Setting the Record Straight on Drinking During Pregnancy

When confronted with so many different types of infections and viruses that can threaten the health of an unborn baby, it’s unfortunate that drinking during pregnancy is still the leading cause of birth defects in this country and abroad. Without knowledge of the devastating effects, it’s easy to have a casual attitude toward drinking but when a fetus is exposed to any amount of alcohol it can lead to a number of permanent and debilitating conditions. These are known as fetal alcohol spectrum disorders (FASD) and can include anything from severe brain damage and growth deficits to lifelong learning and behavioral problems in children. September is designated as FASD Awareness Month but my hope is that at some point in the near future there is no longer a need to observe it because the fact is—FASD is 100 percent preventable.

Disorders as a result of drinking during pregnancy are most likely to occur in infants whose mothers drank heavily, which means three or more drinks per occasion or more than 7 drinks per week. The likelihood of adverse effects is greater if the mother continued to drink heavily throughout her pregnancy but it also can occur with lesser amounts of alcohol use. Even one drink per day can have negative consequences that might not even be apparent until later down the line. According to the Centers for Disease Control and Prevention (CDC), between 2011 and 2013, 10.2 percent of pregnant women in the United States ages 18 to 44 reported drinking alcohol during pregnancy; 3.1 percent reported binge drinking.

A practice called motivational interviewing is emerging as an effective and efficient catalyst for behavior change with regard to alcohol use. Sometimes patients can be resistant to change if they don’t understand the negative consequences of their actions or value the social connection associated with the behavior, or in some cases, the addiction. However, if ob-gyns show sensitivity and empathy while counseling patients, in addition to conveying the medical evidence associated with drinking, the outcomes have an increased chance of being successful. In order to help patients explore and resolve their ambivalence, ob-gyns might try to engage in “reflective listening.” This means letting the patient talk and reflecting back to her what you’ve heard in order identify the thoughts and feelings behind what could be making her continue the unhealthy behavior. Through this discovery, you can begin the process of establishing new thought patterns and practices.

However, understandably, counseling patients on this sensitive topic can be a bit daunting for ob-gyns. According to CDC data, only 17 percent of pregnant women reported that their health care professional talked with them about their alcohol use. While it is not an easy conversation to have, it is certainly one worth having if it means one less child born with FASD. A woman’s ob-gyn should be the person to set the record straight regarding the mixed messages she could possibly be receiving about drinking from well-meaning friends and family. Going forward, let’s all get on the same page and spread the word far and wide—there is no safe time, no safe kind, and no safe amount of alcohol during pregnancy. Period.

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About Tom Gellhaus, MD

Tom Gellhaus, MD is ACOG President through 2017. He is a Clinical Associate Professor in the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Dr. Gellhaus graduated from Yankton High School in Yankton, South Dakota, received his Bachelor of Arts Degree in Chemistry from Augustana College in Sioux Falls, South Dakota and his Doctor of Medicine Degree from the University of Oklahoma in Oklahoma City, Oklahoma. He completed his residency in Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics. Following residency, he entered private practice in Davenport, Iowa and after 20 years in private practice, he returned to academic medicine at the University of Iowa. Over the past 20 years, Dr. Gellhaus has served in many ACOG positions at the local, regional, national and international levels. Dr. Gellhaus’ interests are in the areas of health care advocacy and policy. He has also been very involved and active in global healthcare. He has completed the McCain Fellowship, a month long in-depth experience in advocacy, at ACOG in Washington, D.C. in 1999. In 2001, he was a Primary Care Policy Fellow with the U.S. Department of Health and Human Services. He has remained active in Advocacy and Policy as a member of ACOG’s Government Affairs Committee and the Ob/Gyn PAC. Dr. Gellhaus has also been very active in leading groups on short-term medical and surgical mission projects for the last 20 years. He has done numerous presentations about these short-term medical and surgical mission projects throughout the United States.

2 thoughts on “Setting the Record Straight on Drinking During Pregnancy

  1. Thank you for this missive. Timely for the young generation. I just overheard two young women talking in a clothing store about “it is considered safe now to drink during pregnancy.
    Maybe ACOG should do some public health TV announcements.

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