Alcohol messages disseminated to pregnant women by midwives

ABSTRACT

Background

Pregnant women frequently report inconsistent messages regarding alcohol consumption from their healthcare providers. Midwives play a major role in prenatal care. However, little research has examined alcohol-related information provided by midwives.

Objective

To examine alcohol-related messages disseminated to pregnant women by midwives.

Methods

In 2018, 61 certified professional midwives (CPMs) and certified nurse-midwives (CNMs) were recruited from professional organizations in a southwestern state. Midwives responded to an online cross-sectional survey containing the prompt: “A pregnant patient confides in you that she drinks alcohol. She then asks you to tell her a “safe” level of alcohol consumption that won’t cause harm to her unborn fetus. How would you respond?” Open-ended responses were analyzed through content analysis and categorized using an inductive approach.

Results

Responses were grouped into five non-exclusive themes: “harmful effects and unknown safe limits” (77.0%); “abstaining is best” (50.8%); “light drinking is acceptable” (16.4%); “describe your drinking” (21.3%); “I will refer you” (16.4%). The most frequently shared messages were “safe levels of prenatal alcohol use are unknown” (68.9%) and “discontinue alcohol during pregnancy” (45.9%). However, some messages contradicted US dietary guidelines, including “a little bit of alcohol unlikely to cause harm” (11.5%); “cut-down if having more than 1–2 drinks per occasion” (4.9%); and “if you must drink, wine is best” (1.6%). CPMs were less likely to share abstinence messages (p = .003) and more likely to suggest referrals (p = .024), compared to CNMs.

Conclusion

Concerted efforts are needed to ensure information disseminated aligns with health guidelines and encourages abstinence during pregnancy.

KEYWORDS:

• Alcohol
• pregnancy
• prenatal
• midwives
• healthcare providers
• guidelines
• screening

Acknowledgements

We would like to express our profound gratitude to all certified professional midwives and certified nurse-midwives/certified midwives who participated in this study. We would also like to thank Drs. Yorghos Apostolopoulos, Rajesh Miranda, and James Lindner for generously giving their time to provide insightful feedback on this project.

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

Research reported in this publication was not supported by any funding.