The stigma of alcohol use during pregnancy: Exploring the impact of alcohol strength and social context on public perceptions

Background: To examine stigma and discrimination attributed to pregnant women consuming alcohol of varying strength and the social context in which it occurred, within hypothetical social scenarios. Specifically, we explored whether greater stigma was attributed to consuming alcohol in social settings vs. alone, and whether consumption of low and alcohol-free drinks are less stigmatised than standard strength alcohol drinks. Methods: The research employed a vignette-based experimental design across three studies, involving hypothetical social scenarios depicting alcohol consumption during pregnancy. Participants were randomly assigned to alcohol (3 levels: no, low and standard alcohol) and social context (2 levels: alone or with friends) conditions. A total of 1,054 participants were recruited across three studies. Measures of stigma were assessed using the Stigma and Attribution Assessment (SSA) and Personal and Perceived Public Stigma Measure (PPSM). Discriminatory behaviour was measured in two studies using a novel discrimination task. Results: Pregnant women consuming standard and low-alcohol drinks were more stigmatised than those consuming alcohol free beverages across multiple aspects of stigma. Stigma attribution also varied between low and standard alcohol consumption conditions, but these effects were inconsistent. Social context had minimal impact on stigma attribution. Conclusions: The stigma attributed to women consuming alcohol during pregnancy may vary as a function of alcohol strength, with consumption of alcohol-free products associated with least stigma. Stigma attribution seemed driven by societal norms around abstinence (which may be informed by perceived risk to the foetus), rather than the context of consumption.