Drinking Alcohol During Pregnancy: Risks, Myths, and Recommendations

Pregnancy can prompt a range of emotions, from excitement and anticipation to worry and uncertainty. Life changes and adjustments are made, sometimes eagerly and sometimes begrudgingly. Drinking alcohol, while widely a socially accepted practice, has come under more recent scrutiny, with health experts debating the degree of harm it causes for anyone who chooses to drink any amount. But long before this surge of recent headlines, the risk of alcohol consumption during pregnancy was a widely contested related topic. While some believe that an occasional glass of wine is harmless, most medical experts now advise against any alcohol consumption during pregnancy. Refraining from drinking at all during pregnancy may be an easy choice for some women, but for others, especially those struggling with an alcohol use disorder, abstaining is more difficult. This blog explores the risks, common myths, and expert recommendations regarding alcohol use during pregnancy.

Understanding Alcohol and Pregnancy

Data from the National Survey on Drug Use and Health reports that nearly 1 in 10 pregnant women currently drink alcohol, primarily during the first trimester, and 1 in 22 report binge drinking during pregnancy. It’s important to understand that alcohol easily crosses the placenta, so whatever a pregnant individual drinks – beer, wine, hard ciders and seltzers, hard liquor – gets passed to the developing fetus. Unlike adults, a fetus lacks the enzymes necessary to metabolize alcohol efficiently, which can lead to developmental complications. Studies indicate that both heavy and binge drinking have the most adverse outcomes. However, light to moderate amounts of alcohol can have effects, so understanding the range of risks associated with drinking during pregnancy will help individuals make healthier choices for themself and their baby.

Risks of Drinking Alcohol During Pregnancy

1. Fetal Alcohol Spectrum Disorder (FASD)

One of the most serious risks of alcohol consumption during pregnancy is fetal alcohol spectrum disorder (FASD). FASD is an umbrella term for a range of physical, cognitive, and behavioral disorders caused by prenatal alcohol exposure. Symptoms range in severity and scope and may include:

• Poor coordination

• Hyperactivity

• Difficulty paying attention

• Poor memory

• Vision or hearing problems

• Problems with the heart, kidney, or bones

• Abnormal facial features

• Small head and brain size

• Shorter-than-average height

• Low body weight

• Learning disabilities

• Speech and language delays

• Poor decision-making skills

Children with FASD may have both learning and behavior problems in school that can include difficulty paying attention and aggressive, impulsive, and hyperactive behavior. The child may struggle with making and keeping friends, which can lead to social isolation and feelings of frustration and loneliness. These challenges make succeeding in school difficult, which is hard for both the child and the parent or caregiver. FAS (fetal alcohol syndrome), the most severe of the disorders, occurs in pregnancies during which the mother drinks heavily.

2. Increased risk of miscarriage, stillbirth, and sudden infant death syndrome (SIDS)

Research shows that consuming alcohol during pregnancy, especially in the first trimester, increases the risk of miscarriage and stillbirth. Even moderate drinking can elevate these risks, as alcohol can interfere with the baby’s growth and development in crucial early stages. The risk of sudden infant death syndrome (SIDS) also increases when a mother drinks heavily while pregnant, with significantly increased risk for those who smoke tobacco and drink alcohol.

3. Preterm birth and low birth weight

Alcohol consumption can lead to preterm labor and low birth weight, which increases the risk of complications such as breathing difficulties, developmental delays, and a weakened immune system. Babies born prematurely may face lifelong health challenges, making avoiding alcohol entirely during pregnancy ideal.

4. Long-term developmental and behavioral issues

Unfortunately, children exposed to alcohol in utero can struggle with cognitive and behavioral difficulties that persist throughout their lives. They have an increased rate of mental health disorders such as attention-deficit hyperactivity disorder (ADHD), depression, and anxiety.  As adults, they may struggle to keep a job, perform routine life tasks such as managing money, make and follow a schedule, and demonstrate other skills needed to live independently. These challenges can place significant emotional and financial strain on families.

Common Myths About Alcohol and Pregnancy

Many myths and misconceptions exist about alcohol use during pregnancy, which can lead to confusion and lack of understanding. Let’s take a look at the most common myths:

• Myth 1: “A small amount of alcohol is safe.”

  Despite popular belief, no amount of alcohol has been proven safe during pregnancy. Research suggests that even occasional drinking can impact fetal development. The safest approach is to abstain from alcohol entirely.

• Myth 2: “Drinking in the third trimester is much less harmful.”

  Some people assume that once the major organs have developed, alcohol consumption is less risky. However, the brain continues to develop throughout pregnancy, and alcohol exposure can still cause significant damage at any stage.

• Myth 3: “Certain types of alcohol are safer.”

  Some believe that wine and beer are safer than hard liquor. In reality, all alcoholic beverages contain ethanol, which poses risks to fetal development. The type of alcohol consumed does not change the potential for harm.

• Myth 4: “If I drank before knowing I was pregnant, my baby is doomed.”

  Many people consume alcohol before realizing they are pregnant. While it’s important to stop drinking as soon as pregnancy is confirmed, occasional early alcohol exposure does not necessarily mean the baby will have complications. Brain growth continues throughout pregnancy, so stopping as early as possible will improve the mother and baby’s overall health.

Expert Recommendations on Alcohol and Pregnancy

Making sense of all of the information regarding alcohol use during pregnancy to choose the healthiest path can feel daunting. Here are some tips to get you started:

1. Aim for abstinence

The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the World Health Organization (WHO) all agree that no amount of alcohol is safe during pregnancy. Abstaining from alcohol is the only way to entirely eliminate the risk of FASD and other related complications. But, for those who feel like all-or-nothing is impossible, taking small steps to reduce harm may be a way to begin. For example, individuals could start by progressively reducing the number of drinks each day.

2. Plan for a healthy pregnancy

If you are trying to conceive, consider avoiding alcohol altogether. Because many pregnancies are unplanned, and often women don’t know they are pregnant until 4-6 weeks or later, eliminating alcohol in advance reduces the risk of unintentional exposure in the early weeks.

3. Seek support 

For those struggling to quit drinking, support is available. Talking to a healthcare provider, joining support groups, or seeking counseling can provide guidance and encouragement to maintain an alcohol-free pregnancy.

Having a supportive environment at home can also make avoiding alcohol easier. Partners, family members, and friends can offer encouragement and even choose to abstain from alcohol themselves to show solidarity.

Conclusion

Every pregnancy is unique, and every pregnant individual’s experience and outcomes will differ. Rather than making mothers fret over all of the things that can cause their babies harm, let us instead empower mothers to make informed decisions that will lead to better health for themselves and their babies. The scientific evidence is clear: No amount of alcohol is proven safe to drink during pregnancy. FASD is entirely preventable by avoiding drinking alcohol during pregnancy. Though there is no cure for FASDs, children who are diagnosed early and receive the proper care will most often have better outcomes than those who do not. 

If you or someone you know is struggling with alcohol use during pregnancy, please know there is help available! It’s never too late to reach out and ask for help. For local Sacramento resources, call 916-875-1055 or toll free at 888-881-4811. You can also visit Sacramento County Behavioral Health Services Substance Use Prevention and Treatment Services.

• References

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  • Centers for Disease Control and Prevention. (2024, May 15). About alcohol use during pregnancy. Alcohol and Pregnancy. https://www.cdc.gov/alcohol-pregnancy/about/index.html

  • Chasnoff, I. J., Wells, A. M., Telford, E., Schmidt, C., & Messer, G. (2010). Neurodevelopmental functioning in children with FAS, pFAS, and ARND. Journal of Developmental & Behavioral Pediatrics, 31(3), 192–201. https://doi.org/10.1097/DBP.0b013e3181d5a4e2

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  • England, L. J. (2020). Alcohol use and co-use of other substances among pregnant females aged 12–44 years — United States, 2015–2018. MMWR. Morbidity and Mortality Weekly Report, 69(31). https://doi.org/10.15585/mmwr.mm6931a1

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  • National Institute on Alcohol Abuse and Alcoholism. (2023, August). Understanding fetal alcohol spectrum disorders. Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-fetal-alcohol-spectrum-disorders