This study examines how the Australian media portray alcohol and pregnancy and how women respond to mediated information and advice about drinking during pregnancy. Health advice in Australia states that for women who are pregnant, planning pregnancy or breastfeeding, not drinking is the safest. However, research shows that some women do not abstain from alcohol while pregnant.
This study was designed to address this research gap using qualitative research (including textual analyses of news reports, interviews and focus groups) to explore women’s understanding of drinking alcohol in pregnancy and how they interpret media portrayals of the issue. It involved a framing analysis of 110 items from online and print newspapers, parenting and pregnancy websites and television news and current affairs about alcohol and pregnancy between 1 January 2013 and 31 October 2014. This was complemented by interviews and focus groups with 20 women based in Canberra, who were currently pregnant, had young children, or were planning for pregnancy.
News frame analysis is a form of discourse analysis designed to identify the frame or lens through which journalists and other public actors tell a particular story by emphasising one aspect of an issue and ignoring or downplaying others. In this research five frames characterised news coverage about alcohol and pregnancy in Australia: ‘contested evidence and advice’, ‘FASD crisis’, ‘blame risk-taking mothers’, ‘women’s rights’, and ‘community responsibility’. The analysis of this coverage found that news stories tended to emphasise a particular aspect of the story. Media stories contributed to the confusion around the issue by juxtaposing conflicting scientific and expert advice within a single article, often without discussion or explanation. This leads to women, their families and peers being confronted with contested ways of understanding consuming alcohol while pregnant.
The dominant frame through which journalists reported on this subject was ‘contested evidence and advice’. This frame highlighted contradictory medical advice and research findings about the risks of alcohol consumption during pregnancy, and confusion among women as to what expert advice they should follow. The source of these stories was typically new published research.
The ‘FASD crisis’ frame was also common. This frame highlighted Fetal Alcohol Spectrum Disorders (FASD) as a risk of drinking in pregnancy and provided a backdrop for stories relating to whether women should drink any alcohol in pregnancy. The ‘blame risk-taking mothers’ frame drew on a discourse of individual responsibility and often conveyed a dramatic picture of women continuing to drink during pregnancy despite government advice that is contrary to this. The ‘women’s rights’ frame emphasised women’s rights to make their own decision about drinking during pregnancy as well as the right not to be morally judged for their choices. The ‘community responsibility’ frame emphasised society’s responsibility to provide support for women to abstain from consuming alcohol in pregnancy, to provide support for women who continue to drink, and to advocate on behalf of children who suffer from FASD.
Qualitative interviews and focus groups found that Australian women are generally aware of the link between alcohol consumption during pregnancy and the potential for this to cause harm to a developing fetus, known as FASD. However women’s views of the risk and severity of this association, their perception of news media messages, understanding of health recommendations and, therefore, their experiences and attitudes toward alcohol and pregnancy varied.
More than half of the women who were interviewed in the study reflected on the experience of drinking alcohol before they realised they were pregnant. Their description of these experiences reflected an awareness that drinking while pregnant could harm a fetus. However, most women said they had received reassurance from a health professional or peers which alleviated these concerns.
Women seemed to have accepted the idea that not drinking alcohol during pregnancy is what is expected and generally advised. This attitude was not attributed to any one particular source of information, but rather a culturally accepted norm. However, importantly, many women did not see ‘moderate’ alcohol consumption or having an ‘occasional’ drink as being at odds with this.
Not all women ruled out alcohol completely during pregnancy and many said they knew of others who had made the same choice. Women’s decisions to abstain were not necessarily based on a belief that drinking alcohol would be unsafe, but were often a combination of a range of factors which they considered as part of having a health pregnancy. Women tended to adopt the view that the occasional drink was acceptable, even if they personally had decided to abstain. They quite often expressed the view that small amounts of alcohol while pregnant would not be harmful.
Uncertainty led some women to adopt the ‘better safe than sorry’ approach, but many women also tended to associate harm to the fetus only with heavy drinking. They distanced themselves from messages about extreme alcohol consumption and this was evident in their responses to the media’s use of the ‘FASD crisis’ frame.
Some women mentioned not having to look too far for advice about drinking during pregnancy. Doctors, midwives, friends and partners played a role in helping some women to put risk in context and by offering reassurance. Peer groups also worked to reinforce and encourage acceptable behaviours. Women were generally not aware of the National Health and Medical Research Council’s (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking Alcohol (‘the Guidelines’) but said they understood the precautionary rationale behind them.
Women recognised that there was contested and variable evidence available about the risks associated with consuming alcohol during pregnancy and they often referenced this in their responses to NHMRC Guidelines and media reports. Some saw the NHMRC Guidelines as a responsible public health message while others were critical that the abstinence message was dominant as they perceived there to be an absence of evidence about the harms of low-level drinking.
Women distance themselves from messages about alcohol and pregnancy that they see as alarmist or extreme. By countering alarmist news told through the ‘blame risk-taking mothers’ frame, public health organisations can help to raise awareness about the risks associated with alcohol consumption during pregnancy, including FASD. These are issues confronting the community as a whole, and therefore must be addressed as whole-of-community concerns. Public health organisations and advisers responsible for educating women about drinking alcohol in pregnancy might also consider further capitalising on the ‘women’s rights’ frame, given its strong resonance in women’s accounts.
Official and expert sources play a role in promoting particular news frames. The House of Representatives Standing Committee on Social Policy and Legal Affairs Inquiry into the prevention, diagnosis and management of Fetal Alcohol Spectrum Disorders and the resultant FASD: The hidden harm report, provided opportunities for journalists to develop news stories and access news sources. Public health organisations and researchers can capitalise on journalists’ desire for these news opportunities or occasions to generate and propagate consistent and clear messages about the risks of drinking alcohol during pregnancy.
In promoting the NHMRC Guidelines and advising women on drinking, public health experts and organisations should recognise that women are also actively interpreting the NHMRC Guidelines using their own situated knowledge. That is, to treat women as capable of interpreting and weighing up scientific evidence, including the uncertainties arising from the constraints of conducting research in this area, to make informed decisions in the context of their own pregnancies.
- Dr Kate Holland, Senior Research Fellow in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra, and member of the Health Research Institute at the University of Canberra.
- Associate Professor Kerry McCallum, Associate Professor of Communication and Media Studies in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra.
- Professor R. Warwick Blood, Emeritus Professor of Communication in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra.