Pregnant Women's Attitudes Towards Alcohol Consumption During Pregnancy: A Systematic Review and Meta-Synthesis

Abstract

Issue addressed: Alcohol consumption during pregnancy is associated with significant risks for the unborn child, including Fetal Alcohol Spectrum Disorders, physical deformities and cognitive deficits. Though considerable efforts to minimise alcohol consumption by pregnant women have been made, many women globally continue to consume alcohol while pregnant. As such, there remains a need to understand women's attitudes towards alcohol use in pregnancy. This study aims to investigate pregnant women's attitudes towards the consumption of alcohol during pregnancy. Methods: A meta-synthesis using a meta-aggregative approach was employed. Seven databases (CINAHL, EMBASE, PubMed, PsychINFO, Scopus, Sociological Abstracts and Web of Science) were searched from database inception until mid-May 2021. Potentially eligible articles underwent a quality appraisal before being synthesised. Results: 21 studies met inclusion criteria. Critical appraisals revealed that the reporting quality of included studies was generally high. Three synthesised findings describe the complexities of navigating health advice, implications of abstaining from alcohol during pregnancy, and questions of bodily autonomy. Conclusions: Women receive confusing and contradictory advice regarding the consumption of alcohol in pregnancy. Decisions to consume alcohol in pregnancy are complex, nuanced, and socially situated. Therefore, those offering health advice to pregnant women must consider these complexities. So what? Health campaigns and health professionals must offer consistent health advice with a clear rationale for recommendations to avoid alcohol in pregnancy. Interventions that seek to improve pregnant women’s self-efficacy and involve their support networks are also likely reduce alcohol consumption in pregnancy.