“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy

Vivian Lyall, Lindsay Wolfson, Natasha Reid, Nancy Poole, Karen M. Moritz, Sonya Egert, Annette J. Browne and Deborah A. Askew
Additional contact information
Vivian Lyall: Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia
Lindsay Wolfson: Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada
Natasha Reid: Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
Nancy Poole: Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada
Karen M. Moritz: Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
Sonya Egert: Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia
Annette J. Browne: School of Nursing, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Deborah A. Askew: Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia

IJERPH, 2021, vol. 18, issue 7, 1-24

Abstract: Understanding the factors that contribute to women’s alcohol use in pregnancy is critical to supporting women’s health and wellness and preventing Fetal Alcohol Spectrum Disorder. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy (PROSPERO: CRD42018098831). Twenty-seven ( n = 27) articles were identified through EMBASE, CINAHL, PsycINFO, PubMed and Web of Science. The included articles were thematically analyzed using NVivo12. The analysis was informed by Canada’s Action Framework for Building an Inclusive Health System to articulate the ways in which stigma and related barriers are enacted at the individual, interpersonal, institutional and population levels. Five themes impacting women’s alcohol use, abstention and reduction were identified: (1) social relationships and norms; (2) stigma; (3) trauma and other stressors; (4) alcohol information and messaging; and (5) access to trusted equitable care and essential resources. The impact of structural and systemic factors on prenatal alcohol use was largely absent in the included studies, instead focusing on individual choice. This silence risks perpetuating stigma and highlights the criticality of addressing intersecting structural and systemic factors in supporting maternal and fetal health.

Keywords: Fetal Alcohol Spectrum Disorder; prevention; harm reduction; stigma; trauma-informed; women-centered; qualitative synthesis; women’s health; maternal health; substance use (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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