Discussing alcohol use during pregnancy

Discuss alcohol use with all women and men who are considering having children or are currently pregnant.

Note: Discuss alcohol use with all women and men who are considering having children or are currently pregnant.

Alcohol use in pregnancy and fetal alcohol spectrum disorder (FASD) can be sensitive topics that may stigmatise parents and families, who may feel blame or shame. Discussion of drinking in pregnancy may need to occur over several sessions, once rapport and trust are built with a mother or family.

Several considerations necessitate sensitivity when talking about drinking in pregnancy. Many pregnancies in Australia are unplanned (around 25%) and maternal alcohol use most often occurs prior to women knowing they are pregnant. Information about drinking in pregnancy can be confusing, and knowledge about the risk varies widely among women, men, and healthcare professionals. Social factors can increase the risk of alcohol use; some women use alcohol in the context of partner drinking (a known risk factor for fetal alcohol spectrum disorder), personal and family stresses, mental health issues or trauma. Include information for partners, male and female, in the discussion about drinking in pregnancy; for resources, see Resources on prevention of prenatal alcohol exposure .

When discussing alcohol use in pregnancy, use a considerate approach that incorporates the elements in An approach to discussing alcohol use in pregnancy (the 3 Ss). Ask specific questions to assess pattern of alcohol use and potential or actual prenatal exposure; for examples of screening questions, see Open questions to discuss and assess prenatal alcohol exposure.

Figure 1. An approach to discussing alcohol use in pregnancy (the 3 Ss)

Safety as a priority

ensure rapport and trust established, context provided, and appropriate additional family members or other clinicians present to support conversation

Sympathetic, sensitive and nonstigmatising

use a nonjudgemental and compassionate approach

Standardised, systematic practice

normalise the discussion as standard practice, ask all women/mothers/couples comprehensively about drinking in pregnancy

use a consistent approach, and quantification tool (eg AUDIT-C) when appropriate

Note: AUDIT-C = Alcohol Use Disorders Identification Test–Consumption