“You Don’t Want to Drink? What Are You, Pregnant?!”

Abstract

Background and objective Pregnant women, women of childbearing age, and their partners frequently report obtaining information about alcohol use during pregnancy from the mass media. Relying on mainstream media sources, such as television, can be problematic when the information presented is inaccurate, contributing to inconsistent messaging about the ‘safety’ of alcohol use during pregnancy. In the current study, we aimed to explore the portrayal of alcohol (and substance) use (e.g., tobacco, opioids) during pregnancy in North American, English speaking mainstream prime time and streaming television shows ( N = 25). To the authors’ knowledge, no previous study has explored the representations of alcohol (and/or substance use) during pregnancy in this context. Materials and methods The following inclusion criteria guided the show selection: (1) top 100 shows on cable/streaming services targeting women aged 18 to 49 years, and (2) shows suggested by targeted social media posts. Using ethnographic content analysis (ECA), the content and role of television media narratives in the social construction of alcohol meanings concerning the safety of alcohol use during pregnancy were explored. Results and conclusion In line with ECA, the results and conclusion are discussed together. The results and discussion are presented under an overarching narrative, the dichotomy of women's alcohol and substance use, which illustrates the sociocultural construction of alcohol and substance use during pregnancy. Within this overarching narrative, we focus on two sub-narratives: (1) women's acceptable use and (2) women's villainous use. Our analysis indicates misrepresentations regarding the safety of alcohol use during conception (e.g., Friends from College) and pregnancy (e.g., How I Met Your Mother, The Mindy Project). In addition, a narrative was identified relating to the difficulty of keeping a pregnancy private when not drinking socially (e.g., Friends, The Office). These narratives reinforced a dichotomy between the types of women who drink during pregnancy, including some for whom it was okay to have ‘just a little bit’ (e.g., How I Met Your Mother, The Big Bang Theory, Black Mirror) in contrast to others who were portrayed as villains who engaged in binge drinking behaviour and/or other comorbid substance use (e.g., Grey's Anatomy, Private Practice, Chicago Med, Law & Order). These results demonstrate the need to provide a clear, consistent messaging about the risks of alcohol use during pregnancy, as mixed messages from television can contribute to misinformation. The recommendations for messaging, as well as changing our approaches to fetal alcohol spectrum disorder prevention in the light of these findings are discussed.