Perceptions of perinatal alcohol use and treatment needs in Cape Town, South Africa: a qualitative study

Petal Petersen Williams; Lesley-Ann Erasmus-Claassen; Shantae Taylor; Felicia A Browne; Wendee M Wechsberg; Bronwyn Myers; Charles D H Parry; Yukiko Washio

doi:10.3389/fpsyt.2024.1199647

Perceptions of perinatal alcohol use and treatment needs in Cape Town, South Africa: a qualitative study

Front Psychiatry. 2024 Mar 13:15:1199647. doi: 10.3389/fpsyt.2024.1199647. eCollection 2024.

Authors

Petal Petersen Williams^{1

2

3}, Lesley-Ann Erasmus-Claassen¹, Shantae Taylor⁴, Felicia A Browne^{4

5}, Wendee M Wechsberg^{4

5

6

7}, Bronwyn Myers^{1

3

8}, Charles D H Parry^{1

9}, Yukiko Washio^{4

10}

Affiliations

¹ Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.
² Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
³ Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
⁴ Substance Use, Gender and Applied Research, Research Triangle Institute (RTI) International, Research Triangle Park, NC, United States.
⁵ Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.
⁶ Psychology, North Carolina State University, Raleigh, NC, United States.
⁷ Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.
⁸ Curtin enAble Institute, Curtin University, Bentley, WA, Australia.
⁹ Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.
¹⁰ Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States.

Abstract

Background: South Africa has one of the world's highest rates of foetal alcohol spectrum disorders (FASD). Recent evidence also showed that alcohol use during lactation significantly compromises child development in children exposed to alcohol through breastfeeding, independent of prenatal alcohol exposure. This study explored perceptions of perinatal alcohol use and treatment needs in Cape Town, South Africa, to inform the development of an intervention to encourage alcohol abstinence during pregnancy and breastfeeding.

Methods: Individual in-depth interviews (IDIs) were conducted with women who were pregnant with a recent history of alcohol use (n=32) and clinic and community stakeholders (n=16). Interviews were audio recorded and transcribed verbatim. Coding and thematic analyses were conducted in NVivo 12.

Results: Results indicate widespread perception that women know the dangers of drinking alcohol while pregnant with much less known about drinking while breastfeeding. Mixed views were shared about whether women who are pregnant or breastfeeding experience alcohol-related stigma. Participants described contextual factors impacting drinking that include interpersonal violence, lack of support, stress, anxiety and poverty, and drinking being normalised. Finally, participants had mixed views and conflicting knowledge of available resources to support alcohol reduction and highlighted a desire for support groups and the involvement of partners in alcohol interventions.

Conclusions: Findings from this study highlight the need for an alcohol intervention programme that is innovative and tailored to the needs of women who are pregnant or postpartum. It also highlights the importance of including community-based support and partner involvement in these interventions.

Keywords: South Africa; alcohol use; breastfeeding; perinatal; pregnant women.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health under Award number R21AA029048. The research was also supported by the South African Medical Research Council (SAMRC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or SAMRC.