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Alcohol Use During Pregnancy in a South African Community: Reconciling Knowledge, Norms, and Personal Experience

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Abstract

Objectives

Due to high rates of fetal alcohol spectrum disorder (FASD) in South Africa, reducing alcohol use during pregnancy is a pressing public health priority. The aim of this study was to qualitatively explore knowledge and attitudes about maternal alcohol consumption among women who reported alcohol use during pregnancy.

Methods

The study was conducted in Cape Town, South Africa. Participants were pregnant or within 1 year postpartum and self-reported alcohol use during pregnancy. In-depth interviews explored personal experiences with drinking during pregnancy, community norms and attitudes towards maternal drinking, and knowledge about FASD. Transcripts were analyzed using a content analytic approach, including narrative memos and data display matrices.

Results

Interviews revealed competing attitudes. Women received anti-drinking messages from several sources, but these sources were not highly valued and the messages often contradicted social norms. Women were largely unfamiliar with FASD, and their knowledge of impacts of fetal alcohol exposure was often inaccurate. Participants’ personal experiences influenced their attitudes about the effects of alcohol during pregnancy, which led to internalization of misinformation. The data revealed a moral conflict that confronted women in this setting, leaving women feeling judged, ambivalent, or defensive about their behaviors, and ultimately creating uncertainty about their alcohol use behaviors.

Conclusions

Data revealed the need to deliver accurate information about the harms of fetal alcohol exposure through sources perceived as trusted and reliable. Individual-level interventions to help women reconcile competing attitudes and identify motivations for reducing alcohol use during pregnancy would be beneficial.

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Notes

  1. Participant numbers are linked to data in Table 1.

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Acknowledgments

This project was funded by a Grant from the National Institute of Alcohol Abuse and Alcoholism (R01 AA018074) and supported by the Duke Center for AIDS Research (P30 AI064518) and the HIV/AIDS, Substance Abuse, and Trauma Training Program (R25 DA035692). We are grateful to all the women who participated in this study. We would like to acknowledge Desiree Pieterse, who coordinated data collection, and the local interview team that collected the data, specifically Tembeka Fikizolo and Mariana Bolumole.

Author information

Authors and Affiliations

  1. Duke Global Health Institute, Duke University, Durham, NC, USA

    Melissa H. Watt, Alexis C. Dennis, Karmel W. Choi & Kathleen J. Sikkema

  2. Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA

    Lisa A. Eaton

  3. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA

    Karmel W. Choi & Kathleen J. Sikkema

  4. Department of Psychology, University of Connecticut, Storrs, CT, USA

    Seth C. Kalichman

  5. Unit for Research on Health and Society, Stellenbosch University, Cape Town, South Africa

    Donald Skinner

Authors
  1. Melissa H. Watt
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  2. Lisa A. Eaton
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  3. Alexis C. Dennis
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  4. Karmel W. Choi
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  5. Seth C. Kalichman
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  6. Donald Skinner
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  7. Kathleen J. Sikkema
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Correspondence to Melissa H. Watt.

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Watt, M.H., Eaton, L.A., Dennis, A.C. et al. Alcohol Use During Pregnancy in a South African Community: Reconciling Knowledge, Norms, and Personal Experience. Matern Child Health J 20, 48–55 (2016). https://doi.org/10.1007/s10995-015-1800-4

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  • DOI: https://doi.org/10.1007/s10995-015-1800-4

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