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Why do some women drink alcohol when they are pregnant?

Health professionals, people working in the health promotion space and members of the general public, need to consider the diverse range of factors that influence or impact alcohol use or misuse during pregnancy. These include:

  • lack of knowledge about the effects of alcohol on the fetus
  • having a partner or friend who drinks
  • lack of support from partner, friends and family
  • living in a family or community tolerant of heavy drinking
  • social isolation & living in remote communities
  • poverty
  • unemployment
  • stress, domestic violence, loneliness which may result in self-medicating
  • alcohol and other drug dependency

While poverty and unemployment may be contributing to drinking in some populations, Australian research has found that in mainstream public antenatal care, higher income and tertiary educated women were 2-4 times more likely to drink alcohol throughout pregnancy than women with secondary school education.

Risk of harm

While poverty and unemployment may be contributing to drinking in some populations, Australian research has found that in mainstream public antenatal care, higher income and tertiary educated women were 2-4 times more likely to drink alcohol throughout pregnancy than women with only secondary school education. The risk of harm from alcohol is hard to predict. Factors such as:

  • the mother’s age
  • general health
  • medical conditions
  • genetics
  • stress
  • other drug use and smoking
  • body composition

can influence blood alcohol levels and hence the risk of harm to the baby.  

Other contributing factors

Other components that create an environment that contribute to risky drinking include:

  • Alcohol supply and promotion
  • Pricing
  • Liquor outlets that do not adhere to legislation that prohibits serving alcohol to intoxicated customers

Prevention strategies

There is a lack of published information on the evaluation of campaigns and messaging about alcohol use in pregnancy which makes it difficult to determine what are the most effective strategies with respect to health professionals (talking to women about alcohol use in pregnancy) and women, their partners, family and friends.

It is important that everyone is aware of the advice that 'to prevent harm from alcohol to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol.' It is also important that health professionals pass on this message, and the community understands the risks of drinking alcohol during pregnancy and the effects it can have on the developing fetus.

No level of maternal alcohol consumption at any time during pregnancy can be guaranteed to be completely ‘safe’ or ‘no risk’ for the developing fetus.

Information provided in awareness/prevention campaigns must be:

  • Culturally sensitive to the community where it is being delivered
  • Respectful
  • Be informed by community knowledge, attitudes and practices
  • Focus on the damage that alcohol can do – not focus blame on the woman
  • Engage not only women but all the community including men
  • Consistent with the Australian guidelines to reduce health risks from drinking alcohol

Community awareness campaigns can include:

  • Government funded campaigns re alcohol use in pregnancy, which include advertising in regular media such as television and radio, and social networking sites such as Facebook, Twitter, Instagram, YouTube, Pinterest, Snapchat, Reddit, LinkedIn
  • Non-government organisation and advocacy groups campaigns through social media
  • Education Department supported information for secondary school students as part of the drug and alcohol education programs

 

Health professionals have a key role in preventing FASD:

  • knowledge of Australian guidelines to reduce health risks from drinking alcohol
  • education and training to enable them to ask the question about alcohol use in pregnancy of all women, advise that ‘no alcohol when planning a pregnancy and when pregnant is the safest option’, discuss the risks of drinking alcohol during pregnancy and provide brief interventions where necessary
  • discuss contraception with women who are drinking alcohol
  • targeted support and services for women with dependency – referral to specialised drug and alcohol services
  • education and training to enable early diagnosis and interventions (in addition to helping the child, may prevent drinking alcohol in future pregnancies)

Service providers working with women:

  • have education and training to provide messages consistent with Australian guidelines to reduce health risks from drinking alcohol
  • can provide information on the risks of drinking alcohol during pregnancy
  • know how/where to refer women to specialised drug and alcohol services

Government can:

  • enable legislation pertaining to compulsory labelling (‘no alcohol during pregnancy is the safest option’ messages that are clearly visible), volumetric taxation, service of alcohol, advertising, opening hours, number of liquor outlets
  • support liquor restrictions where this is supported by the community

Researchers can:

  • work with organisations/communities to design prevention strategies that meet their needs
  • evaluate the effectiveness of awareness campaigns
  • evaluate the effectiveness of education and training for health professionals