Toward prevention of alcohol exposed pregnancies: characteristics that relate to ineffective contraception and risky drinking

Abstract

Alcohol-exposed pregnancy is a leading cause of preventable birth defects in the United States. This paper describes the motivational patterns that relate to risky drinking and ineffective contraception, two behaviors that can result in alcohol-exposed pregnancy. As part of an intervention study aimed at reducing alcohol-exposed pregnancy 124 women were recruited and reported demographic characteristics, readiness to change, stages of change, drinking, contraception, and sexual behavior history. Our results showed the following. Drinking: A significant positive correlation was found between the number of drinks consumed in 90 days and the Importance to reduce drinking (r = .23, p = .008). A significant negative correlation between number of drinks and confidence to reduce drinking (r = -.39, p = .000) was found as well. Significant differences were found in the total number of drinks consumed in 90 days between the five stages of change (F = (4,118), 3.12, p = .01). Women in Preparation reported drinking a significantly higher number of drinks than women in other stages of change. Contraception: There were significant negative correlations between ineffective contraception and Importance (r = -.38, p = .00), confidence (r = -.20, p = .02) and Readiness (r = -.43, p = .00) to use contraception effectively. Significant differences in contraception ineffectiveness were found for women in different stages of change (F = (4,115) 8.58, p = .000). Women in Precontemplation reported significantly higher levels of contraception ineffectiveness compared to women in other stages of change. Results show a clear relationship between higher alcohol consumption and higher levels of motivation to reduce drinking. In contrast, higher levels of ineffective contraception were related to lower levels of motivation to use contraception effectively. This suggests risky drinking may be better targeted with brief skills building interventions and ineffective contraception may require interventions that enhance problem awareness and motivation.

Fig. 1

Importance, confidence, readiness and number of drinks in 90 days by stage of change for drinking. Motivational level (0 = lowest levels of importance, confidence and readiness; 100 = maximum levels of importance, confidence and readiness)

Fig. 2

Importance, confidence, readiness and ineffective contraception by stage of change for contraception. 0-100 scale. 0 = lowest levels of importance, confidence, readiness and ineffectiveness (most effective use of contraception); 100 = maximum levels of importance, confidence, readiness and ineffectiveness (least effective use of contraception)