Alcohol use during pregnancy can damage the fetus. Midwives at antenatal care (ANC) screen pregnant women for risk drinking in early pregnancy. There are however, no routines involving both parents-to-be in a dialogue about alcohol. The aim of this thesis is to investigate alcohol use among pregnant women and their partners and to evaluate a method for midwives’ dialogue about alcohol in a life cycle perspective with both parents-to-be. Study I was a quasi-experiment within ANC. An intervention group (IG) received counseling with the midwife about alcohol use. The IG (238 couples) and a comparison group (271 couples) filled out questionnaires in early and in late pregnancy about alcohol use and support for an alcohol-free pregnancy. Study II was a cross-sectional study where 444 partners of pregnant women filled out a questionnaire at ANC about alcohol use, motives for decreased drinking and their perception about the midwives’ counseling about alcohol. Alcohol consumption was low among the pregnant women. One third (30 %) had decreased alcohol use before pregnancy and 90% stopped drinking after pregnancy confirmation. Of the partners, 24 % decreased alcohol use before pregnancy and 40 % decreased during pregnancy. Around 90 % of the women received support for an alcohol-free pregnancy, compared to 37 % of the partners. Twenty per cent of partners and 25 % of pregnant women reported alcoholism in their family. Partners who had alcoholism in the family drank more than partners without this experience. A majority, 95 %, of the partners in study II used alcohol, 29 % were binge drinking on a normal drinking day and 74 % were binge drinking occasionally. Most partners appreciated the counseling about alcohol and reported various motives for decreased alcohol consumption. Many pregnant women and partners decreased alcohol consumption in transition to parenthood, which is a crucial time for changing alcohol-drinking patterns. Involving both parents-to-be in counseling about alcohol restrictions during pregnancy may be a useful health promotion strategy.

Researchers have examined social relationships as a basic need, showing that being well integrated in a network of social ties is related to various positive health outcomes including reduced mortality and risk behavior (e.g. reduced alcohol consumption). Conversely, a lack of strong social ties is related to negative outcomes including depression, suicide, and substance use (Berkman & Syme, 1979; Durkheim, 1951; Sarason, Sarason, & Gurung, 2001). Loneliness, a negative affective experience resulting from relationship deficits, is related to similar health outcomes as social isolation including depression and problematic alcohol use (Cacioppo, Hawkley, Crawford et al., 2002). However, research to date examining loneliness and health behavior has predominantly employed cross-sectional measures (e.g. UCLA Loneliness Scale; Russell, Peplau, & Cutrona, 1980), therefore failing to capture more fluctuating experiences of and responses to loneliness which may signify maladaptive patterns of coping behavior (Hawkley, Burleson, Bernston, & Cacioppo, 2003; Shankur, McMunn, Banks, & Steptoe, 2011). The purpose of this present study was to examine responses to daily loneliness (i.e. social and solitary alcohol consumption) as a function of social integration and gender, through a secondary analysis of data collected in a larger daily process study. Results indicated that daytime loneliness predicted evening increases in solitary consumption and decreases in social consumption. Further, these within-person effects were influenced by gender and social integration. These findings provide a unique understanding of specific processes by which social relationships, or the perceived lack thereof, influence health and more specifically, mood-related health behavior.