NICE proposes alcohol consumption screening at every antenatal appointment

on 17 September 2020

The National Institute for Health and Care Excellence (NICE) quality standards have proposed alcohol screenings to be carried out at every antenatal appointment a pregnant woman attends.

If a woman presents low to mid-level alcohol consumption during pregnancy, this will be recorded and transferred onto the child’s health record, according to the latest proposal.  

The UK Screening Committee has repeatedly rejected such measures.

The Royal College of Midwives (RCM) has raised concerns that the proposals appear to expand the definition of prenatal alcohol exposure (PAE) by removing a lower threshold for alcohol consumption.

Executive Director of Professional Leadership at the RCM, Birte Harlev-Lam, said: “The RCM has already raised concerns with NICE that this proposed approach could cause women to be stigmatised, or cause self-stigmatisation, and may disrupt or prevent the development of a trusting relationship between a woman and her midwife. We are also concerned that the proposal may be self-defeating, as women who are in most need of help will feel the need to conceal the consumption of alcohol from their midwife.”

There is currently no known safe level of alcohol consumption during pregnancy, therefore the safest approach is to not drink alcohol at all.

“We believe routine inquiry about alcohol consumption should be approached in a non-judgemental fashion, and recording should occur where women have continued to consume alcohol against advice throughout the pregnancy.

“Midwives are best placed to make assessments concerning what information to document during antenatal appointments, and given the demands on their time, midwives should maintain autonomy to tailor their advice and support according to women’s needs as they would personalise other parts of antenatal or postnatal care,” Birte Harlev-Lam adds.