Responses to Alcohol and Pregnancy Policy

Background

Recent years have seen the development of a new policy framework focused on alcohol consumption in pregnancy, and the diagnosis of fetal alcohol spectrum disorder (FASD). Stemming from the publication of Guidance 156, issued by the Scottish Intercollegiate Guidelines Network (SIGN) in 2019, the UK has seen an increasing number of policy documents which seek to enforce mandatory alcohol screening as part of ‘routine’ antenatal care. The notion of mandatory screening has since been included in the National Institute of Health and Care Excellence’s (NICE) Draft Quality Standard on FASD, Public Health England’s (PHE) Maternity High Impact Area 4: Reducing the incidence of harms caused by alcohol in pregnancy, and most recently, the Department of Health and Social Care’s (DHSC) Health Needs Assessment for FASD.

Dr Fiona Woollard is part of the CRRC at BPAS Alcohol and Pregnancy Collaborative Network. This is a network of academics and NGOS (including the British Pregnancy Association and Birthrights) who share concerns about discourse and policy surrounding alcohol in pregnancy. There are several policies currently under consultation/ up for renewal that they are aiming to influence.

Objectives

We aim to carry out an online survey and online focus group gathering midwives' views on proposal for mandatory screening of alcohol in pregnancy to feed into our response to the 2022 review of SIGN’s Guidance 156 and the NICE Quality Standard currently under consultation and similar policies.
- guidance and support from PPUOS in influencing these policies.

We will explore the views of midwives who are tasked with enforcing this new dimension of care. While recent empirical work has sought to hear the views of midwives as to enforcing wider alcohol guidance in pregnancy (Schölin and colleagues, 2021) – mandatory screening was not explicitly addressed. We seek to gain an understanding of how the introduction of mandatory screening has impacted the patient-HCP relationship, from the perspective of midwives.

Through conducting a survey and subsequent focus group, it is our hope to hear:
• Views re: mandatory screening
• Views re: future plans to transfer alcohol information to a child’s health record
• How this has impacted the patient-HCP relationship (ethical practice and care)
• How this has impacted HCP view of their own role

As the SIGN’s Guidance 156 will be considered for review in 2022, and the NICE Quality Standard is still under consultation, it is our hope that this empirical data will be able to feed into the current trajectory. This is vital given there is not current mention of the impact on midwives or the medical profession more broadly in any equality impact assessments.

Resources