Study Design:

A mixed-methods study comprising qualitative and quantitative methods

Disease Area:



National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme

Chief Investigator:

Professor of Women’s Public Health Institute for Clinical and Applied Health Research




Drinking too much alcohol can damage a woman’s health and also harm her baby. Sometimes this can lead to Fetal Alcohol Syndrome. These problems are lifelong and can affect a child’s growth and development, including their physical and mental health, their behaviour and their ability to learn. Up to 17 in 100children in England might have symptoms of this disorder. National guidelines advise midwives to: ask pregnant women how much they drink; advise women not to drink alcohol when pregnant; and help women to access specialist support for alcohol problems. However, our recent research shows that not all midwives have this conversation at routine antenatal appointments. We identified some of the main reasons why this is not happening, and co-designed interventions to address them. Our overall aim is to assess the feasibility and acceptability of the implementation intervention to support midwives in assessing, advising and recording a woman's alcohol consumption during antenatal appointments.

What we plan to do

In PHASE I of our study, a team of researchers from the University of Hull, Birmingham City University, Northumbria University and the FASD Network UK carried out co-design workshops with maternity service users and midwives to design pragmatic interventions to support midwives implementing antenatal care addressing alcohol consumption during pregnancy. In PHASE II, we will test the feasibility and acceptability of the implementation interventions and antenatal care practices addressing alcohol consumption during pregnancy in two NHS Trusts in North East England over a three-month period.

We will recruit a total of 30-40 midwives from two NHS Trusts in North East England to implement the interventions. We will collect information from the maternity records of all women on the caseload of the midwives to see whether drinking alcohol was discussed and written in the notes and what actions were taken. After the 3-month period, we will recruit and interview 12-15 of the midwives and 12-15 women to assess the feasibility and acceptability of the intervention

What we will achieve

The study will help us to assess the engagement with each of the implementation intervention components by midwives, elicit the views of midwives of each of the implementation intervention components to assess their acceptability, perceived utility and impact on their practices during antenatal appointments. It will also help us to elicit the views of maternity service users regarding alcohol assessment and advice received from midwives in antenatal appointments during the implementation period, and assess the parameters that could inform the design of a future trial to test effectiveness and cost effectiveness of the implementation intervention components.


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Trial progress

In set-up


Hull Health Trials Unit
3rd Floor AMB
University of Hull