Alcohol and Pregnancy
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Overview

Alcohol use during pregnancy can cause fetal alcohol spectrum disorders (FASDs), which are physical, behavioral, and intellectual disabilities that last a lifetime. More than 3 million US women are at risk of exposing their developing baby to alcohol because they are drinking, having sex, and not using birth control to prevent pregnancy. About half of all US pregnancies are unplanned and, even if planned, most women do not know they are pregnant until they are 4-6 weeks into the pregnancy. This means a woman might be drinking and exposing her developing baby to alcohol without knowing it. Alcohol screening and counseling helps people who are drinking too much to drink less. It is recommended that women who are pregnant or might be pregnant not drink alcohol at all. FASDs do not occur if a developing baby is not exposed to alcohol before birth.

Women can:

  • Talk with their health care provider about their plans for pregnancy, their alcohol use, and ways to prevent pregnancy if they are not planning to get pregnant.
  • Stop drinking alcohol if they are trying to get pregnant or could get pregnant.
  • Ask their partner, family, and friends to support their choice not to drink during pregnancy or while trying to get pregnant.
  • Ask their health care provider or another trusted person about resources for help if they cannot stop drinking on their own.


More than 3 million US women are at risk of exposing their developing baby to alcohol.
3 in 4 women who want to get pregnant as soon as possible report drinking alcohol.
100% Fetal alcohol spectrum disorders are completely preventable.

Problem

Alcohol can harm a developing baby before a woman knows she is pregnant.

Why take the risk?

  • Women who are pregnant or who might be pregnant should be aware that any level of alcohol use could harm their baby.
  • All types of alcohol can be harmful, including all wine and beer.
  • The baby’s brain, body, and organs are developing throughout pregnancy and can be affected by alcohol at any time.
  • Drinking while pregnant can also increase the risk of miscarriage, stillbirth, prematurity, and sudden infant death syndrome (SIDS).


​Doctors, nurses, or other health professionals can help prevent alcohol use during pregnancy in 5 ways:

  1. Provide alcohol screening and brief counseling to all women.
  2. Recommend birth control to women who are having sex (if appropriate), not planning to get pregnant, and drinking alcohol.
  3. Advise women who are trying to get pregnant to stop drinking alcohol.
  4. Refer for additional services for women who cannot stop drinking on their own.
  5. Follow up yearly or more often, as needed.

Alcohol Poisoning Deaths
A deadly consequence of binge drinking
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On average, 6 people died every day from alcohol poisoning in the US from 2010 to 2012. Alcohol poisoning is caused by drinking large quantities of alcohol in a short period of time. Very high levels of alcohol in the body can shutdown critical areas of the brain that control breathing, heart rate, and body temperature, resulting in death. Alcohol poisoning deaths affect people of all ages but are most common among middle-aged adults and men.
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States and communities can take steps to reduce alcohol poisoning deaths by preventing binge drinking, including:

  • Partnering with police, community groups, health departments, and doctors, nurses, and other health care providers to reduce binge drinking and related harms.
  • Tracking the role of alcohol in injuries and deaths.
  • Supporting proven programs and policies that decrease binge drinking. States with stronger alcohol policies have less binge drinking.



Problem

There are 2,200 alcohol poisoning deaths in the US each year.Alcohol poisoning deaths:

  • Most people who die are 35-64 years old.
  • Most people who die are men.
  • Most alcohol poisoning deaths are among non- Hispanic whites. Although a smaller share of the US population, American Indians/Alaska Natives have the most alcohol poisoning deaths per million people of any of the races.
  • Alaska has the most alcohol poisoning deaths per million people, while Alabama has the least.
  • Alcohol dependence (alcoholism) was identified as a factor in 30% of alcohol poisoning deaths.


​Binge drinking can lead to death from alcohol poisoning.

  • Binge drinking (4 or more drinks for women or 5 or more drinks for men in a short period of time) typically leads to a blood alcohol concentration (BAC) that exceeds 0.08 g/dL, the legal limit for driving in all states.
  • US adults who binge drink consume an average of about 8 drinks per binge, which can result in even higher levels of alcohol in the body.
  • The more you drink the greater your risk of death. 

Alcohol Screening and Counseling
​An effective but underused health service
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Alcohol screening and brief counseling can reduce the amount consumed on an occasion by 25% in those who drink too much.
At least 38 million adults drink too much and most are not alcoholics. Drinking too much includes binge drinking, high weekly use, and any alcohol use by pregnant women or those under age 21. It causes about 88,000 deaths in the US each year, and costs the economy about $224 billion. Alcohol screening and brief counseling can reduce drinking on an occasion by 25% in people who drink too much, but only 1 in 6 people has ever talked with their doctor or other health professional about alcohol use. Talking with a patient about their drinking is the first step of screening and brief counseling, which involves:

  • Using a set of questions to screen all patients for how much and how often they drink.
  • Counseling patients about the health dangers of drinking too much, including women who are (or might be) pregnant.
  • Referring only those few patients who need specialized treatment for alcohol dependence.


Doctors and other health professionals can use alcohol screening and brief counseling to help people who are drinking too much to drink less. The Affordable Care Act requires new health insurance plans to cover this service without a co-payment.


Problem

Doctors, nurses, and other health professionals should screen all adult patients and counsel those who drink too much.Most adults have not talked with a doctor, nurse, or other health professional about how much they drink.

Drinking too much is dangerous and can lead to heart disease, breast cancer, sexually transmitted diseases, unintended pregnancy, fetal alcohol spectrum disorders, sudden infant death syndrome, motor-vehicle crashes, and violence.

Public health experts recommend alcohol screening and counseling should happen more often than it does. Yet, people report a doctor, nurse, or other health professional has rarely talked with them about alcohol, the important first step for addressing problems with drinking too much:

It can reduce how much alcohol a person drinks on an occasion by 25%.
It improves health and saves money just as blood pressure screening, flu vaccines, and cholesterol or breast cancer screening.
It is recommended for all adults, including pregnant women.

  • Alcohol screening and brief counseling has been proven to work.


Only 1 in 6 adults have discussed their drinking.

  • Few binge drinkers (1 in 4) have talked about alcohol use. Binge drinking is defined as men drinking 5 or more alcoholic drinks or women drinking 4 or more, in about 2-3 hours.
  • Even among adults who binge drink 10 times or more a month, only 1 in 3 have discussed drinking.
  • Only 17% of pregnant women have talked about drinking.
  • Most states had less than 1 in 4 adults who discussed their drinking. Washington, D.C. had the highest percentage with 25%.

Binge Drinking

A Serious, Under-Recognized Problem Among Women and Girls

Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem. Drinking too much – including binge drinking* – results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.

About 1 in 8 women aged 18 years and older and 1 in 5 high school girls binge drink. Women who binge drink do so frequently – about 3 times a month – and have about 6 drinks per binge. There are effective actions communities can take to prevent binge drinking among women and girls.

*Binge drinking for women is defined as consuming 4 ormore alcohol drinks (beer, wine, or liquor) on an occasion.

Problem

Drinking too much can seriously affect the health of women and girls.Drinking too much can seriously affect the health of women and girls.

  • Women’s and girls’ bodies respond to alcohol differently than men’s. It takes less alcohol for women to get intoxicated because of their size and how they process alcohol.
  • Binge drinking can lead to unintended pregnancies. It is not safe to drink at any time during pregnancy.
  • If women binge drink while pregnant, they risk exposing their developing baby to high levels of alcohol, increasing the chances the baby will be harmed by the mother’s alcohol use.
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Drinking is influenced by your community and your relationships.

  • Alcohol use in a community is affected by alcohol’s price and availability.
  • Underage drinking is affected by exposure to alcohol marketing.
  • Underage drinking is also influenced by adult drinking, and youth often obtain alcohol from adults.