Midwives fear women could feel stigmatised if mandatory alcohol screening introduced at every antenatal appointment  

By Gemma Murphy on 16 September 2020 RCM Midwives Pregnancy Alcohol and pregnancy Antenatal / Prenatal Women Midwifery NICE - The National Institute for Health and Care Excellence

The Royal College of Midwives (RCM) has today responded to NICE quality standard proposals to include mandatory screening for alcohol at every antenatal appointment.

Such measures have already been repeatedly rejected by the UK Screening Committee says the RCM which believes this approach - recording low to mid-level alcohol consumption in pregnancy and transferring this information to the child’s record - should be approached with caution.

The RCM has also raised concerns that the proposals appear to expand the definition of prenatal alcohol exposure (PAE) by removing a lower threshold for alcohol consumption. This would have the effect of flagging children as ‘at risk’ where a woman has recorded any alcohol consumption at all.

Commenting, Birte Harlev-Lam, Executive Director of Professional Leadership at the RCM said:

“The RCM has already raised concerns with NICE that this proposed approach could cause women to be stigmatised, or cause self-stigmatisation, and may disrupt or prevent the development of a trusting relationship between a woman and her midwife. We are also concerned that the proposal may be self-defeating, as women who are in most need of help will feel the need to conceal the consumption of alcohol from their midwife.”

As there is no known safe level of alcohol consumption during pregnancy, the RCM says it is appropriate and important for midwives to advise women that the safest approach is not to drink alcohol during pregnancy. 

Birte added:

“We believe routine inquiry about alcohol consumption should be approached in a non-judgemental fashion, and recording should occur where women have continued to consume alcohol against advice throughout the pregnancy. Midwives are best placed to make assessments concerning what information to document during antenatal appointments, and given the demands on their time, midwives should maintain the autonomy to tailor their advice and support according to women’s needs as they would personalise other parts of antenatal or postnatal care.”


To contact the RCM media office call 020 7312 3456 or email [email protected].  

Notes to Editors 


The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at https://www.rcm.org.uk/