Pregnancy and Alcohol

What Happens When Pregnant Women Drink Alcohol?

Drinking alcohol during pregnancy can put both a mother and her child at an increased risk for health problems. No amount of alcohol is safe for consumption during pregnancy.

Drinking any amount of alcohol during pregnancy can lead to fetal alcohol effects. These effects can include:

• Miscarriage
• Stillbirth
• Physical disabilities
• Behavioral abnormalities
• Intellectual disabilities

According to a study by the Centers for Disease Control and Prevention (CDC), from 2018 to 2020:

• 13.5% of pregnant women reported drinking alcohol within the last 30 days
• 5.2% reported binge drinking during the same time frame

Research shows that drinking, especially binge drinking, is teratogenic and poses a high risk for health complications.

How Does Consumed Alcohol Pass to the Baby?

Alcohol in your bloodstream can pass through the placental barrier and into fetal circulation through the umbilical cord. If a pregnant person engages in binge drinking, high blood alcohol concentration (BAC) can stop essential nutrients from reaching the developing baby.

The fetus’ BAC reaches the mother’s only 2 hours after prenatal alcohol exposure. The alcohol remains in the fetus’ system longer because its alcohol metabolism is slower.

Can an Alcohol-Exposed Pregnancy Affect Breastfeeding?

Alcohol exposure can shorten breastfeeding duration, as it decreases milk production. It also increases milk ejection and can reduce overall production by up to 10%.¹⁰

In addition, alcohol can be transferred to the baby through breast milk, with levels peaking between 30 and 60 minutes after consumption. To minimize risks, mothers should consider waiting at least 2 hours after consuming alcohol before breastfeeding. 

Alcohol can linger in breast milk for up to 3 hours. The duration varies based on factors like:

• The mother's alcohol intake
• Consumption speed
• Food consumption (whether the alcohol is taken with or without food)
• The mother's weight
• The mother’s metabolism

Contrary to popular belief, pumping or expressing breast milk does not reduce the amount of alcohol. Once the mother’s alcohol blood level falls, the alcohol in her breast milk will decrease. 

Does Moderate Alcohol Consumption Make It Harder to Conceive?

Alcohol consumption can make it harder for someone to get pregnant, as it can affect fertility in the following ways:

• Causes irregular menstrual cycles and missed periods, making it difficult to predict ovulation
• Disrupts hormonal balances in the body, restricting the release of eggs during ovulation 
• Produces lower-quality eggs, decreasing the probability of a successful pregnancy
• Affects male fertility, reducing sperm count, motility, and morphology
• Impacts the efficacy of in vitro fertilization procedures

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How Much Alcohol Is Dangerous?

There is no known safe amount of alcohol to consume while pregnant or breastfeeding.

Both the CDC and the American College of Obstetrics and Gynecology (ACOG) advise pregnant women not to consume any form of alcohol. Prenatal alcohol exposure causes severe negative effects on the baby's development (fetus).

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When Is It Safe to Drink Alcohol During Pregnancy?

It is safest to avoid alcohol use during pregnancy altogether, as fetal alcohol exposure can cause growth and central nervous system problems at any time.

While some individuals believe alcohol use is safe during the first trimester, alcohol can cause the developing fetus to have abnormal facial features, a low birth weight, and behavioral problems.

In addition, alcohol consumption during the first 6 to 12 weeks of gestation can affect the baby’s teeth, palate, and genitals.

Is It Illegal for a Pregnant Woman to Drink Alcohol?

In most countries, it is not illegal for pregnant individuals to drink alcohol. However, significant public health recommendations and guidelines strongly advise against alcohol consumption during pregnancy. Even low-level alcohol consumption can lead to poor health in the developing fetus.

Recently, some states have passed punitive laws regarding maternal alcohol use, allowing involuntary commitment to treatment centers. 

The following states consider alcohol consumption during pregnancy to be a form of child abuse:

Individuals may experience a range of penalties, including fines and jail time. However, punishments vary depending on the nature and severity of prenatal alcohol exposure.

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What Are the Effects of Drinking Alcohol While Pregnant?

The leading preventable cause of congenital disabilities in the U.S. is prenatal exposure to drugs or alcohol.

Moderate drinking during the first 3 months of pregnancy can result in abnormal facial features. Other adverse effects on the developing baby include the following:

• Growth issues
• Behavioral issues
• Low birth weight
• Fetal Alcohol Spectrum disorders
• Miscarriage
• Stillbirth
• Physical, mental, or intellectual disabilities

The baby’s brain develops throughout pregnancy and can be affected by alcohol exposure at any time. The sooner you avoid alcohol altogether, the better it will be for you and your developing baby. Complete abstinence from alcohol is still the best course of action.

Can Alcohol Use During Pregnancy Cause a Miscarriage?

Studies suggest that alcohol consumption during pregnancy increases the risk of a miscarriage. Each additional alcoholic drink per week can increase the risk of miscarriage by up to 6%.¹¹

Understanding Fetal Alcohol Spectrum Disorders

The term “Fetal Alcohol Spectrum Disorder” (FASD) defines a spectrum of effects caused by prenatal exposure to alcohol, including:

• Fetal Alcohol Syndrome (FAS)
• Partial FAS (pFAS)
• Alcohol-Related Neurodevelopmental Disorder (ARND)
• Alcohol-Related Birth Defects (ARBD)
• Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)

Symptoms of Fetal Alcohol Spectrum Disorders

Everyone with FASD has a unique set of symptoms that cause long-term issues. These symptoms and afflictions present themselves in a variety of ways.

Physical 

FASD may produce abnormal facial features such as:

• Narrow eye openings
• Greater distances between eyes
• Thin upper lips
• Smooth ridges between the nose and upper lip (philtrum)

Additional symptoms include:

• Smaller heads
• Shorter heights
• Lower body weights

Medical 

People with FASD may experience vision or hearing issues. It can also affect the heart, kidneys, or bones.

Mental Health 

The unborn baby is also at a higher risk of developing mental illnesses such as:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Depression
• Anxiety
• Substance use disorders

Behavioral 

People with FASD often have attention issues and may struggle to focus or shift their attention. They also struggle to control their emotions and impulsivity and may require behavioral counseling.

Educational

Children with FASD may struggle in school and experience developmental disabilities impacting daily life skills, including:

• Learning disabilities
• Memory problems
• Difficulty understanding and following directions

Social

FASD can impact a person’s ability to communicate and socialize. They may struggle with:

• Decision-making
• Repetitive mistakes
• Understanding the consequences of their actions
• Eating
• Personal hygiene
• Money management
• Personal safety

Recognizing Substance Abuse in Pregnant Individuals

According to a study, 85% of surveyors (from a sample of 1,500) would stop drinking alcohol upon realizing they were pregnant.³ However, this isn’t the case for all mothers-to-be, especially if they already have an alcohol use problem. 

Knowing how to recognize the signs of alcohol use disorder (AUD) can prevent issues in early pregnancy. Here are a few common symptoms of an alcohol use problem in pregnant individuals:

• Isolating oneself from friends and family
• Lying to loved ones about alcohol use
• Concealing or denying the pregnancy
• Timing visits to health care providers so alcohol does not show up in urine tests
• Skipping doctor’s appointments and prenatal care altogether
• Resisting behavioral interventions

Treatment for Alcohol Use Disorder (AUD) for Pregnant Women

Pregnant women who suffer from AUD often have co-occurring disorders. It is essential to treat pregnant women who drink with kindness and compassion.

Treatment for AUD for pregnant women should involve:

• Women-centered care
• Comprehensive care (prenatal care and substance use counseling)
• Respect and non-judgment
• A harm-reduction philosophy

Medication Treatment Options

When treating pregnant women with AUD, healthcare providers must carefully evaluate the potential risks associated with treating pregnant women with medication. Currently, there are three FDA-approved medications for treating AUDs:

• Naltrexone
• Disulfiram
• Acamprosate

These are category C medications, indicating that animal studies have shown potential adverse effects on fetuses. However, no experimental evidence suggests safety risks in human use.

Addiction Treatment Programs

There are a few types of addiction treatment programs that can help pregnant women:

Inpatient Treatment

Inpatient treatment programs are the most effective rehab programs. These are intensive programs that can last 30, 60, 90 days. They may last longer in some instances, depending on a person’s needs.

In these programs, the patient lives, sleeps, eats, and undergoes treatment at the facility.

Partial Hospitalization Programs (PHPs)

Partial hospitalization programs are also called intensive outpatient programs (IOPs). They are almost as intensive as inpatient programs, but you return home to sleep.

Outpatient Programs

Outpatient programs are less intensive than inpatient treatment and PHPs. They offer a more flexible treatment schedule.

They are best for people who have work, home, or school responsibilities, along with a high motivation to get sober.

Support Groups

Pregnant women suffering from substance abuse may benefit from feeling less alone during their recovery journey. Some support groups offering help to pregnant individuals include:

• Alcoholics Anonymous
• Women for Sobriety
• SMART Recovery for Women
• HER Place
• She Recovers
• Women’s Recovery
• Addiction Hope Women’s Recovery

Tips for Avoiding Alcohol Consumption During Pregnancy

It can be challenging for a pregnant person with alcohol dependence to quit drinking cold turkey. Thus, having a strategy for eliminating risky drinking patterns is crucial. 

Here are a few tips for avoiding drinking during pregnancy:

• Engage in light exercise, such as walking, prenatal yoga, or swimming.
• Consume healthier drinks, such as water, milk, ginger tea, seltzer, and fruit and vegetable smoothies. Avoid caffeinated beverages, soda, and unpasteurized milk.
• Remove all alcoholic drinks from your home. 
• Avoid social gatherings that may encourage drinking behavior. If you’re keen to attend, consider asking a friend or family member to hold you accountable.
• Fill your day with other relaxing activities, such as meditation, reading, journaling, knitting, and other hobbies.

Remember, if you or someone you love is struggling with AUD during pregnancy, help is always available. Reach out to a professional today.

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