In 2005, the United States Surgeon General re-issued an advisory regarding alcohol and pregnancy. The advisory states that women should abstain from alcohol if they are pregnant or if they are considering a pregnancy due to the risk of birth defects. It also advised that women who have already consumed alcohol during their pregnancy stop drinking alcohol.
About 50% of all pregnancies are unplanned. As a result, many women consume alcohol without knowing that they are pregnant. The Surgeon General's advisory further states, "A pregnant woman who has already consumed alcohol during her pregnancy should stop in order to minimize further risk." The advisory also suggests that women of childbearing age should consult their physician about how best to reduce the risk of prenatal alcohol exposure.
Alcohol and Pregnancy
"Every other week there seems to be another article released in the media suggesting that "moderate" alcohol use is safe while pregnant. It's important to understand that we all have a different view of what moderation is, and that it is very easy to underestimate the amount of alcohol we actually consume. I drank while I was pregnant, all five times. I had no idea that drinking on the weekends would harm my children. Today, I have a 37 year old that plays with baby dolls; she has Fetal Alcohol Syndrome (FAS) and intellectual disability. I have another daughter that suffers with chronic migraines and a host of other health problems. My last two children both died before they were 3 months old. There is not a day that goes by that I do not regret the fact that I drank while pregnant. I would not wish that hell on another mother. I love women--they are all my sisters--and I want them to know it is not safe to drink any alcohol while pregnant. Don't risk it, wait, there'll be plenty of time to celebrate and consume alcohol, after the baby is born!"
Kathleen Tavenner Mitchell
Vice President and International Spokesperson
National Organization on Fetal Alcohol Syndrome
The Science of Alcohol and Human Development
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The first paper in U.S. medical literature appeared in 1973 by doctors David Smith and Ken Lyons Jones (University of California, San Diego). As of 2011, nearly 4,000 papers have been published confirming the teratogenicity of prenatal alcohol exposure and the underlying mechanisms of alcohol-induced damage to the embryo or fetus.
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Alcohol, like mercury, is a confirmed teratogen (a neurotoxicant agent that produces central nervous system malformations with associated neurobehavioral dysfunction), with the capacity to interfere with human development at any stage of pregnancy. By comparison, lead is a neurotoxin but not a teratogen in that it produces neurobehavioral dysfunction in the absence of CNS malformations.
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Ethanol is the principal psychoactive constituent in alcoholic beverages. In utero it has been found to:
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Interfere with normal proliferation of nerve cells;
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Increase the formation of free radicals--cell damaging molecular fragments;
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Alter cells ability to regulate cell growth, division and survival;
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Impair the development and function of astocytes, cells that guide the migration of nerve cells to their proper places;
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Interfere with the normal adhesion of cells to one another;
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Alter the formation of axons, nerve cell extensions that conduct impulses away from the cell body;
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Alter the pathways of biochemical or electrical signals within cells;
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Alter the expression of genes, including genes that regulate cell development.
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The basic and biomedical research demonstrates that alcohol damages the developing brain through multiple actions at different cellular sites interfering with normal development by disrupting cell migration, cell functions and causing cell death.
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Alcohol can induce brain damage, specifically to the corpus collosum (connects brain hemispheres), cerebellum (consciousness and voluntary processes), basal ganglia (movement and cognition), hippocampus (emotional behavior and memory), hypothalamus (sensory input), among other neural regions.
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Science definitively recognizes that when a pregnant woman consumes alcohol, the alcohol crosses the placenta into the blood supply of the developing embryo or fetus.
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An embryo or fetus has neither the developed organ systems nor enzymes able to metabolize alcohol.
- Of all the substances of abuse, including marijuana, cocaine and heroin, alcohol produces by far the most serious neurobehavioral effects on the embryo or fetus.
- Human development occurs in an orderly process of biochemical and structural transition during which new constituents are being formed and spatially arranged throughout gestation. At any time in the span of development these ongoing processes can be subtly or severely disturbed or abruptly halted resulting in abnormal development or fetal death.
- Therefore, at any time alcohol is present it has the potential to harm development. For example, the hallmark facial dysmorphology associated with Fetal Alcohol Syndrome will only occur if alcohol is present during the specific window of development.
(References: National Institute on Alcohol Abuse and Alcoholism and the Institute of Medicine)
Women at Risk
- Some light and moderate drinkers have offspring with identifiable birth defects while some women who consume alcohol throughout pregnancy have offspring without any apparent or quantifiable birth defects. Research is currently exploring both the genetic and protective factors involved in the manifestation of alcohol-related birth defects.
- Factors known to contribute to the risk of having a child with alcohol-related birth defects include: biological susceptibility, poor nutrition, poor general health, and a lack of prenatal care.
- An examination of sociodemographic factors indicate that generally more older women (~30 or 35 years old and older) drink during pregnancy, but younger women (~24 years old or younger) face higher risks of binge drinking or drinking in the few months prior to recognizing they are pregnant (Altfeld et al., 1997; CDC, 2009; Chambers et al., 2005; Floyd et al., 1999; Hollander, 1995; Jones-Webb et al., 1999; Morris et al., 1994; Perriera & Cortes, 2006; Tsai et al., 2007a,b). With regard to race and ethnicity, White women report a higher prevalence of alcohol use than Black or Hispanic women (Floyd et al., 1999; Hanna et al., 1994; Hollander, 1995; Perriera & Cortes, 2006; Project CHOICES, 2002; Tsai & Floyd, 2004; Tsai et al., 2007a,b), although Hispanic women may increase use as they become more acculturated in the United States (Chambers et al., 2005). Differences in prevalence based on geographic location appeared potentially important, with binge drinking more prevalent in the North-central sections of the United States and less so in the Southeast (Tsai & Floyd, 2004). Higher education (CDC, 2009; Chambers et al., 2005; Floyd et al., 1999; Hollander, 1995; Tsai et al., 2007a) and higher income (Chambers et al., 2005; Chang et al., 2006; Hollander, 1995; Morris et al., 1994) were linked specifically to higher rates of alcohol use during pregnancy in some studies.
- Health care providers can play an important role in encouraging abstinence from alcohol during pregnancy, but the literature demonstrated that they do not always seem to do so (Jones-Webb et al., 1999; Kogan et al., 1994; Logan et al., 2003). In fact, it appeared that sometimes physicians and other health care providers encourage women to participate in light drinking during pregnancy (as a way to relax, for example) (Barbour, 1990; National Organization on Fetal Alcohol Syndrome, 1999).
What Do Alcohol-Related Birth Defects Look Like?
- Only about 20% of the individuals with alcohol-related birth defects present with the full manifestation of Fetal Alcohol Syndrome: 1) neurodevelopmental abnormalities (brain damage), 2) growth deficiency, and 3) facial dysmorphology. These are the easiest cases to identify, yet very few are actually diagnosed at birth and most go undiagnosed until adolescence, or later.
- Far more common are individuals with no growth deficiency or facial abnormalities who have subtle to severe developmental disabilities. These individuals can be highly functioning and their disabilities could be manifested as subtle deficits in executive functioning, the neurologically-based skills involving mental control and self-regulation, and adaptive behavior, the ability to manage appropriate social and personal behavior.
- As school-aged children they may be labeled as defiant, disobedient or willful, and they may be diagnosed as autistic or as having attention deficit disorder, if they receive a diagnosis at all.
- Although Fetal Alcohol Syndrome has broad name recognition very few people are able to accurately define the disorder. Most believe that FAS is profound brain damage, so a highly functioning individual who knew that there mother used alcohol while she was pregnant would never identify with the disorder.
- It is very difficult, if not impossible, to quantify a reduction in IQ or subtle problems with executive functioning or adaptive behavior linked to prenatal alcohol exposure.
- Problems with executive functioning or adaptive behavior (subtle to severe) in individuals prenatally exposed to alcohol who have normal or above average intellectual functioning can include:
- Inappropriate sexual behavior;
- Problems with attention and memory;
- Learning difficulties;
- Poor impulse control;
- Poor understanding of right from wrong;
- Poor understanding of the consequences of behavior;
- Inability to learn from experience;
- Lack of empathy or consideration of others.
What if I Can't Stop Drinking Alcohol?
Some women may find it hard to stop drinking during their pregnancy. If you’re pregnant and you can’t stop drinking you may need help. You may be affected by a disease known as alcoholism. There are many different resources that can help you stop drinking. Please click this link for a listing of some of the places you can get help. Even if you have tried a program before and it didn’t work, try again.
Problems with alcohol can harm your physical health, behavior and relationships. If you are pregnant or breastfeeding, drinking alcohol also can pose a risk to your baby. Alcohol can affect your baby's development in the very first weeks—before you know you are pregnant. If you are drinking, you can have a miscarriage or your baby may have some problems, including:
Remember, there is no known safe level of alcohol consumption during pregnancy.
The best thing to do is to stop drinking during your pregnancy or if you are planning to become pregnant. Please see the links on the left for more information.
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Beer = 12oz Glass
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Wine = 5oz Glass
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Liquor = 1.5oz Shot Glass
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Visit the Circle of Hope- Birth Mothers Network.
For Partners, Family, and Friends
Many women are unaware of the consequences of drinking during pregnancy. Some women believe wine or beer is not alcohol. In some cases, she may be suffering from alcoholism. She may need to know what effects alcohol can have on the baby. She may also need help getting into treatment. In such cases, you should contact a treatment professional at a local addiction center for advice on how to help her.
It's easier to change a habit with the help and support of a partner, friend, or family member. Behavior change is a difficult process, but it may be your support that makes a difference for success.
Here are other things you can do to help:
- Help plan strategies to make it easier to stop or cut back on drinking;
- Talk on the telephone for support when needed;
- Do fun things together that do not involve alcohol;
- Be understanding and be a good listener;
- Encourage the use of alternative, nonalcoholic beverages;
- Be a cheerleader. Help her believe she can succeed;
- Encourage her to follow up with her health care provider.
Suggestions of what NOT to do:
- Don't be judgmental or critical;
- Don't expect instant success or perfect results;
- Don't get discouraged;
- Don't overextend yourself. Be honest about what you are able to do.
A male partner can do many things to help during the pregnancy. He can:
- Help minimize stress for you and your baby;
- Be patient and supportive;
- Promote good nutrition and a healthy lifestyle;
- Make exercise a part of your lives;
- Attend prenatal visits with you.
Click here for more information if you are pregnant, planning to become pregnant, or could be pregnant. |