Section One: The review explores available evidence of women’s drinking both nationally and internationally. The impact of drinking patterns is discussed and, in relation to pregnancy, the highest risk patterns for the pregnant woman and her unborn child are described. Many women are into week 4, 5 or even later when their pregnancies are confirmed. For this reason, the importance of preconception care is highlighted. Some factors put women at increased risk of drinking in pregnancy including the vulnerability associated with adverse childhood experiences and familial history of drinking. Post-traumatic stress related to domestic abuse and mental health issues will also be described. 

Section Two: The types of screening tools most commonly used to collect information on alcohol consumption are described, and the advantages and disadvantages of using them are discussed. Alternatives to using standardised screening tools will be noted, as will some of the legal and ethical concerns around the use of the information collected. Aspects of what enables the development of a positive relationship between the pregnant woman and the health professionals are described, along with the issues that get in the way of this important step. These enablers and barriers will be explored. The internal view of the health professional includes attitudes, beliefs and values that may help or hinder the process. The internal view of the woman, and how she perceives the health professionals, depends on her past experiences in life. The external aspects - for example, the noise of a busy clinic or the problem of seeing a different health professional at every visit - will be highlighted. Issues that affect both pregnant women and health professionals, such as stigma, will be discussed. The impact of the partner’s drinking will be described. Some postnatal aspects, such as the effect of alcohol on breastfeeding, will be noted. 

Section Three: Although this neurodevelopmental condition has the word ‘Fetal’ in the title, this is a lifelong condition. The physical issues that people with Fetal Alcohol Spectrum Disorder (FASD) experience across the life course will be described. Problems encountered by children, young people and adults themselves, as well as their parents, carers and siblings will be addressed. The behavioural aspects of Fetal Alcohol Spectrum Disorder (FASD) will also be described, and the problems experienced at different ages will be highlighted. The implications for a parent, carer or sibling of a person with FASD will be noted too. 

Section Four: This fourth section will describe and explore some of the training around prenatal alcohol exposure that evidence has shown to be effective. The need for improved knowledge, understanding and communication between health professionals and prospective parents, before and after conception, will be highlighted. Suggestions on improvements and further development of training to be made available to health professionals will be offered. Finally, recommendations for ways forward in this area are suggested for the Queens Nursing Institute Scotland, for Partners in Scotland’s Coalition for Healthier Pregnancies, Better Lives Healthier Pregnancies, Better Lives (qnis.org.uk) and for Scottish society

See also, Plant, Moira (2022) Women, alcohol, pregnancy and FASD. QNIS Blog