A non-judgemental, woman-centred approach is effective in engaging women in the decision to change behaviours. It’s especially helpful for women who drink above low-risk levels and who may have other problematic substance use issues.
Unless otherwise reported, assume use of alcohol by all women. Try to frame questions in the past tense to avoid triggers associated with the stigma of alcohol use during pregnancy. For example: “In a typical week, on how many occasions did you usually have something to drink?”
A woman may be concerned about drinking before she knew she was pregnant. Reassure her that if she cuts down or stops, she can help her baby (while also offering help on how to cut down or stop drinking).
To encourage more accurate reporting, suggest high levels of alcohol consumption. For example: “And on those days, would it be something like 3 to 4 drinks or about 8 to 10 drinks?”