97% of Australian women think health professionals should ask about alcohol use in pregnancy1. A survey undertaken (link to pdf of survey on resources page) for the Women Want to Know project has also highlighted that health professionals want information about how to speak to women about alcohol and pregnancy.2
In 2009 the National Health and Medical Research Council's Australian Guidelines to Reduce Health Risks from Drinking Alcohol (Alcohol Guidelines) were updated and the information on alcohol and pregnancy was revised. The revised Alcohol Guidelines specified that ‘Maternal alcohol consumption can harm the developing fetus or breastfeeding baby’ and ‘For women who are pregnant or planning a pregnancy, not drinking is the safest option’ also, ‘For women who are breastfeeding, not drinking is the safest option.’
The development of the National Health and Medical Research Council's Australian Guidelines to Reduce Health Risks from Drinking Alcohol included public consultation and an independent peer review process. The guidelines are based, where possible, on meta-analyses and systematic reviews which synthesise results from a number of single studies.
The National Health and Medical Research Council's Australian Guidelines to Reduce Health Risks from Drinking Alcohol provide advice on levels of alcohol consumption that will enable healthy adults to minimise their risk of alcohol-related accidents, injuries, diseases and death both in the short and long term.
Guideline 4 focuses on pregnancy and breastfeeding. The guideline is based on an assessment of the evidence of the potential harms to the health of the mother and the developing fetus.
Guideline 4: Pregnancy and breastfeedingMaternal alcohol consumption can harm the developing fetus or breastfeeding baby.
A: For women who are pregnant or planning a pregnancy, not drinking is the safest option.
B: For women who are breastfeeding, not drinking is the safest option.3
How to initiate conversations about alcohol consumption and pregnancyHealth professionals can positively influence a woman’s choices about alcohol during pregnancy having a quick conversation of five to ten minutes within a consultation and by providing women with advice and guidance about alcohol at the time. One way to discuss alcohol consumption with women is to use the 5A’s approach. This is an evidence-based framework and helps to structure the conversation so that it is appropriate to the patient..4,5 The 5A’s are: Ask, Assess, Advise, Assist and Arrange.
1 Peadon E, Payne J, Henley N, O’Leary C, D’Antoine H, Bartu A, Bower C, Elliott E. (2011). How do women want to be informed about alcohol use in pregnancy? In: Book of Abstracts. 4th International Conference on Fetal Alcohol Spectrum Disorders 2011. The Power of Knowledge. Integrating Research, Policy, and Promoting Practice Around the World. March 2-5, 2011, Vancouver, Canada.
2 Ipsos Social Research Institute (2013). Women Want to Know: Pre-Intervention Survey results.
3 National Health and Medical Research Council. (2009). Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: Commonwealth of Australia.
4 Fiore, M., Bailey, W., Cohen, S., Dorfman, S., Goldstein, M., Gritz E, et al. (2000). Treating tobacco use and dependence: clinical practice guideline. US Department of Health and Human Services, Rockville MD
5 Goldstein, M., Whitlock, E. and DePue, J. (2004) Multiple behavioral risk factor interventions in primary care. Summary of research evidence. American Journal of Preventive Medicine ;27 (2 Suppl):61-79.