ArticleBMC pregnancy and childbirth2021
Barriers and enablers of implementation of alcohol guidelines with pregnant women: a cross-sectional survey among UK midwives.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- Dual psychometric evaluation of measures assessing attitudes toward prenatal alcohol exposure and fetal alcohol spectrum disorder.Alcohol, clinical & experimental research · 2026Article
- The fundamentals of fetal alcohol spectrum disorder: Evaluation of an awareness-raising webinar.Alcohol, clinical & experimental research · 2026Article
- Prenatal substance use during the COVID-19 pandemic in the United Kingdom: associations with depression, anxiety, and pandemic stressors.Frontiers in public health · 2026Article
- The use of alcohol-free and low-alcohol drinks in pregnancy in the UK.European journal of public health · 2025Article
- Implementation science promotes clinical practice of guidelines: a scoping review.BMC health services research · 2025Article
- Effectiveness of dissemination strategies of maternal clinical guidelines: A narrative review.African journal of primary health care & family medicine · 2024Review
- Barriers and enablers to addressing smoking, nutrition, alcohol consumption, physical activity and gestational weight gain (SNAP-W) as part of antenatal care: A mixed methods systematic review.Implementation science communications · 2024Review
- Virtual recruitment and participant engagement for substance use research during a pandemic.Current opinion in psychiatry · 2022Review
- Challenges for Antepartum Care of the Individual with Perinatal Substance Use: An Empirical Integrative Review of Novel Approaches to Improve Care.Journal of midwifery & women's healthReview
- Supportive alcohol policy as a key element of fetal alcohol spectrum disorder prevention.Women's health (London, England)Review
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2016, the UK Chief Medical Officers revised their guidance on alcohol and advised women to abstain from alcohol if pregnant or planning pregnancy. Midwives have a key role in advising women about alcohol during pregnancy. The aim of this study was to investigate UK midwives' practices regarding the 2016 Chief Medical Officers Alcohol Guidelines for pregnancy, and factors influencing their implementation during antenatal appointments.
methodsOnline cross-sectional survey of a convenience sample of UK midwives recruited through professional networks and social media. Data were gathered using an anonymous online questionnaire addressing knowledge of the 2016 Alcohol Guidelines for pregnancy; practice behaviours regarding alcohol assessment and advice; and questions based on the Theoretical Domains Framework (TDF) to evaluate implementation of advising abstinence at antenatal booking and subsequent antenatal appointments.
resultsOf 842 questionnaire respondents, 58% were aware of the 2016 Alcohol Guidelines of whom 91% (438) cited abstinence was recommended, although 19% (93) cited recommendations from previous guidelines. Nonetheless, 97% of 842 midwives always or usually advised women to abstain from alcohol at the booking appointment, and 38% at subsequent antenatal appointments. Mean TDF domain scores (range 1-7) for advising abstinence at subsequent appointments were highest (indicative of barriers) for social influences (3.65 sd 0.84), beliefs about consequences (3.16 sd 1.13) and beliefs about capabilities (3.03 sd 073); and lowest (indicative of facilitators) for knowledge (1.35 sd 0.73) and professional role and identity (1.46 sd 0.77). Logistic regression analysis indicated that the TDF domains: beliefs about capabilities (OR = 0.71, 95% CI: 0.57, 0.88), emotion (OR = 0.78; 95%CI: 0.67, 0.90), and professional role and identity (OR = 0.69, 95%CI 0.51, 0.95) were strong predictors of midwives advising all women to abstain from alcohol at appointments other than at booking.
conclusionsOur results suggest that skill development and reinforcement of support from colleagues and the wider maternity system could support midwives' implementation of alcohol advice at each antenatal appointment, not just at booking could lead to improved outcomes for women and infants. Implementation of alcohol care pathways in maternity settings are beneficial from a lifecourse perspective for women, children, families, and the wider community.
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