Alcohol during pregnancy: Understanding how pregnant women see risk

(3-4 mins)

When it comes to consuming alcohol in pregnancy, the message is clear: there is no safe amount of alcohol to drink at any time during pregnancy.

However, how women perceive the risks of drinking during pregnancy depends not just on the quality and consistency of information, but also on social norms and prior personal experiences, according to a new study.

May Erng, PhD candidate from The University of Queensland, explains how her work developing the Prenatal Alcohol Risk Perception (PARP) model helps us to understand pregnant women and their influences, and better prevent prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder (FASD).

Breaking down risk: How vulnerable am I? How severe are the consequences? And how do I feel about it?

According to this research, how a woman assesses her own risk when it comes to drinking during pregnancy can be broken down into three dimensions.

• Perceived Susceptibility: How vulnerable am I or my baby to the consequences of drinking in pregnancy?
• Perceived Severity: How severe are the possible consequences of drinking during pregnancy?
• Affective risk Perception: What feelings do I associate with drinking during pregnancy?

Women’s feelings about alcohol use or its associated risks are important component of their risk perception. Someone who associates drinking with positive emotions such as stress relief will assess this risk differently to someone who associates it with feelings of guilt or fear, the research explains.

This is important for health and other professionals working with pregnant women to consider, says May.

“For health professionals, this may mean asking how women feel about alcohol use, quitting alcohol, or risk information.  Is a person drinking to reduce stress? Or have fun with their friends? Do they feel worried? Or guilty? The acknowledgement of these feelings will help understand how women can be better supported and empowered to reduce or abstain from pregnancy alcohol use.”
-May Erng, PhD Candidate, The Unversity of Queensland

Social norms, personal experience, and information quality are influences

Additionally, the study identified informational, sociocultural, and individual  factors as having an influence in the perception of the risks of drinking alcohol during pregnancy.

How consistent information is, whether information confirms any existing biases, the strength of the evidence base, and relevance of this information to a particular situation are all important factors.

Social norms, such as the expectation of drinking in social settings, and how other women in social circles viewed drinking in pregnancy, are another important influence.

Finally, individual factors such as prior personal experiences can take precedence, even over advice provided by health professionals.

“Health professionals are not able to change these wider contextual factors in a person’s life. However, they can help women develop the awareness of the factors that could influence their risk perceptions,” explained May.

“Unpacking these factors create the opportunity to reflect on the reasons for their risk beliefs and alcohol use behaviour. The understanding could help direct tailored advice, help and intervention to women.”

When sharing information, health and other professionals are advised to be open, honest, and consistent about the evidence (and its limitations) for low-to-moderate levels of alcohol use in pregnancy, as well as to avoid fear-based messaging.  Instead, correcting misconceptions, and helping women to navigate sociocultural and individual circumstances are advised.

No “one-size-fits-all” when it comes to Prenatal Alcohol Exposure (PAE) and FASD prevention

Women are not passive, unbiased recipients of information, stresses this research. Instead, risk perception is unique to each individual, and a more tailored approach is needed when it comes to education about pregnancy, alcohol and FASD.

“Different individuals perceive risks differently and will have different factors influencing their risk perceptions…A tailored approach stresses the importance of identifying the relevant components for different individuals and focus the education and communication of risks according to the individuals’ needs,” said May.

More information

To find out more about the Prenatal Alcohol Risk Perception, you can read the publication here.