Introduction:
Public health policies recommend stopping alcohol consumption for expectant and breastfeeding mothers, due to the risk of a range of adverse neonatal outcomes, including Fetal Alcohol Spectrum Disorder (FASD). However, about 16 to 25% of women in Europe, including Switzerland, consume alcohol during pregnancy and breastfeeding. Little is known about how women perceive this risk and how risk perception changes during the transition to motherhood. The present study aims to explore the subjective transition from woman’s perspective on perceptions of alcohol as a risk, changes in alcohol consumption in daily life and experienced support from health professionals.

Material and Methods:
This study uses the theoretical framework of sociocultural risk and life course transition. Qualitative longitudinal interviews were conducted with a purposive sample of 46 women in the German and French speaking parts of Switzerland. They were interviewed first during pregnancy and then until six months after birth. We applied the principles of thematic analysis to the data, using Atlas.ti software.

Results:
Five significant stages of transition related to low and moderate alcohol consumption were identified: (1) Around conception and getting pregnant: the intangible risk of alcohol consumption, (2) Manifestation of pregnancy: weighing the psychosocial and medical risks of alcohol consumption, (3) Being pregnant: dealing with the concept of abstinence, (4) The first weeks after birth: alcohol consumption incompatible with childcare (5) The public mother: the risk of being criticised for consuming alcohol.

Conclusions:
Pregnant and breastfeeding women perceive alcohol consumption as a risk to the health of the child. Abstinence is sought especially during pregnancy, but this does not preclude occasional and low-level consumption. Exceptions are not motivated in the same way in the different stages. From the women’s perspective, there was a lack of counselling from health professionals. Stages 1 and 2 should be taken more into account, as women experience themselves as particularly vulnerable during this time. Low-threshold counselling should be offered from the stage around conception until the end of the breastfeeding period overcoming the barriers faced by professionals in addressing the issue of alcohol with pregnant and breastfeeding women.