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“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

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  • Watt, Melissa H.
  • Eaton, Lisa A.
  • Choi, Karmel W.
  • Velloza, Jennifer
  • Kalichman, Seth C.
  • Skinner, Donald
  • Sikkema, Kathleen J.

Abstract

The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who drink during pregnancy is lacking. Convenience sampling in alcohol-serving venues was used to identify women who were currently pregnant (n = 12) or recently post-partum (n = 12) and reported drinking during the pregnancy period. In-depth qualitative interviews were conducted between April and August 2013. Interviews explored drinking narratives, with textual data analyzed for themes related to factors that contributed to drinking during pregnancy. All but one woman reported her pregnancy as unplanned. The majority sustained or increased drinking after pregnancy recognition, with patterns typically including multiple days of binge drinking per week. Analysis of the textual data revealed five primary factors that contributed to drinking during pregnancy: 1) women used alcohol as a strategy to cope with stressors and negative emotions, including those associated with pregnancy; 2) women drank as a way to retain social connection, often during a difficult period of life transition; 3) social norms in women's peer groups supported drinking during pregnancy; 4) women lacked attachment to the pregnancy or were resistant to motherhood; and 5) women were driven physiologically by alcohol addiction. Our data suggest that alcohol-serving settings are important sites to identify and target women at risk of drinking during pregnancy. Intervention approaches to reduce alcohol use during pregnancy should include counseling and contraception to prevent unwanted pregnancies, mental health and coping interventions targeting pregnant women, peer-based interventions to change norms around perinatal drinking, and treatment for alcohol dependence during pregnancy. Our findings suggest that innovative interventions that go beyond the boundaries of the health care system are urgently needed to address FASD in this region.

Suggested Citation

  • Watt, Melissa H. & Eaton, Lisa A. & Choi, Karmel W. & Velloza, Jennifer & Kalichman, Seth C. & Skinner, Donald & Sikkema, Kathleen 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, Elsevier, vol. 116(C), pages 119-125.
    • Handle: RePEc:eee:socmed:v:116:y:2014:i:c:p:119-125
    DOI: 10.1016/j.socscimed.2014.06.048
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    2. Marlow, Marguerite & Christie, Hope & Skeen, Sarah & Rabie, Stephan & Louw, Jacobus G. & Swartz, Leslie & Mofokeng, Shoeshoe & Makhetha, Moroesi & Tomlinson, Mark, 2021. "Alcohol use during pregnancy in rural Lesotho: “There is nothing else except alcohol”," Social Science & Medicine, Elsevier, vol. 291(C).
    3. Vivian Lyall & Lindsay Wolfson & Natasha Reid & Nancy Poole & Karen M. Moritz & Sonya Egert & Annette J. Browne & Deborah A. Askew, 2021. "“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy," IJERPH, MDPI, vol. 18(7), pages 1-24, March.
    4. Lesch, Elmien & Adams, Arlene R., 2016. "Couples living with and around alcohol abuse: A study of a farmworker community in the Cape Winelands, South Africa," Social Science & Medicine, Elsevier, vol. 156(C), pages 167-174.
    5. Fletcher, Olivia V. & May, Philip A. & Seedat, Soraya & Sikkema, Kathleen J. & Watt, Melissa 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, Elsevier, vol. 215(C), pages 98-106.

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