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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
arts and humanities
"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 and Medicine, Volume 116, Year 2014
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Description
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. © 2014 Elsevier Ltd.
Authors & Co-Authors
Watt, Melissa Harper
United States, Durham
Duke University
Eaton, Lisa A.
United States, Storrs
University of Connecticut
Choi, Karmel W.
United States, Durham
Duke University
Velloza, Jennifer
United States, Durham
Duke University
Kalichman, Seth Charles
United States, Storrs
University of Connecticut
Skinner, Donald
South Africa, Stellenbosch
Stellenbosch University
Sikkema, Kathleen J.
United States, Durham
Duke University
Statistics
Citations: 70
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1016/j.socscimed.2014.06.048
ISSN:
02779536
e-ISSN:
18735347
Research Areas
Maternal And Child Health
Mental Health
Sexual And Reproductive Health
Substance Abuse
Study Design
Randomised Control Trial
Study Approach
Qualitative
Study Locations
South Africa
Participants Gender
Female