‘Mixed messaging’ around drinking alcohol while pregnant, says RCM

The Royal College of Midwives has warned of ‘mixed messaging’ after a study revealed that midwives are giving different advice around alcohol consumption during pregnancy.  

One in five (19%) midwives surveyed as part of the research, funded by the Institute of Alcohol Studies,  incorrectly reported that the chief medical officers’ (CMO) 2016 guidelines advised a limit of 1-2 units once or twice per week.

The CMO began advising pregnant women to abstain completely from alcohol in 2016, but one in four (42%) of midwives surveyed said they were not aware of the actual content CMO guidelines update.

The National Institute for Health and Care Excellence (NICE) guidance were only updated to reflect the CMO guidelines in December 2018, which the survey indicated may account for incorrect identification of the CMO guidance content among midwives.

Commenting on the findings, RCM professional policy advisor Clare Livingstone warned that the CMO and NICE are ‘out of step, resulting in mixed messaging’.

She went onto ask for a ‘standardised approach to alcohol screening and advice’, as the survey suggested that there is no such thing during antenatal appointments.

The study revealed that nearly all midwives (97%) ‘always’ or ‘usually’ advised all women to abstain from alcohol during pregnancy at the first appointment – but the proportion who did so at later appointments dropped to 38%.

Most midwives (69%) reported having fewer than four hours of alcohol training pre-qualification and 19% had received none. After qualifying, a third (33%) of midwives had not received any alcohol-related training and only a quarter (25%) were offered this within annual training updates.

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