A new study funded by the Institute of Alcohol Studies (IAS) highlights there is no standardised approach to screening for alcohol consumption during antenatal appointments and inconsistency in official guidance has led to midwives giving different advice on alcohol consumption in pregnancy.
Download ‘Alcohol guidelines for pregnant women: Barriers and enablers for midwives to deliver advice’ [pdf].
Nine out of ten midwives reported alcohol abstinence was advised within the guidelines, however four out of ten midwives were not aware of the actual content of the 2016 alcohol guidelines on pregnancy.
Although nearly all midwives (97%) ‘always’ or ‘usually’ advised all women to abstain from alcohol during pregnancy at the booking appointment (the first appointment), the proportion of who did so at later appointments fell to 38%.
The survey also found that two thirds (65%) of midwives ‘always’ or ‘usually’ reported discussing the effects of drinking on the woman and her baby at booking, but this fell by half for subsequent appointments (to 31%).Most also reported having little formal alcohol training: 69% of midwives had received fewer than four hours of alcohol training pre-qualification and 19% had received none.
Results identified three areas that midwives scored as barriers to advising abstinence at appointments other than booking: women disliking being advised; midwives not feeling confident; and not feeling the advice will have any impact. On the other hand, midwives' scores indicated several facilitators to advising abstinence: desire to give the advice; seeing it as part of their role; and feeling that it's expected of them.
Lead author Lisa Schölin said:
‘Our findings that 42% midwives were not aware of the CMO guidelines suggests that the government did not effectively communicate the introduction of these updated recommendations. The CMO guidelines were introduced almost three years before the NICE guidelines were updated in line with them, meaning that during that time both guidelines were live, and no coherent message was given from all sources midwives may refer to.
‘We also found that approaches varied greatly across the UK and whilst adaptation and tailoring is important, more needs to be done to standardise approaches to assessment and recording of alcohol consumption and associated care pathways. That would allow us to better compare and understand the impact of services across the UK.’
A guest post earlier this year highlighted a lack of evidence about the effects of low to moderate alcohol use during pregnancy, thus supporting calls to raise awareness amongst pregnant mothers and midwives and that alcohol free pregnancies are safest.
Project funding to support work around foetal alcohol spectrum disorder (FASD) was recently announced by The Department of Health and Social Care (DHSC). The fund totals £473,000 though DHSC are aiming for a smaller number of grants and therefore encourage application via consortia where projects align. Earlier this year the first guidelines to help healthcare professionals in diagnosing FASD were published for Scotland.
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