Midwives and nurse-midwives may underestimate the dangers of prenatal alcohol use

Alcohol use during pregnancy can have harmful consequences on the fetus including restricted growth, facial anomalies, and neurobehavioral problems. No amount of alcohol use during pregnancy has been proven safe. Yet a recent survey of midwives and nurses who provide prenatal care showed that 44% think one drink per occasion is acceptable while pregnant, and 38% think it is safe to drink alcohol during at least one trimester of pregnancy.

"Many prenatal care providers remain inadequately informed of the risks of drinking during pregnancy," said John Hannigan, Ph.D., one of the study's authors and a professor of at Wayne State University's Merrill Palmer Skillman Institute. "They fail to screen actively for alcohol use and miss opportunities for intervention." The research team analyzed 578 survey responses from professional members of the American College of Nurse Midwives. In collaboration with researchers at University of Massachusetts, the survey assessed knowledge of the effects of prenatal alcohol use, attitudes toward and perceived barriers to screening for alcohol use, and the use of standard screening tools in clinical practice.

"Only about one in three respondents said they screen for alcohol use at least some of the time," Hannigan said, "and many screening tools aren't validated for use in pregnant women." Midwives and nurses who believed alcohol was safe at some point in pregnancy were significantly less likely to screen their patients.

These results expand previous research that found prenatal care providers are often inadequately informed of the risks of drinking during pregnancy and fail to actively screen for alcohol use. The study recommends more comprehensive training for providers of care during pregnancy. "Midwives need to understand the health effects of alcohol use during pregnancy, the importance of screening, and the most reliable screening tools to use," Hannigan said. "The good news is this problem can be fixed."