Women who drank while pregnant: The importance of social context in the lives of South African pregnant women

Aims: This study aimed to explore how women who drank alcohol while pregnant understand and make sense of alcohol use. Methods: Using social representation theory and elements of Foucauldian discourse analysis, 14 narrative episodic interviews were conducted in a Western Cape, South African community with women who drank alcohol while pregnant, and two focus group discussions with 13 members of the pregnant women’s community. The interview and focus group data were analysed using thematic decomposition analysis. Findings: Drinking alcohol was represented by participants as a social activity, a way of coping with domestic problems, and also as connected to their experiences of motherhood. Access to social support through their partners and a desire to protect the fetus and care for their children helped some participants to cease drinking during their pregnancies. These representations highlight that alcohol use is not simply an individual decision but is embedded in a particular social context and also framed by particular discourses. Conclusion: Interventions should prioritise the social context of drinking, include a component that works with both pregnant women and their partners, use a supportive and non-judgemental approach that capitalises on pregnancy and motherhood, and focus on empowering pregnant women to manage problems effectively.