Conversations about alcohol and pregnancy August 2015 Kate Holland, Kerry McCallum and R. Warwick Blood This research was funded by the Foundation for Alcohol Research and Education. About the Foundation for Alcohol Research and Education The Foundation for Alcohol Research and Education (FARE) is an independent, not-for-profit organisation working to stop the harm caused by alcohol. Alcohol harm in Australia is significant. More than 5,500 lives are lost every year and more than 157,000 people are hospitalised making alcohol one of our nation’s greatest preventative health challenges. For over a decade, FARE has been working with communities, governments, health professionals and police across the country to stop alcohol harms by supporting world-leading research, raising public awareness and advocating for changes to alcohol policy. In that time FARE has helped more than 750 communities and organisations, and backed over 1,400 projects around Australia. FARE is guided by the World Health Organization’s Global Strategy to Reduce the Harmful Use of Alcohol1 for stopping alcohol harms through population-based strategies, problem directed policies, and direct interventions. If you would like to contribute to FARE’s important work, call us on (02) 6122 8600 or email [email protected]. Researcher affiliations Dr Kate Holland, Associate Professor Kerry McCallum and Professor R. Warwick Blood Kate Holland is a Senior Research Fellow in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra, and a member of the Health Research Institute at the University of Canberra. Kerry McCallum is Associate Professor of Communication and Media Studies in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra. R. Warwick Blood is Emeritus Professor of Communication in the News and Media Research Centre, Faculty of Arts and Design, University of Canberra. The correct citation for this publication is: Holland, K., McCallum, K., Blood, R.W. (2015). Conversations about alcohol and pregnancy. Canberra: Foundation for Alcohol Research and Education. Acknowledgements We would like to thank the women who participated in the research for taking the time to share their views and experiences with us. We would also like to thank Alex Walton and Emily Robertson for their research assistance. We are grateful for the funding from the Foundation for Alcohol Research and Education (FARE) to undertake this research and would like to thank their Director of Policy and Research, Caterina Giorgi, for her feedback on the draft report. 1 World Health Organization (2010). Global strategy to reduce the harmful use of alcohol. Geneva: World Health Organization. 2 FOUNDATION FOR ALCOHOL RESEARCH AND EDUCATION Contents Executive summary .......................................................................................................... 5 Introduction ..................................................................................................................... 8 National Health and Medical Research Council Alcohol Guidelines ................................................... 8 FASD and alcohol consumption among pregnant women ................................................................. 9 Pregnancy as a risk issue ................................................................................................................... 10 Media reporting of alcohol and pregnancy ...................................................................................... 11 Women’s views about alcohol and pregnancy ................................................................................. 13 Research approach ......................................................................................................... 16 Media analysis: Sample ..................................................................................................................... 16 Media analysis: Coding ..................................................................................................................... 17 News frame analysis ......................................................................................................................... 17 Interviews and focus groups ............................................................................................................. 17 Thematic analysis .............................................................................................................................. 18 Media portrayals of alcohol in pregnancy ....................................................................... 19 Mapping reporting of alcohol in pregnancy: Quantitative results ................................................... 19 Framing alcohol in pregnancy: Qualitative results ........................................................................... 21 Frame 1: Contested evidence and advice ......................................................................................... 21 Frame 2: The FASD crisis ................................................................................................................... 25 Frame 3: Blame risk-taking mothers ................................................................................................. 30 Frame 4: Women’s rights .................................................................................................................. 31 Frame 5: Community responsibility .................................................................................................. 33 Summary: Framing alcohol and pregnancy in Australian media ...................................................... 35 Women talk about alcohol in pregnancy ......................................................................... 36 1. Experiences of alcohol in pregnancy ......................................................................................... 37 2. Views and practices in relation to alcohol in pregnancy .......................................................... 38 3. Clarity and impact of information and advice about alcohol and pregnancy .......................... 41 4. The role of peers and family in women’s decisions .................................................................. 46 5. Responses to media reports about alcohol and pregnancy ..................................................... 48 Summary: Women talk about alcohol in pregnancy......................................................................... 52 CONVERSATIONS ABOUT ALCOHOL AND PREGNANCY 3 Discussion ...................................................................................................................... 54 FASD in media and women’s accounts ............................................................................................. 54 Contested evidence and advice in media and women’s accounts ................................................... 55 Women’s rights and negotiations of risk and responsibility ............................................................ 55 Social and cultural context of alcohol and pregnancy ...................................................................... 56 Implications and future research .................................................................................... 57 Implications for social marketing activities and media interventions .............................................. 58 Future research directions ................................................................................................................ 59 References ..................................................................................................................... 60 Appendix A: List of media items included in the dataset ................................................. 64 Newspapers (print) ........................................................................................................................... 64 Newspapers (online) ......................................................................................................................... 65 Websites ........................................................................................................................................... 66 Television news ................................................................................................................................. 67 Appendix B: Project flyer ................................................................................................ 68 Appendix C: Participant information sheet ...................................................................... 69 Appendix D: Interview guide........................................................................................... 71 Appendix E: Ethics approval letter .................................................................................. 75 4 FOUNDATION FOR ALCOHOL RESEARCH AND EDUCATION Executive summary This study examines how the Australian media portray alcohol and pregnancy and how women respond to mediated information and advice about drinking during pregnancy. Women’s alcohol consumption has attracted increasing media attention in the past decade (Gentile, 2011), yet little is known about how women interpret and respond – in terms of their consumption and information seeking practices – to claims about the risks of consuming alcohol during pregnancy. Health advice in Australia states that for women who are pregnant, planning pregnancy or breastfeeding, not drinking is the safest (NHMRC, 2009). However, research