Page 11 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback

General Introduction Introduction 1
“In my previous pregnancy I used to drink alcohol, and my child is perfectly healthy” is an often heard justification for pregnant women drinking alcohol. Many women drink alcohol in pregnancy, despite the risks. For example, because they believe their alcohol use is not risky for their child, or they know women who also used alcohol during their pregnancy and had not experienced any negative consequences (e.g. Jones, et al., 2011).
There is accumulating scientific evidence that even low levels of prenatal alcohol exposure can cause adverse neurobehavioral effects in children (Nathanson, Jayesinghe, & Roycroft, 2007). This makes alcohol use in pregnancy one of the leading preventable causes of mental retardation in children (Centers for Disease Control and Prevention, 2002). Accordingly, in an advisory report published in 2005, the Health Council of the Netherlands concluded that no lower limit for alcohol use could be determined that would certainly have no effect on the foetus and the pregnancy (Health Council of the Netherlands, 2005). In the same report, the Health Council estimated that 35 to 50% of the Dutch pregnant women use alcohol.
The harmful effects of prenatal alcohol exposure in combination with the high number of Dutch, pregnant women using alcohol call for effective strategies to discourage prenatal alcohol use. In this dissertation two brief interventions to reduce prenatal alcohol use are described. This introductory chapter first elaborates on the need of an effective intervention to reduce prenatal alcohol use. Subsequently, more details are given of the pregnant women using alcohol and the alcohol advice they receive from health professionals. Then, the theoretical background, the strategies and the content of the interventions are described. Finally, the rationale for the studies on the development, effectiveness and implementation of the interventions presented in this dissertation is explicated.
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