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Table 3 Prevention of alcohol consumption in prenatal care in 2008 and 2018

From: Midwives’ engagement in smoking- and alcohol-prevention in prenatal care before and after the introduction of practice guidelines in Switzerland: comparison of survey findings from 2008 and 2018

VariablesNYear 2008 (N = 227)aYear 2018
(N = 300)a
Chi-2dfp
n (%)n (%)
Risk perception: rarely sipping on a glass of alcohol
 harmless501186(83.8)169(60.6)34.7972< 0.001
 slightly risky 34(15.3)90(32.3)   
 highly risky 2(0.9)20(7.2)   
Risk perception: 3 glasses/week
 harmless50150(22.9)5(1.8)108.8892< 0.001
 slightly risky 115(52.8)90(31.8)   
 highly risky 53(24.3)188(66.4)   
Risk perception: 1 glass/day
 harmless5044(1.8)0(0.0)68.2742< 0.001
 slightly risky 70(31.7)15(5.3)   
 highly risky 147(66.5)268(94.7)   
Risk perception: Sporadically alcohol use large amounts (4 glasses/occasion)
 harmless5031(0.5)0(0.0)2.35820.308
 slightly risky 8(3.6)6(2.1)   
 highly risky 211(95.9)277(97.9)   
Screening: Routinely asking all women whether they consume alcohol
all508188(83.2)231(81.9)0.14420.931
 only those suspected for alcohol use 30(13.3)40(14.2)   
 none 8(3.5)11(3.9)   
Screening: Specific questions asked regarding alcohol
Frequency of alcohol use occasions497205(90.7)254(93.7)1.59110.207
 Average amount of alcohol consumed497172(76.1)203(74.9)0.09610.757
 Frequency of binge drinking (4 glasses on a single occasion)49720(8.8)46(17.0)7.06310.008
 Type of alcoholic beverages consumed49792(40.7)125(46.1)1.4710.225
 Screening: Asking whether the partner uses alcohol50570(31.1)78(27.9)0.63810.425
 Perceived importance of partner’s alcohol use (rather or very important)b500170(76.2)209(75.5)0.04110.839
 Routinely explaining to all women the risks of alcohol consumption for the child506135(59.7)176(62.9)0.51510.473
Stop alcohol drinking interventions when a woman uses alcohol:
 Explaining the risks for the child508181(80.1)253(89.7)9.34410.002
 Repeatedly addressing alcohol use in consequent appointments50898(43.4)147(52.1)3.8610.049
 Assisting in elaboration of a plan to stop or reduce alcohol use50831(13.7)64(22.7)6.65210.010
 Providing information material to alcohol users50820(8.8)65(23.0)18.1571< 0.001
 Referral to an expert508100(44.2)135(47.9)0.66310.416
 no intervention50813(5.8)15(5.3)0.04510.832
Barriers: Reasons not to address alcohol use (rather or very true)c:
 Shortage of time42919(9.4)26(11.5)0.52410.469
 I already know many of the women and their habits from previous pregnancies46056(27.1)55(21.7)1.75610.185
 Most women already know the risks46679(37.6)89(34.8)0.40710.523
 Women with children are generally well informed about the risks46284(40.2)88(34.8)1.43310.231
 It is not within my area of responsibility46610(4.8)10(3.9)0.22410.636
 Uncertainty about clinical relevance of alcohol use45939(18.8)31(12.4)3.60410.058
 Uncertainty about being able to intervene effectively46459(28.1)70(27.6)0.01610.898
 Giving advice to alcohol users is not effective45296(46.6)66(26.8)19.0621< 0.001
 Pregnant women probably do not honestly report on alcohol use465117(55.7)108(42.4)8.23210.004
 In vocational training I was not informed on the risks of alcohol use46637(17.6)39(15.2)0.48110.488
 Alcohol use in pregnancy is a matter of private life and should not be interfered with46411(5.2)6(2.4)2.69410.101
Advice given regarding alcohol consumptiond:
 strict abstinence50932(14.3)120(40.0)42.2461< 0.001
  “strict abstinence” & “never drink more than just sipping” NA45(15.7)   
  “strict abstinence” & “reasonable consumption” NA3(1.0)   
  “strict abstinence” & “never more than just sipping” & “reasonable consumption” NA3(1.0)   
  “never drink more than just sipping”50975(33.6)77(25.7)   
  “never drink more than just sipping” & “reasonable consumption” NA14 (4.9)   
 reasonable consumption (“a glass every now and then”)509109(48.9)21(7.0)   
 one glass/day5092(0.9)0(0.0)   
  1. aThe numbers of participants in analyses differ slightly due to missing values
  2. b The answers ranged from very important to very irrelevant on a 4-point scale, we merged them into two categories: ‘rather or very important’ that took 1 and ‘rather or very unimportant’ that took 0
  3. c The answers ranged from very true to very untrue on a 4-point scale, we merged them into two categories: ‘rather or very true’ that took 1 and ‘rather or very untrue’ that took 0
  4. dIn the 2018 assessment, multiple responses were possible, i.e. midwives could indicate advising both ‘strict abstinence’ and ‘up to sipping from the glass’ (which may depend on circumstances. The Chi2 calculated is between respondents that have reported ‘strict abstinence’ as the only type of advice given regarding alcohol consumption in 2008 and 2018