Drinking and smoking in pregnancy: what questions do Swiss physicians ask?

BACKGROUND: Although drinking and smoking during pregnancy can have hazardous effects to exposed children, a certain number of pregnant women continues to consume alcohol and nicotine. It was investigated whether physicians and midwives in Switzerland ask pregnant women about their drinking and smoking habits. METHOD: A self-report questionnaire was used to assess whether pregnant women were screened for alcohol and nicotine consumption by physicians or midwives. Data of 368 women were included in the analyses. RESULTS: 30.0% reported drinking alcohol at least once a month after pregnancy recognition, 2.2% reported binge drinking and 10.1% were smokers. Only in 36.1% of the sample drinking during pregnancy was addressed. The subgroup, which drank alcohol, was not more likely to be asked about drinking habits than non-drinkers. In contrast, smoking was addressed in 66.3% of the total sample and it was addressed in nearly 90% of the smokers' subgroup. CONCLUSION: A change in the screening practice in prenatal care with regard to alcohol drinking during pregnancy is recommended. Brief interventions can reduce drinking during pregnancy.

Memory of childbirth in the second year: the long-term effect of a negative birth experience and its modulation by the perceived intranatal relationship with caregivers.

OBJECTIVE: To assess the memory of various subdimensions of the birth experience in the second year postpartum, and to identify women in the first weeks postpartum at risk of developing a long-term negative memory. DESIGN, METHOD, OUTCOME MEASURES: New mothers' birth experience (BE) was assessed 48-96 hours postpartum (T1) by means of the SIL-Ger and the BBCI (perception of intranatal relationships); early postnatal adjustment (week 3 pp: T1(bis)) was also assessed. Then, four subgroups of women were defined by means of a cluster-analysis, integrating the T1/T1(bis) variables. To evaluate the memory of the BE, the SIL-Ger was again applied in the second year after childbirth (T2). First, the ratings of the SIL-Ger dimensions of T1 were compared to those at T2 in the whole sample. Then, the four subgroups were compared with respect to their ratings of the birth experience at T2 (correlations, ANOVAs and t-tests). RESULTS: In general, fulfillment, emotional adaptation, physical discomfort, and anxiety improve spontaneously over the first year postpartum, whereas in negative emotional experience, control, and time-going-slowly no shift over time is observed. However, women with a negative overall birth experience and a low level of perceived intranatal relationship at T1 run a high risk of retaining a negative memory in all of the seven subdimensions of the birth experience. CONCLUSIONS: Women at risk of developing a negative long-term memory of the BE can be identified at the time of early postpartum, when the overall birth experience and the perceived intranatal relationship are taken into account.