Alcohol in pregnancy: attitudes, knowledge, and information practice among midwives in Denmark 2000 to 2009

Abstract

Background: Most pregnant women in Denmark say they have not talked to their midwives about alcohol in pregnancy, and they have mostly been advised that some alcohol intake is all right. From 1999 to 2007, the Danish National Board of Health advised pregnant women that some alcohol intake was acceptable. Since 2007, the recommendation has been alcohol abstinence. The aim of this study was to describe the attitudes toward, knowledge about, and information practice concerning alcohol drinking in pregnancy among midwives in Denmark in 2000 and 2009 and how their answers related to the 2 different official recommendations at the time.

Methods: In 2000, we invited all midwives in the antenatal care center at Aarhus University Hospital. Ninety-four percent were interviewed about their attitudes toward and beliefs and knowledge about alcohol during pregnancy. Questions were also asked about information on alcohol provided to pregnant women. Identical questions were asked to all midwives (100%) in the antenatal care center in 2009.

Results: In 2000, most midwives (69%) considered some alcohol intake in pregnancy acceptable, mostly on a weekly level, and only 28% advised abstinence. Binge drinking, on the other hand, was considered harmful by most. There was considerable inter-person variation in the participants' attitudes and what they recommended to pregnant women. In 2009, substantially more midwives (48%) considered abstinence to be best, and significantly, more midwives (61%) gave this advice to pregnant women. Participants had received information on alcohol mostly in a professional context. Their knowledge about the official recommendations about alcohol was good, but many did not inform about the official recommendation.

Conclusions: The attitudes toward and beliefs and knowledge about drinking in pregnancy among midwives have changed along with a change in official policy. The change was mostly independent of personal characteristics of the midwives, including age, gender, and place of work.