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Review

“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy

1
Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia
2
Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada
3
Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R OA4, Canada
4
Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
5
School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
6
Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia
7
School of Nursing, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
*
Author to whom correspondence should be addressed.
Co-first author, these authors contributed equally to this work.
Academic Editors: Sarah Blackstone and Laura Merrell
Int. J. Environ. Res. Public Health 2021, 18(7), 3445; https://doi.org/10.3390/ijerph18073445
Received: 15 February 2021 / Revised: 22 March 2021 / Accepted: 24 March 2021 / Published: 26 March 2021
(This article belongs to the Special Issue Women’s Empowerment and Women’s Health Outcomes)
Understanding the factors that contribute to women’s alcohol use in pregnancy is critical to supporting women’s health and wellness and preventing Fetal Alcohol Spectrum Disorder. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy (PROSPERO: CRD42018098831). Twenty-seven (n = 27) articles were identified through EMBASE, CINAHL, PsycINFO, PubMed and Web of Science. The included articles were thematically analyzed using NVivo12. The analysis was informed by Canada’s Action Framework for Building an Inclusive Health System to articulate the ways in which stigma and related barriers are enacted at the individual, interpersonal, institutional and population levels. Five themes impacting women’s alcohol use, abstention and reduction were identified: (1) social relationships and norms; (2) stigma; (3) trauma and other stressors; (4) alcohol information and messaging; and (5) access to trusted equitable care and essential resources. The impact of structural and systemic factors on prenatal alcohol use was largely absent in the included studies, instead focusing on individual choice. This silence risks perpetuating stigma and highlights the criticality of addressing intersecting structural and systemic factors in supporting maternal and fetal health. View Full-Text
Keywords: Fetal Alcohol Spectrum Disorder; prevention; harm reduction; stigma; trauma-informed; women-centered; qualitative synthesis; women’s health; maternal health; substance use Fetal Alcohol Spectrum Disorder; prevention; harm reduction; stigma; trauma-informed; women-centered; qualitative synthesis; women’s health; maternal health; substance use
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MDPI and ACS Style

Lyall, V.; Wolfson, L.; Reid, N.; Poole, N.; Moritz, K.M.; Egert, S.; Browne, A.J.; Askew, D.A. “The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. Int. J. Environ. Res. Public Health 2021, 18, 3445. https://doi.org/10.3390/ijerph18073445

AMA Style

Lyall V, Wolfson L, Reid N, Poole N, Moritz KM, Egert S, Browne AJ, Askew DA. “The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. International Journal of Environmental Research and Public Health. 2021; 18(7):3445. https://doi.org/10.3390/ijerph18073445

Chicago/Turabian Style

Lyall, Vivian, Lindsay Wolfson, Natasha Reid, Nancy Poole, Karen M. Moritz, Sonya Egert, Annette J. Browne, and Deborah A. Askew 2021. "“The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy" International Journal of Environmental Research and Public Health 18, no. 7: 3445. https://doi.org/10.3390/ijerph18073445

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