Alcohol in the lives of first time professional mothers recently returned to work - an interpretative phenomenological analysis

Introduction - The rise in female drinking has been identified as one of the key trends in drinking in the UK. Those in higher socio-economic groups appear to be drinking the most and most frequently (Office for National Statistics [ONS], 2016). Many women become mothers and the wider impact of parental drinking is well documented and causing growing political concern (McGovern et al., 2018). Most mothers give up alcohol during pregnancy and resume drinking in the years that follow (Bailey, Hill, Hawkins, Catalano, & Abbott, 2008; Lui, Mumford, & Petras, 2014; Meurk, Broom, Adams, Hall, & Lucke, 2014). This period represents a teachable moment for behaviour change in relation to mothers and smoking (Baxter et al., 2011; McBride, Emmons, & Lipkus, 2003), and potentially alcohol but this has yet to be explored. This thesis fills a gap in the literature by speaking to first time professional mothers about their experiences of alcohol as they negotiate the transitions of motherhood and the return to professional life. Method - A cross sectional survey was devised for the sole purpose of recruiting first time professional mothers, who had returned to work within the last two years, given up alcohol whilst pregnant, and since resumed drinking as indicated by a positive AUDIT C score. The survey was distributed via on-line forums and nursery mailing lists. Seven purposefully selected participants participated in a semi-structured interview about their lived experience of alcohol. The interviews were recorded and transcripts analysed using Interpretative Phenomenological Analysis. Individual analysis was conducted for each participant before moving on to group analysis. Results - Three super-ordinate themes emerged from the analysis with twelve interrelated sub-ordinate themes. The mothers interviewed revealed ambivalent feelings towards alcohol. They moved between defending past excessive drinking and distancing themselves from it as it threatened their new identity as responsible mothers. The experience of becoming a mother had been isolating and there was a shame in finding it difficult. As new mothers the women had experienced the loss of alcohol as a flag for identity and as an important element of social activity. It felt as if the women were at different points in a journey towards acceptance of this change and re-authoring their relationship with alcohol. Notable was the extent to which the decision not to drink was experienced as socially unacceptable and hidden. Discussion - This study elucidates our understanding of professional women’s relationship with alcohol during this significant period of transition. Findings suggest that this period represents a teachable moment. A positive intervention at this time, offering mothers the opportunity to reflect on their relationship with alcohol, could help them to build on their recent period of abstinence and alter their drinking behaviour in the future. The findings are discussed in relation to psychological theory and clinical implications highlighted. Methodological limitations are discussed and areas for future research recommended.