With this research, we aimed to raise elements to enhance the understanding of alcohol consumption among pregnant women in Brazil. Fourteen women identified as alcohol consumers during pregnancy were interviewed. Alcohol consumption during pregnancy seemed to be associated with three groups of interconnected issues: subjective and individual issues (such as expectations, motivations, and women’s difficulty in identifying their own consumption as risky); sociocultural and environmental issues (such as alcohol cultural value, easy access, and influence from relatives, friends, and partners); misinformation, inconsistent opinions publicized through media and lack of technically addressing the subject during prenatal care. Collective and individual health educative actions seem necessary to decrease alcohol consumption among Brazilian women with similar sociocultural characteristics. Media campaigns and explicit information about negative alcohol effects, articulated with individualized actions, such as a systematic approach of this theme during prenatal care, could allow earlier and more appropriate identification and intervention of women at risk.
AgrawalA.DickD. M.BucholzK. K.MaddenP. A.CooperM. L.SherK. J.HeathA. C. (2008). Drinking expectancies and motives: A genetic study of young adult women. Addiction, 103(2), 194–204. https://doi.org/10.1111/j.1360-0443.2007.02074.x
2.
AlvikA.AalenO. O.LindemannR. (2013). Early fetal binge alcohol exposure predicts high behavioral symptom scores in 5.5-year-old children. Alcoholism, Clinical and Experimental Research, 37(11), 1954–1962. https://doi.org/10.1111/acer.12182
AndersonA. E.HureA. J.Kay-LambkinF. J.LoxtonD. J. (2014). Women’s perceptions of information about alcohol use during pregnancy: A qualitative study. BMC Public Health, 14, Article 1048. https://doi.org/10.1186/1471-2458-14-1048
6.
BaptistaF. H.RochaK. B. B.MartinelliJ. L.AvóL. R. S.FerreiraR. A.GermanoC. M. R.MeloD. G. (2017). Prevalence and factors associated with alcohol consumption during pregnancy. Revista Brasileira de Saúde Materno Infantil, 17(2), 271–279. https://doi.org/10.1590/1806-93042017000200004
BrownC.StewartS. H. (2021). Harm reduction for women in treatment for alcohol use problems: Exploring the impact of dominant addiction discourse. Qualitative Health Research, 31(1), 54–69. https://doi.org/10.1177/1049732320954396
12.
BrownS. A.GoldmanM. S.InnA.AndersonL. R. (1980). Expectations of reinforcement from alcohol: Their domain and relation to drinking patterns. Journal of Consulting and Clinical Psychology, 48(4), 419–426. https://doi.org/10.1037//0022-006x.48.4.419
13.
CamposE. A.ReisJ. G. (2010). Representations on the use of alcohol among women undergoing treatment at a reference center in the city of São Paulo, Brazil. Interface—Comunicação, Saúde, Educação, 14(34), 539–550. https://doi.org/10.1590/S1414-32832010005000006
14.
CavarianiM. B.OliveiraJ. B.Kerr-CorrêaF.LimaM. C. (2012). Positive expectations towards alcohol use and binge drinking: Gender differences in a study from the GENACIS project, São Paulo, Brazil. Cadernos de saude publica, 28(7), 1394–1404. https://doi.org/10.1590/s0102-311x2012000700017
15.
ChoateP.BadryD.MacLaurinB.AriyoK.SobhaniD. (2019). Fetal alcohol spectrum disorder: What does public awareness tell us about prevention programming?International Journal of Environmental Research and Public Health, 16(21), 4229. https://doi.org/10.3390/ijerph16214229
16.
Corrales-GutierrezI.MendozaR.Gomez-BayaD.Leon-LariosF. (2019). Pregnant women’s risk perception of the teratogenic effects of alcohol consumption in pregnancy. Journal of Clinical Medicine, 8(6), 907. https://doi.org/10.3390/jcm8060907
Crawford-WilliamsF.SteenM.EstermanA.FielderA.Mikocka-WalusA. (2015). “My midwife said that having a glass of red wine was actually better for the baby”: A focus group study of women and their partner’s knowledge and experiences relating to alcohol consumption in pregnancy. BMC Pregnancy and Childbirth, 15, 79. https://doi.org/10.1186/s12884-015-0506-3
FabbriC. E.FurtadoE. F.LapregaM. R. (2007). Alcohol consumption in pregnancy: Performance of the Brazilian version of the questionnaire T-ACE. Revista de saude publica, 41(6), 979–984. https://doi.org/10.1590/s0034-89102006005000044
FletcherO. V.MayP. A.SeedatS.SikkemaK. J.WattM. H. (2018). Attitudes toward alcohol use during pregnancy among women recruited from alcohol-serving venues in Cape Town, South Africa: A mixed-methods study. Social Science & Medicine, 215, 98–106. https://doi.org/10.1016/j.socscimed.2018.09.008
23.
FlickU. (2004). Triangulation in qualitative research. In FlickU.von KardorffE.SteinkeI. (Eds.), A companion to qualitative research (pp. 178–183). SAGE.
24.
FontanellaB. J.CamposC. J.TuratoE. R. (2006). Data collection in clinical-qualitative research: Use of non-directed interviews with open-ended questions by health professionals. Revista latino-americana de enfermagem, 14(5), 812–820. https://doi.org/10.1590/s0104-11692006000500025
25.
FortneyJ.MukherjeeS.CurranG.FortneyS.HanX.BoothB. M. (2004). Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers. The Journal of Behavioral Health Services & Research, 31(4), 418–429. https://doi.org/10.1007/BF02287693
26.
FrazerZ.McConnellK.JanssonL. M. (2019). Treatment for substance use disorders in pregnant women: Motivators and barriers. Drug and Alcohol Dependence, 205, 107652. https://doi.org/10.1016/j.drugalcdep.2019.107652
27.
GarciaA. M. (2004). And the verb (re)made man: Study of the conversion process from active alcoholic to passive alcoholic (1st ed.). Intertexto.
28.
GearingR. E.McNeillT.LozierF. A. (2005). Father involvement and fetal alcohol spectrum disorder: Developing best practices. Journal of FAS International, 3, Article e14. https://www.researchgate.net/publication/228616932
29.
GibsonS.NagleC.PaulJ.McCarthyL.MuggliE. (2020). Influences on drinking choices among Indigenous and non-Indigenous pregnant women in Australia: A qualitative study. PLOS ONE, 15(4), Article e0224719. https://doi.org/10.1371/journal.pone.0224719
30.
GouilhersS.MeyerY.InglinS.Pfister BoulenazS.SchneggC.HammerR. (2019). Pregnancy as a transition: First-time expectant couples’ experience with alcohol consumption. Drug and Alcohol Review, 38(7), 758–765. https://doi.org/10.1111/dar.12973
31.
GuimarãesV. A.FernandesK. S.LuccheseR.VeraI.MartinsB.AmorimT. A.GuimarãesR. A. (2018). Prevalence and factors associated with alcohol use during pregnancy in a maternity hospital in Goiás, Central Brazil. Ciencia & saude coletiva, 23(10), 3413–3420. https://doi.org/10.1590/1413-812320182310.24582016
HockingM.O’CallaghanF.ReidN. (2020). Women’s experiences of messages relating to alcohol consumption, received during their first antenatal care visit: An interpretative phenomenological analysis. Women and Birth Journal of the Australian College of Midwives, 33(2), e122–e128. https://doi.org/10.1016/j.wombi.2019.02.002
34.
JagerJ.PutnickD. L.BornsteinM. H. (2017). II. More than just convenient: The scientific merits of homogeneous convenience samples. Monographs of the Society for Research in Child Development, 82(2), 13–30. https://doi.org/10.1111/mono.12296
JonesS. C.TelentaJ. (2012). What influences Australian women to not drink alcohol during pregnancy?Australian Journal of Primary Health, 18(1), 68–73. https://doi.org/10.1071/PY10077
37.
JonesT. B.BaileyB. A.SokolR. J. (2013). Alcohol use in pregnancy: Insights in screening and intervention for the clinician. Clinical Obstetrics and Gynecology, 56(1), 114–123. https://doi.org/10.1097/GRF.0b013e31827957c0
38.
KehayesI. L.MackinnonS. P.SherryS. B.LeonardK. E.StewartS. H. (2017). Similarity in romantic couples’ drinking motivations and drinking behaviors. Substance Abuse, 38(4), 488–492. https://doi.org/10.1080/08897077.2017.1355869
39.
Kerr-CorrêaF.TucciA. M.HegedusA. M.TrincaL. A.de OliveiraJ. B.FloripesT. M.KerrL. R. (2008). Drinking patterns between men and women in two distinct Brazilian communities. Revista brasileira de psiquiatria, 30(3), 235–242. https://doi.org/10.1590/s1516-44462008000300010
40.
MartinelliJ. L.GermanoC.de AvóL.FontanellaB.MeloD. G. (2019). Motivation for alcohol consumption or abstinence during pregnancy: A clinical-qualitative study in Brazil. PLOS ONE, 14(10), Article e0223351. https://doi.org/10.1371/journal.pone.0223351
41.
MendozaR.Morales-MarenteE.PalaciosM. S.Rodríguez-ReinadoC.Corrales-GutiérrezI.García-AlgarÓ. (2020). Health advice on alcohol consumption in pregnant women in Seville (Spain). Gaceta sanitaria, 34(5), 449–458. https://doi.org/10.1016/j.gaceta.2018.11.008
42.
MeurkC. S.BroomA.AdamsJ.HallW.LuckeJ. (2014). Factors influencing women’s decisions to drink alcohol during pregnancy: Findings of a qualitative study with implications for health communication. BMC Pregnancy and Childbirth, 14, Article 246. https://doi.org/10.1186/1471-2393-14-246
NovickG.SadlerL. S.KennedyH. P.CohenS. S.GroceN. E.KnaflK. A. (2011). Women’s experience of group prenatal care. Qualitative Health Research, 21(1), 97–116. https://doi.org/10.1177/1049732310378655
45.
PalinkasL. A.HorwitzS. M.GreenC. A.WisdomJ. P.DuanN.HoagwoodK. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y
46.
PaternoM. T.LowM.GubriumA.SangerK. (2019). Mothers and mentors: Exploring perinatal addiction and recovery through digital storytelling. Qualitative Health Research, 29(4), 545–556. https://doi.org/10.1177/1049732318777474
RoozenS.PetersG. Y.KokG.TownendD.NijhuisJ.KoekG.CurfsL. (2018). Systematic literature review on which maternal alcohol behaviours are related to fetal alcohol spectrum disorders (FASD). BMJ Open, 8(12), Article e022578. https://doi.org/10.1136/bmjopen-2018-022578
49.
SchölinL.FitzgeraldN. (2019). The conversation matters: A qualitative study exploring the implementation of alcohol screening and brief interventions in antenatal care in Scotland. BMC Pregnancy and Childbirth, 19(1), Article 316. https://doi.org/10.1186/s12884-019-2431-3
50.
SokolR. J.MartierS. S.AgerJ. W. (1989). The T-ACE questions: Practical prenatal detection of risk-drinking. American Journal of Obstetrics and Gynecology, 160(4), 863–870. https://doi.org/10.1016/0002-9378(89)90302-5
TuratoE. R. (2013). Treatise of methodology in clinical-qualitative research: Theoretical-epistemological construction, compared discussion and application in humanities and health area (6th ed.). Vozes.
54.
van der WulpN. Y.HovingC.de VriesH. (2013). A qualitative investigation of alcohol use advice during pregnancy: Experiences of Dutch midwives, pregnant women and their partners. Midwifery, 29(11), e89–e98. https://doi.org/10.1016/j.midw.2012.11.014
55.
WadaK.EvansM. K.de VrijerB.NiskerJ. (2018). Clinical research with pregnant women: Perspectives of pregnant women, health care providers, and researchers. Qualitative Health Research, 28(13), 2033–2047. https://doi.org/10.1177/1049732318773724
56.
WattM. H.EatonL. A.ChoiK. W.VellozaJ.KalichmanS. C.SkinnerD.SikkemaK. J. (2014). “It’s better for me to drink, at least the stress is going away”: Perspectives on alcohol use during pregnancy among South African women attending drinking establishments. Social Science & Medicine, 116, 119–125. https://doi.org/10.1016/j.socscimed.2014.06.048
57.
WattM. H.EatonL. A.DennisA. C.ChoiK. W.KalichmanS. C.SkinnerD.SikkemaK. J. (2016). Alcohol use during pregnancy in a South African Community: Reconciling knowledge, norms, and personal experience. Maternal and Child Health Journal, 20(1), 48–55. https://doi.org/10.1007/s10995-015-1800-4
XuR.Honerkamp-SmithG.ChambersC. D. (2019). Statistical sensitivity analysis for the estimation of fetal alcohol spectrum disorders prevalence. Reproductive Toxicology, 86, 62–67. https://doi.org/10.1016/j.reprotox.2019.04.002
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