Women who drank while pregnant: The importance of social context in the lives of South African pregnant women

Abstract

Aims: This study aimed to explore how women who drank alcohol while pregnant understand and make sense of alcohol use. Methods: Using social representation theory and elements of Foucauldian discourse analysis, 14 narrative episodic interviews were conducted in a Western Cape, South African community with women who drank alcohol while pregnant, and two focus group discussions with 13 members of the pregnant women’s community. The interview and focus group data were analysed using thematic decomposition analysis. Findings: Drinking alcohol was represented by participants as a social activity, a way of coping with domestic problems, and also as connected to their experiences of motherhood. Access to social support through their partners and a desire to protect the fetus and care for their children helped some participants to cease drinking during their pregnancies. These representations highlight that alcohol use is not simply an individual decision but is embedded in a particular social context and also framed by particular discourses. Conclusion: Interventions should prioritise the social context of drinking, include a component that works with both pregnant women and their partners, use a supportive and non-judgemental approach that capitalises on pregnancy and motherhood, and focus on empowering pregnant women to manage problems effectively.

Keywords:

• Alcohol use
• pregnancy
• social representations
• discourse
• South Africa

Acknowledgements

The authors gratefully acknowledge Leslie London, Taryn van Niekerk and Leon Van Wyk for their input in this research project. We would also like to extend our sincere thanks to the Foundation for Alcohol Related Research for their valuable support in the research process, and also to the participants, who so kindly shared their stories.

Declaration of interest

No potential conflict of interest was reported by the authors.

Funding

The support of the following organisations towards this work is hereby acknowledged: the National Research Foundation (NRF), the Harry Crossley Foundation and the DST-NRF Centre of Excellence (CoE) in Human Development at the University of the Witwatersrand, Johannesburg in the Republic of South Africa. Opinions expressed and conclusions arrived at are those of the authors and are not to be attributed to the NRF, the Harry Crossley Foundation or the CoE in Human Development. These grants were to the first author.

Notes

Notes

1. In order to ensure complete anonymity, the name of the study community is not included.

2. Coloured (mixed race origin) refers to one of four racial categories defined by apartheid legislation in South Africa (Black, Coloured, White and Asian/Indian). We make note of these classifications here not because we endorse them – we do not – but because of continuing disparities across these previously legislatively defined racial groups in terms of access to health care generally (Coovadia, Jewkes, Barron, Sanders, & McIntyre, 2009), and substance abuse treatment in particular (Myers et al., 2010).

3. Afrikaans is one of the 11 official languages in South Africa.