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The midwife´s dialogue about alcohol in a lifecycle perspective with both parents-to-be
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2016 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Alcohol use during pregnancy can damage the fetus. Midwives at antenatal care (ANC) screen pregnant women for risk drinking in early pregnancy. There are however, no routines involving both parents-to-be in a dialogue about alcohol.

The aim of this thesis is to investigate alcohol use among pregnant women and their partners and to evaluate a method for midwives’ dialogue about alcohol in a life cycle perspective with both parents-to-be.

Study I was a quasi-experiment within ANC. An intervention group (IG) received counseling with the midwife about alcohol use. The IG (238 couples) and a comparison group (271 couples) filled out questionnaires in early and in late pregnancy about alcohol use and support for an alcohol-free pregnancy. Study II was a cross-sectional study where 444 partners of pregnant women filled out a questionnaire at ANC about alcohol use, motives for decreased drinking and their perception about the midwives’ counseling about alcohol.

Alcohol consumption was low among the pregnant women. One third (30 %) had decreased alcohol use before pregnancy and 90% stopped drinking after pregnancy confirmation. Of the partners, 24 % decreased alcohol use before pregnancy and 40 % decreased during pregnancy. Around 90 % of the women received support for an alcohol-free pregnancy, compared to 37 % of the partners. Twenty per cent of partners and 25 % of pregnant women reported alcoholism in their family. Partners who had alcoholism in the family drank more than partners without this experience. A majority, 95 %, of the partners in study II used alcohol, 29 % were binge drinking on a normal drinking day and 74 % were binge drinking occasionally. Most partners appreciated the counseling about alcohol and reported various motives for decreased alcohol consumption.

Many pregnant women and partners decreased alcohol consumption in transition to parenthood, which is a crucial time for changing alcohol-drinking patterns. Involving both parents-to-be in counseling about alcohol restrictions during pregnancy may be a useful health promotion strategy.

Place, publisher, year, edition, pages
Uppsala: Uppsala University, Department of Women's and Children's Health , 2016. , 59 p.
Keyword [en]
alcohol consumption, AUDIT-C, drinking context, health promotion, intervention, life cycle perspective, partners, pregnancy, social support
National Category
Medical and Health Sciences Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-280613OAI: oai:DiVA.org:uu-280613DiVA: diva2:911407
Presentation
2016-03-07, Auditorium, Gustavianum, Akademigatan 3, Uppsala, 13:00
Available from: 2016-03-15 Created: 2016-03-11 Last updated: 2016-07-27Bibliographically approved
List of papers
1. Alcohol Consumption among partners of pregnant women in Sweden: a cross sectional study
Open this publication in new window or tab >>Alcohol Consumption among partners of pregnant women in Sweden: a cross sectional study
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2016 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, 694Article in journal (Refereed) Published
Abstract [en]

Background: Antenatal care in Sweden involves a visit in pregnancy week 6-7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perception of the midwife’s counseling about alcohol.

Method: The study was conducted at 30 antenatal care centers across Sweden in 2009 - 2010.  All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption.

Results: Questionnaires from 444 partners were analyzed. Most, 95%, of the partners reported alcohol consumption before pregnancy; 18% were binges drinking (6 standard drinks or more/occasion, each drink containing 12 grams of pure alcohol) at least once every1month during the last year. More than half, 56%, of all partners had decreased their alcohol consumption since pregnancy recognition and a higher proportion of frequent binge drinkers (every month or more often) decreased their alcohol consumption compared to non-frequent binge drinkers (p=0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving drinking) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37% reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Most partners appreciated the midwife’s counseling on alcohol.

Conclusion: A majority of partners decreased their alcohol consumption in transition to parenthood, which seems to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife ́s talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking during pregnancy and parenthood, also for the partners. Written information addressing alcohol use and directed to partners is needed.

Keyword
alcohol consumption, audit-c, drinking context, generations, health promotion, life-cycle perspective, partner, pregnancy, social support
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-272338 (URN)10.1186/s12889-016-3338-9 (DOI)000381004300014 ()27484750 (Scopus ID)
Funder
Public Health Agency of Sweden , HFÅ 2012/113
Available from: 2016-02-25 Created: 2016-01-13 Last updated: 2017-11-30Bibliographically approved
2. Dialogue between Midwives and Parents-to-Be about Alcohol, from a Life Cycle Perspective—An Intervention Study
Open this publication in new window or tab >>Dialogue between Midwives and Parents-to-Be about Alcohol, from a Life Cycle Perspective—An Intervention Study
2015 (English)In: Creative Education, ISSN 2151-4755, E-ISSN 2151-4771, Vol. 6, 489-500 p.Article in journal (Refereed) Published
Abstract [en]

The objective was to investigate the use of alcohol during pregnancy among parents-to-be and to develop and evaluate a method for a dialogue about alcohol from a life cycle perspective. The study was a quasi-experiment. An intervention group (IG) with 238 couples and a comparison group (CG) with 271 couples participated. All of the participants were recruited at public antenatal care clin- ics (ANC) in Sweden. At registration, the midwife had a dialogue about alcohol with the IG, and the intervention was evaluated using questionnaires in pregnancy weeks 12 and 33. Alcohol consump- tion, alcoholism in the family, social support, and source of information were measured. More than 91% of all pregnant women reported that they never drank alcohol either at registration or late in pregnancy, with no difference between the intervention group and the comparison group. Their male partners had a different pattern; 6% abstained from alcohol and about half of them drank alcohol two to four times a month. Nine percent of the participants had experienced an alcohol-de- pendent parent and 35% of the couples reported alcoholism in either of their families. Most women (92%) stated that the partner’s support to give up alcohol was important. After the intervention, more women in the IG were offered alcohol-free alternatives. About 40% of the partners had re- duced their alcohol consumption; they received less social support for alcohol reduction than the pregnant women. A majority, 68%, of the women in the IG stated ANC as the most important source of information about alcohol and pregnancy, compared to 53% in the CG (p < 0.001). After the intervention, a higher proportion of women in the IG were offered alcohol-free alternatives and ANC became the most important source of information about alcohol. Involving the partner in counseling about alcohol-restriction during pregnancy may be a useful health promotion strategy.

Keyword
alcohol, intervention, pregnancy, partner, social support
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-272332 (URN)10.4236/ce.2015.65049 (DOI)
Funder
Public Health Agency of Sweden , HFÅ 2012/113
Available from: 2016-02-25 Created: 2016-01-13 Last updated: 2017-11-30Bibliographically approved

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