included participants that identified as Caucasian Australian ( n = 59) [ 30 , 42 ], Black or Coloured South African ( n = 24) [ 28 ], Caucasian American ( n = 24) [ 33 , 43 ], Santal or Munda in India ( n = 19) [ 54 ], non-Indigenous Australian ( n = 15) [ 29 ], Aboriginal and Torres Strait Islander in Australia ( n = 14) [ 29 ], Caucasian Brazilian ( n = 13) [ 51 , 52 ], Indigenous or African American ( n = 11) [ 45 ], Black Brazilian ( n = 10) [ 51 , 52 ], African American ( n = 7) [ 43 ], Mixed-ethnicity Brazilian ( n = 4) [ 51 , 52 ], Brazilian Other ( n = 1) [ 52 ], and Asian Australian ( n = 1) [ 30 ].…”

“…Qualitative study methods included combinations of interviews ( n = 21) [ 28 , 29 , 33 , 34 , 35 , 36 , 40 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 ], focus groups ( n = 8) [ 29 , 30 , 39 , 41 , 45 , 49 , 54 , 55 ], participant observation ( n = 2) [ 33 , 34 ], diary entries ( n = 2) [ 33 , 34 ], online chat room discussions ( n = 1) [ 53 ], and visual data production ( n = 1) [ 47 ]. The majority of studies adopted an individual behaviouralist focus when exploring women’s experiences concerning alcohol use during pregnancy [ 29 , 33 , 34 , 35 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ,…”

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

“…Further, our findings suggest that there should be greater emphasis on increasing midwives' familiarity with the Guideline, increasing midwives' self-efficacy, and improving the way in which clinical tools are available to them across different work settings, particularly in hospitals. To increase the effectiveness of counselling, midwives' vocational training may include practical training in intervention techniques such as motivational interviewing, and hospitals may adopt longer consulting sessions to enable midwives to develop a patient-centered approach and to build a relationship of trust with their clients and potentially their partners [34]. Further, conventional (e.g.…”