It is in a child’s best interests for a prospective mother not to drink alcohol while pregnant due to the risk of developmental brain disorders to the child.
Yet two out of three women in Ireland continue to drink alcohol during their pregnancy. The most recent advice from the Department of Health’s Chief Medical Officer[i] is clear:
“Given the harmful drinking patterns in Ireland and the propensity to binge drink, there is a substantial risk of neurological damage to the fetus resulting in Fetal Alcohol Spectrum Disorders (FASD). Therefore, it is in the child’s best interest for a pregnant woman not to drink alcohol during pregnancy.”
A study of women who attended the Coombe Women’s Hospital found that almost two-thirds (63%) of the 43,318 women surveyed said they drank alcohol during their pregnancy.[ii] The situation is put into stark relief when the number of women who stopped drinking during pregnancy 13.2% is contrasted with the almost 50% who gave up smoking.
While women may receive information telling them that alcohol should be avoided during pregnancy that information is outweighed by the extent of alcohol marketing which adds to the cultural acceptability and normalising of problem levels of alcohol use. Alcohol is marketed and sold in supermarkets, petrol stations and convenience stores as if it were just another grocery so that it has become an everyday item in the family shopping basket.
Anecdotal evidence suggests that women receive either little information or contradictory information on alcohol during pregnancy from a number of sources including health care providers. Providing information on the risks associated with drinking alcohol during pregnancy through labels on packaged alcohol would go some way to informing consumers. However, labelling is simply not enough to balance out the positive, risk-free images of alcohol and its use portrayed in our constant exposure to alcohol marketing.
A higher proportion of Irish women drink when compared with other European countries with four out of ten women drinkers having a harmful pattern of drinking.
What are the Fetal Alcohol Spectrum Disorders? And what are the risks?
Alcohol consumption can lead to disorders in how the brain develops in the womb as the placenta does not act as a barrier to alcohol. The amount of alcohol required to impair the fetus is still subject to uncertainty, as is the timing of alcohol exposure. However, what is clear is that there are no known health benefits from drinking alcohol during pregnancy.
Damage to the fetus from alcohol takes a number of forms and can show up as behavioural, social, learning and attention difficulties in childhood, adolescence and throughout adulthood. As such, there can be lifelong consequences for an individual with any of the conditions among the FASD.
Fetal Alcohol Syndrome (FAS), is the rarest, but most easily recognised condition on the spectrum, and presents in children exposed to extreme levels of alcohol during pregnancy. FAS affect a child’s facial features and height, as well as their central nervous system. [iii]
Partial Fetal Alcohol Syndrome, (pFAS), Alcohol Related Neurodevelopmental Disorder (ARND), and Alcohol Related Birth Defects are far less easily diagnosed, but experts in the United States say that ARND is 10 times more prevalent than FAS. Due to difficulties in recognition and diagnosis of ARND, those affected are less likely to receive early diagnosis and appropriate treatment, often resulting in poor outcomes for those with the condition.
Drinking heavily during pregnancy can also increase the chances of complications during pregnancy and childbirth, as well as increasing the risk of miscarriage and stillbirth. A leaflet on women and alcohol published by the Health Promotion Unit-advises that there is no known safe level of alcohol use during pregnancy and that women should stop drinking during this time. [iii] It makes the following points:
- More than three drinks a day increases the risk of miscarriage
- More than 12 drinks in a week increases the risk of premature birth
- Sudden high levels of alcohol damages the developing brain
What needs to happen?
The Steering Group of the National Substance Misuse Strategy identifies effective policies and actions to reduce the harm caused by alcohol and Alcohol Action Ireland calls for the recommendations of the Steering Group to be implemented in full. The Report makes a number of recommendations on how best to reduce the harms caused by alcohol during pregnancy. These are
- Implement policies and clinical protocols in all healthcare settings to prevent, assess and respond to issues arising in relation to pregnant women affected by alcohol use
- Strengthen FASD surveillance in maternity hospitals through the Eurocat Reporting System and promote greater awareness among healthcare professionals of FASD so as to improve the diagnosis and management of FASD
- Labels on alcohol products sold in Ireland to include information on alcohol content, calorific content and health warnings in relation to consuming alcohol during pregnancy
Alcohol Action Ireland also calls for supports and services to be put in place for families and children coping with Fetal Alcohol Spectrum Disorders.
[ii] Barry S, Kearney A, Lawlor E, McNamee E and Barry J (2006) The Coombe Women’s Hospital Study of Alcohol, Smoking and Illicit Drug Use, 1988-2005. Dublin: Coombe Women’s Hospital
[iii] Babor, T. et al (2003) Alcohol: No Ordinary Commodity. Oxford Medical Publications
[iv] Health Promotion Unit (2003) Little Book of Women and Alcohol: Take a Closer Look at What Drink is Doing to You