Absolute Abstinence?
A mixed methods study of alcohol use during pregnancy
among parents and midwives in England and Sweden
Lisa Schölin, PhD
Liverpool John Moores University
2003
Department of
Health (2016)
NICE CG6
(2003)
2008
NICE CG62
(2008)
2016
What are the prevalence, perceptions and
approaches to prevention in England and
Sweden, and are there any
differences/similarities?
Mixed Methods – Parallel convergent design
1
2
3
STUDY 1
Survey with 347
parents (218 women)
STUDY 2
Semi-structured interviews
with 44 parents
STUDY 3
Semi-structured interviews
with 16 midwives
Main
themes
Meta
themes
Key messages
1
There are significant differences in prevalence of prenatal
alcohol use between England and Sweden, and perception
of risk more nuanced in England
2
Context of drinking was often in social settings, most
commonly “a glass of wine”, and midwives noted might
women may find it difficult not to not drink at special
occasions
3
Type of advice differed in the two countries, though
midwives in both countries promoted complete abstinence
as the appropriate advice
LIMITATIONS: Small, non-representative sample; primarily high
education; selection bias; recall bias; social desirability bias
1
44% of English women reported any
alcohol use in pregnancy, compared
to 4% of Swedish women (p<0.001)
2
60% drank
after first
trimester
“sophistication of
wine” and
perceptions of
acceptability with
controlled drinking
(Ford, 2013)
No trend in
drinking only
at typical or
special
occasions
I was just always of the opinion that I just wouldn’t have anything but
then when I actually got pregnant I did slack in a little bit and like “ah I
don’t think the odd glass of wine is not going to matter too much”
English Woman 5
3
The odds for any alcohol use was more than
four times greater if the advice was that small
amounts was okay
•
Clear message about abstinence in Sweden,
varied/contradicting information given to
parents in England
•
!?
All midwives believed abstinence was the best
advice, and the advice they gave to all women
(important to tailor to the individual)
3
I think the Government should be saying “don’t
drink” […] I think that we should all be singing
from the same hymn sheet
English midwife 7
Thank you for listening!
Supervisory team:
Dr Lorna Porcellato (LJMU), Prof Karen Hughes and Prof Mark
Bellis (Public Health Wales), Prof Charli Eriksson (Örebro
University)
Thank you to:
Regional and local maternity services in Liverpool and Örebro,
Children’s Centres in Liverpool, midwives, parents, Dr Kate
Fleming (LJMU)
@lesaangelica