Alcohol messages disseminated to pregnant women by midwives

Background: Pregnant women frequently report inconsistent messages regarding alcohol consumption from their healthcare providers. Midwives play a major role in prenatal care. However, little research has examined alcohol-related information provided by midwives. Objective: To examine alcohol-related messages disseminated to pregnant women by midwives. Methods: In 2018, 61 certified professional midwives (CPMs) and certified nurse-midwives (CNMs) were recruited from professional organizations in a southwestern state. Midwives responded to an online cross-sectional survey containing the prompt: “A pregnant patient confides in you that she drinks alcohol. She then asks you to tell her a “safe” level of alcohol consumption that won’t cause harm to her unborn fetus. How would you respond?” Open-ended responses were analyzed through content analysis and categorized using an inductive approach. Results: Responses were grouped into five non-exclusive themes: “harmful effects and unknown safe limits” (77.0%); “abstaining is best” (50.8%); “light drinking is acceptable” (16.4%); “describe your drinking” (21.3%); “I will refer you” (16.4%). The most frequently shared messages were “safe levels of prenatal alcohol use are unknown” (68.9%) and “discontinue alcohol during pregnancy” (45.9%). However, some messages contradicted US dietary guidelines, including “a little bit of alcohol unlikely to cause harm” (11.5%); “cut-down if having more than 1–2 drinks per occasion” (4.9%); and “if you must drink, wine is best” (1.6%). CPMs were less likely to share abstinence messages (p = .003) and more likely to suggest referrals (p = .024), compared to CNMs. Conclusion: Concerted efforts are needed to ensure information disseminated aligns with health guidelines and encourages abstinence during pregnancy.