Norwegian midwives' use of screening for and brief interventions on alcohol use in pregnancy

• Almost all Norwegian midwives ask pregnant women about alcohol use, but not always with a screening tool.
• Partners are more seldom asked.
• Higher perceived competence in Brief Intervention (BI) increases chances of performing a BI.
• Perceived competence in BI is most strongly influenced by repeated training in Motivational Interviewing (MI).

ObjectiveThis study assessed the current screening for and brief intervention (BI) on alcohol use in pregnancy among midwives in Norway, as well as perceived barriers for such practice.Design, setting and participantsAn Internet and telephone survey was conducted among all 200 registered municipal midwives in the Norwegian health regions North, West and South in the period December 2013–May 2014. Of these, 103 midwives were reached and responded (52%).Measurement and findingsMost of the midwives (97%) asked the pregnant women about their alcohol use at their first consultation. 42% of the midwives reported using a screening instrument. When asked which one, AUDIT or TWEAK was mentioned by 16%. The need for more training in screening tools was reported by 66%. Sixty-four percent of midwives working in municipalities that had received special training compared with 50% among the rest said that they intervened themselves if alcohol use was detected (χ2 = 0.32, P = .645). Motivational Interviewing was well known and frequently used. Low perceived BI competence and finding it difficult to discuss alcohol use with parents with a different ethnicity both reduced chances of carrying out a BI. Time constraints and lack of organizational support were other frequently mentioned barriers.Key conclusions and implications for practiceIt seems that the Norwegian midwives find screening and brief interventions for alcohol use to be important and part of their job, but still could use more training, stronger guidelines and more time for following up parents.