Development of an alcohol liaison midwifery service in a health Trust in Northern Ireland
Consumption of alcohol is integrated into the social fabric of UK society and the guidelines for drinking alcohol during pregnancy have only recently been updated in the UK to a zero approach. There is clear evidence that alcohol may have an impact on both the ongoing pregnancy and the developing fetus.
To identify and support pregnant women with a history of alcohol misuse.
In 2013, one health Trust in Northern Ireland received support from the Big Lottery Fund to set up an Alcohol Liaison Midwifery service. This article provides an overview of the effect of maternal alcohol consumption during pregnancy and the development of a new alcohol liaison midwifery service.
The aims of the service were achieved and due to the legacy from the educational programme some may be continued by midwives.
The support required by the ongoing complex caseload of women with a history of alcohol misuse is dependent on a close working relationship between addiction and maternity services which requires a key central role to continue.
The global prevalence of alcohol use during pregnancy is estimated to be 9.8%, with an estimated prevalence of fetal alcohol syndrome in the general population of 14.6 per 10 000 people (Popova et al, 2017). There is an increasing focus on early intervention strategies to prevent potential long-term health problems, the root cause of which are often linked to lifestyle behaviours, and pregnancy is an ideal time to address issues that may impact on the future health of the fetus. Misuse of alcohol affects the individual and the family, and is reported to be a considerable economic burden to wider society, both nationally and globally (Burton et al, 2016). Consequently, health policies include an emphasis on reducing harm caused by alcohol misuse.
The UK alcohol strategy encourages hospitals to identify and support pregnant women who drink alcohol during pregnancy (HM Government, 2012). The Northern Ireland Department of Health, Social Services and Public Safety (DHSSPS) New Strategic Direction for Alcohol and Drugs (Phase 2, 2011-2016) states that: ‘hidden harm is a priority and those at risk or vulnerable include children of substance-using parents and pregnant substance misusers’ (DHSSPS, 2011). In addition, the Strategy for Maternity Care in Northern Ireland 2012–2018 (DHSSPS, 2012) proposes to give every baby and family the best start in life by reducing the percentage of pregnant women who misuse alcohol or drugs (DHSSPS, 2012). Consumption of alcohol is integrated into the social fabric of UK society, as demonstrated in the Infant Feeding Survey (McAndrew et al, 2012), where 81% of mothers surveyed across the UK reported that they drank alcohol pre-pregnancy. The Infant Feeding Survey also found that 40% of the women (and 35% in Northern Ireland) reported having drunk alcohol during pregnancy (McAndrew et al, 2012).
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