Edinburgh Napier University

  Background: Many factors, including alcohol consumption, may affect a baby’s likelihood of being born with Foetal Alcohol Spectrum Disorders (FASD), yet most qualitative research does not explore contextual factors or the perspectives of women who drink at ‘high risk’ levels.

Aim: The aim of this study was to explore the views and experiences of women who drink (or drank) during pregnancy, and professionals who provide treatment and care for pregnant women drinkers, including how various aspects of women’s lives intersect with one another and with alcohol consumption.

Methods: Drawing on feminist standpoint theory, intersectionality theory and feminist fractured foundationalism, semi-structured photo-elicitation interviews and focus groups were undertaken with 14 women, including 3 who had been involved with specialist services, and 10 specialist practitioners in the UK. These were analysed using a narrative-informed approach to reflexive thematic analysis.

Findings: Participants described a range of interconnected contextual factors as important in relation to drinking during pregnancy, including poverty, trauma, and social factors. Women who had been involved with specialist services during pregnancy had all experienced multiple intersecting adversities, mediated by structural inequalities, which affected every part of their lives including their drinking. This thesis demonstrates the importance of taking women’s contexts into account when attempting to understand and respond to drinking during pregnancy, but suggests that current structures, policies, and narratives based around individual responsibility, reproductive citizenship and child protection render services unable to offer intensive support for women’s complex contexts. The current policy approach may instead add further adversity and exacerbate women’s powerlessness.

Conclusion: This thesis reframes drinking during pregnancy as a social issue. It argues for a social approach to drinking during pregnancy based on principles of anti-oppressive policy and practice, to provide effective care and support for women who may be at a higher risk of having a baby with FASD.