No Alcohol in Pregnancy

: Better Safe or Better Worry? A Mixed-Methods Analysis of Public Discourse, Digital Communication, and Message Framing

Abstract

Prenatal alcohol exposure remains a public health concern, yet the Chief Medical Officers’ abstinence guidelines continue to cause debate. This thesis aimed to further the understanding of the perception of alcohol consumption during pregnancy using social media data, and to investigate how to best communicate the abstinence message.
First, a review of how prenatal health messaging and campaigns had been evaluated in terms of impact, acceptability, effectiveness, and unintended consequences, using social media data was conducted. The findings highlighted a need to develop and adopt a sound methodology for the benefit of future research using social media data, and to inform public health practice.
Secondly, a study assessing the questions and topics raised about alcohol in pregnancy on an online UK-based parenting forum was conducted. It was mapped against two critical events: the implementation of the revised UK Chief Medical Officers’ (CMO) low-risk drinking guidelines (2016) and the first COVID-19 lockdown (2020). It showed that users were often unclear on the guidance and risks associated with prenatal alcohol use and often sought reassurance from peers. Thirdly, this thesis set out to explore discussions related to alcohol consumption before pregnancy awareness on the same parenting forum to understand the nature of peer responses and assess the accuracy of information against official health guidelines and scientific literature. Results showed that many found reassurance but that misinformation about alcohol consumption was frequently spread. Lastly, a study was conducted to investigate how different types of framing within prenatal alcohol exposure campaigns influence intentions to abstain from alcohol during a potential future pregnancy. Participants exposed to risk-framed campaigns showed greater intentions compared to those exposed to benefit-framed campaigns.
Together, these findings suggest that women experience confusion and anxiety around alcohol in pregnancy and that public health agencies need to offer clear, accurate, and reassuring information.

Date of Award	30 Sept 2025
Original language	English
Awarding Institution	University of Bristol
Supervisor	Angela S Attwood (Supervisor) & Cheryl McQuire (Supervisor)