The missed opportunity? The important role of gynaecologists, midwives, and addiction specialists in the prevention of prenatal alcohol exposure

Aims Fetal alcohol spectrum disorders (FASDs), caused by prenatal alcohol exposure, represent a significant public health challenge. Despite their prevalence, prevention remains insufficient. This study explores knowledge gaps and barriers among gynaecologists, midwives, and addiction specialists, identifying opportunities for improvement. Methods An online survey investigated experiences of obstetric professionals and addiction specialists with pregnant women consuming alcohol, approaches to prevention, and needs for improved care in Bavaria, Germany, in 2022. Results Of 96 obstetric professionals and 123 addiction specialists, half had knowingly treated pregnant patients consuming alcohol. Fourteen percent of gynaecologists, 28% of midwives, and 15% of addiction specialists did not routinely ask pregnant women about alcohol use. Addiction specialists were more proactive, educating 80% of pregnant patients and 59% of those trying to conceive in high-risk substance use clientele. They also provided more detailed education on general risks (85% vs. 53%) and FASD (67% vs. 49%), compared to obstetric professionals. Providers desired educational materials and collaboration with FASD-experienced centres. Discussion Prevention currently focuses on high-risk populations but is often insufficient. In the general population, the lack of awareness and prevention leaves room for improvement. Addiction specialists prioritize high-risk groups, providing detailed education. Obstetric professionals deliver less comprehensive information to mostly lower-risk populations. Prevention strategies need to incorporate education for the general population and systematic screening in healthcare. Conclusion Alcohol use in pregnancy remains underestimated, and education of women in low- and high-risk populations is still insufficient. Our findings highlight missed opportunities for proactive prevention extending beyond pregnancy, addressing broader audiences, and fostering collaboration among providers.