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All pregnant women and women contemplating pregnancy should be asked about their alcohol use. Ideal times to have this conversation may include:
It is important to use a nonjudgmental approach. Pregnant and parenting women can experience significant barriers and stigma when seeking help for their alcohol use. Pregnant or parenting women may be become less open to discussing changes in drinking behaviour if too direct an approach is taken at the onset.
It is a good idea to ask about alcohol more than once during the course of prenatal care. As rapport builds with the patient, it is good practice to ask again about alcohol later in the pregnancy.
Communicate to patients that it is never too late to quit drinking during a pregnancy. Stopping or reducing alcohol use at any time will improve both the woman’s health and the health of her fetus.
It may be useful to ask partners of pregnant women about their alcohol use, and to encourage them to support their pregnant partners to abstain.
Don't assume knowledge about standard drink size or effects of alcohol on the fetus. Provide pregnant women with literature related to drinking during pregnancy.
For further information on alcohol use and pregnancy, and for formal screening tools for pregnant women such as TWEAK, the T-ACE or the 5Ps, refer to the Society of Gynaecologists and Obstetricians Alcohol Use and Pregnancy Consensus Clinical Guidelines.