In 2021, FARE commissioned Heartward Strategic to conduct research to inform the development of the Fetal Alcohol Spectrum Disorder (FASD) – National Awareness Campaign for Pregnancy and Breastfeeding Women (hereafter the National Campaign). This report presents the findings of a rapid evidence review and in-depth interviews with 36 health professionals who see pregnant women (predominantly GPs, but also nurses and allied health practitioners) and outlines the implications for communicating this topic with health professionals.
The research finds that health professionals by and large show interest and willingness to expand their knowledge, provide more information and increase their role in communicating about alcohol and pregnancy, with the primary focus naturally falling to GPs (especially shared care) and midwives; with Aboriginal and Torres Strait Islander health workers, and maternal and child health nurses and practice nurses, also playing a role.
Health professionals, therefore, form the primary audience for Stream 3 of the National Campaign. There is also a potential role for other health professionals who encounter pregnant women (particularly pharmacists, nutritionists/dieticians and naturopaths) to display and/or distribute campaign materials and/or consistently reinforce the message for pregnant women to speak with their main pregnancy healthcare professionals about alcohol. Though this may not be seen as a core part of their role, these allied health professionals have an overall impact regarding communication about alcohol, reinforcing the need for consistency of message.
Opportunities exist at all stages of pregnancy to assist in reducing the incidence of alcohol-exposed pregnancies, with the greatest importance being at the pre-conception planning stage and in early pregnancy.
This research also suggests that health professionals need to improve the consistency and depth of their communication with women in the first consultations when pregnancy is confirmed and to revisit the topic throughout pregnancy.
This research finds that there is a need to focus on increasing both the capabilities and opportunities for health professionals to engage on this issue and that the National Campaign should particularly focus on the following:
- The skills, confidence and beliefs that health professionals need to effectively and sensitively discuss alcohol with all women who are pregnant and planning pregnancy, even outside of these life stages.
- When health professionals discuss alcohol with women, they must do so universally and consistently and in a manner that is aligned with the guidelines and overall general public campaign. This should be done by increasing their knowledge of clinical care and alcohol guidelines and ensuring they recognise that alcohol consumption can be under-reported and can change over the course of the pregnancy.
- Health professionals need to understand and consider the risks of alcohol consumption during pregnancy. Health professionals need to believe in the urgency and importance of communicating this topic as early as possible and consider the issue relevant to all women. This can be achieved by addressing knowledge deficits and reducing reliance on personal experiences, beliefs, assumptions, biases and other non-clinical frames to guide clinical decisions.
- Health professionals encountering women who are pregnant or planning pregnancy need to be aware that they have an important role to play in delivering a consistent message about alcohol consumption.
Authors: Heartward Strategic (Anne De Silva, Bettina Spence, Christina Falsone)