Supporting alcohol-free pregnancy and safe breastfeeding
She has two children, aged 3 and nearly 5. She works part-time as a solicitor.
As part of your routine antenatal assessment, you ask Phillipa whether she’s been drinking alcohol. She responds by saying that she knows the advice - but she drank in her previous pregnancies with no untoward effect on her children – and she sees no reason to give up the glass of wine she looks forward to each evening.
What are your considerations for Phillipa’s pregnancy and baby, and how would you proceed?
You may be concerned for Phillipa and her baby, especially as she is aware that she should not be drinking alcohol during pregnancy.
It’s important that Phillipa feels able to talk to you about her regular drinking and the risks it poses both to her and the baby. To ensure this, it is important to not make assumptions, ask open-ended questions, find out what she understands about the risks of drinking alcohol in pregnancy and be non-judgemental in your responses.
To assist in structuring this conversation, it can be helpful to follow the 5A’s framework: Ask, Assess, Advise, Assist and Arrange - You have already asked her whether she is drinking alcohol. You can now assess her drinking using a validated tool (AUDIT-C) (2) and advise her according to the assessed level of risk.
If she is drinking one standard drink daily, her pregnancy and baby are at risk of harm from prenatal alcohol exposure, placing her at a medium risk level. You can use motivational interviewing techniques to assist her in exploring how she can stop drinking. With her agreement, you might arrange for her to see a specialist service for further support.
These are not always easy discussions to have – but they are crucial in helping to prevent detrimental pregnancy outcomes as well as Fetal Alcohol Spectrum Disorder (FASD). The Foundation for Alcohol Research and Education (FARE) has developed a range of resources for Health Professionals including a series of online, case-based, learning modules.
Supporting alcohol-free pregnancy and safe breastfeeding course
This course is designed to support health professionals to provide accurate information and advice on this topic. The content is based on the Alcohol Guidelines and has been developed in collaboration with health professionals and experts in the field. This course is accredited with ACM, RANZCOG, RACGP & ACRRM.
Enrol for the course now, and learn more about Every Moment Matters.
References
1. NHMRC: Australian guidelines to reduce health risks from drinking alcohol
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