The midwife's role in supporting pregnant women who are alcohol dependent

Excessive alcohol intake among pregnant women increases the likelihood of miscarriage, premature birth, intrauterine death and fetal alcohol spectrum disorder. The aim of this article is to inform midwives’ care, management and treatment of women who are alcohol dependent and their fetus/neonate. The information provided will educate midwives on identifying women who are alcohol dependent through use of screening scales, biomarkers and sensitive communication. Post-recognition, care should be individualised and tailored to identify risk, measure harm and help women abstain from alcohol. Pregnant women who are alcohol dependent require dedicated treatment services; this article outlines an example guideline of teachable points. Educational objectives are also provided to guide module development to preparing midwives for this specialist role. Psychosocial care is paramount, with examples of interventions discussed, such as compassionate mind training. Throughout delivery of care, it is important for midwives to consider causal factors that hamper women's abstinence and improve their treatment responses. Barriers to clinic attendance also require exploration.