A Typology of Strategies Women Use to Navigate Alcohol Abstinence During Pregnancy

Current guidelines recommend alcohol abstinence during pregnancy and while trying to conceive to prevent avoidable harms. However, social norms favoring alcohol use can make abstinence difficult, especially while trying to conceal a pregnancy. The aim of this study was to identify feasible alcohol avoidance strategies and categorize them into a typology that can be used to communicate about this topic with women of child-bearing age.

Online focus groups (n = 37) and individual interviews (n = 6) were conducted with 43 Australian women aged 18-44 years who were pregnant or had recently been pregnant at the time of data collection and who had consumed alcohol at least weekly before conception. Projective techniques were used that involved presenting participants with scenarios of fictional women in situations that may arise when trying to avoid alcohol during pregnancy.

Findings indicate that those who are pregnant or trying to conceive may benefit from ready access to information about alcohol avoidance strategies that have been found effective by the women who went before them. Identified strategies were classified as Avoid/constrain the drinking context, Substitute drinks, Use an accomplice, Simulate drinking, Fib, Educate, Refuse, and Disclose.

These strategies could form the basis of health practitioner advice and user-friendly resources that are made available to women of childbearing age and pregnant women to increase their ability to avoid alcohol while trying to conceive and during pregnancy.