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.