Alcohol and Pregnancy: The CDC Maintains the Two Don’t Mix

In the fall of last year, the American Academy of Pediatrics (AAP) made it clear in a report published in the journal Pediatrics that no amount of alcohol is considered safe for women who are pregnant.

Mothers cannot be sure how their use of alcohol will impact their developing child, and if too much alcohol is ingested at the wrong developmental point, it can cause:

• Fetal alcohol spectrum disorders (FASDs)
• Learning disabilities
• Birth defects
• Premature birth and low birth weight

According to the report: “There is no known absolutely safe quantity, frequency, type, or timing of alcohol consumption during pregnancy, but having no PAE (prenatal alcohol exposure) translates into no FASD. Despite research evidence clearly documenting the spectrum of detrimental consequences of PAE, too many women continue to drink alcohol during pregnancy.”

In fact, the report said that 10 percent of women in the US who were pregnant reported occasional alcohol consumption while about 33 percent of that number reported binge drinking in the last month. Additionally, researchers estimated that as many as 5 percent of first graders may be living with a fetal alcohol spectrum disorder.

The good news is that fetal alcohol spectrum disorders and alcohol-related birth defects and disabilities are all 100 percent preventable. How? Simply stop drinking alcohol.

The Centers for Disease Control and Prevention (CDC) took this report a step further with their updated page on alcohol and pregnancy released last month. While the AAP report assumed that the woman knew she was pregnant and discussed making choices about alcohol after a positive pregnancy test, the CDC discussed the risk of fetal alcohol spectrum disorders and related issues among women who were drinking and having unprotected sex – women who were not pregnant.

According to the CDC, an estimated 3 million women are in this category, and the organization described them as “at risk of exposing their developing baby to alcohol.” The CDC went on to state that about half of all pregnancies are not planned, and that even women who are trying to get pregnant may not know when they become pregnant for more than a month. If women are drinking during the period they are pregnant but not yet aware, they could be inadvertently exposing their unborn child to the risks associated with alcohol. They state flat out that women who are pregnant or may be pregnant should not drink alcohol in any amount.

Reading between the lines, many have interpreted this report to mean that all women should stop drinking. Or that if a woman is having sex without use of any birth control, she should remain abstinent in an effort to protect any potential children that come of the union. But no birth control is 100 percent effective (other than abstinence) so does the CDC’s report imply that women have to choose between having sex and having a drink in order to be safe?

Not really. What the CDC report appears to find problematic is that about 75 percent of women who are actively trying to get pregnant are still drinking alcohol despite the fact that they may end up exposing a child to alcohol before they realize they are pregnant. Because the first weeks of development are so significant, exposure to alcohol can be problematic. Their point: Why take the risk? Given that fetal alcohol spectrum disorders are devastating for a lifetime and entirely preventable, if someone is actively trying to get pregnant, avoiding alcohol altogether is their recommendation.

If fetal alcohol spectrum disorder sounds like a vague issue without concrete description, it is because, like autism spectrum disorders, it can manifest differently in different people. Some people struggle with a severe form while others exhibit mild to moderate issues caused by the disorder.

For the rest of their lives, children born with an FASD may struggle with mental health issues, substance use and abuse, living on their own, doing well in social situations and at work or school, and staying on the right side of the law.

For some women, attempting to stop drinking in order to have a healthy pregnancy proves to be more difficult than they imagined. This inability to stop drinking for an extended period may be an indication that an alcohol use disorder is at play. The good news is that there is a great deal of support for women in recovery, especially when children are involved. There are support groups in place for pregnant women in recovery. Doctors are trained to screen for substance abuse issues during prenatal visits and to connect patients with services that will support them in maintaining optimal health during this time. No matter what level of support is needed – from outpatient services to comprehensive inpatient care – women who are pregnant or have recently given birth, and who are working toward maintaining sobriety for their own health and for the wellbeing of their babies, can find the help and support they need.