2. Sarah Fox - Consultant Midwife Sian Phillips - Midwife

3. Is it an awkward question? Alcohol consumption increases “risky” sexual behaviour which can result in unplanned pregnancies. Upwards of 50% of pregnancies are “unplanned” Alcohol is likely to have been consumed by many women in the first trimester

4. What % of women consume alcohol at some point during their pregnancy? 75%

5. What % of women report a “binge” (6 or more units on 1 occasion) episode during pregnancy? One third

6. What % of women report a “binge” (6 or more units on 1 occasion) episode during pregnancy but after their first trimester? 1% *statistics obtained from BMJ Online Journal cited in The Independent 6/7/15

7. What may be the barriers to an honest conversation? Lack of knowledge of the impact of alcohol Lack of time Client sensitivity Stigmatisation Alienation Lack of knowledge of referral pathways

8. All Wales what questioning is required from a midwife? NB the women complete the booking notes prior to the midwife arriving. The midwife will review what is written and ask questions where appropriate and to confirm accuracy. Is this helpful to the “awkward question”?

10. Role play Types of ways to ask the questions: How many unit of alcohol do you drink per week? Do you mind if I ask whether you drink any alcohol? How many units of alcohol have you consumed in the last week? In the last month?

11. To think about Which is easier counting cigarettes or units of alcohol? Alcohol is more socially acceptable and it is legal

12. What next? Unit consumed at booking and at 36/40 Refer if: Drinking while pregnant Serious history with alcohol in the past

13. Sarah.fox@wales.nhs.uk