Midwifery 101: Alcohol in pregnancy

The last thing I want to do is start a big debate about what is still a pretty taboo topic in Britain. I’m sure many of you can turn around and say “I drank in pregnancy, and my baby’s fine”. I will not dispute that. It happens. However, alcohol does carry it’s own risks.

So, all I’m going to do with this Midwifery 101 is state the facts. No judgement, no opinion, just facts.

What are the main risks to pregnancy from alcohol?

• Miscarriage (especially in the first trimester)
• Intra-uterine growth retardation (where the baby grows at a slower rate than normal, or stops growing full stop)
• Alcohol is teratogenic, meaning it can cause all sorts of abnormalities in babies, such as intellectual impairment and structural deformities.

How does the alcohol get to the baby?
Alcohol passes from your blood stream to your baby through the placenta. Babies have very immature livers, which cannot process the alcohol like yours does and get rid of it.

What is fetal alcohol syndrome?
Fetal alcohol syndrome is a collection of symptoms including:

• IUGR
• Neurological abnormalities and intellectual impairment
• Behavioural dysfunction
• Skull and/or brain malformation
• FAS facial features:
        -Skin folds at eye corner
        -Small eye opening
        -Thin upper lip
        -Low set ears
        -Small head circumference
        -Indistinct (smooth) nasal philtrum
• Cognitive impairement

The women most at risk from FAS are those who drink over six units of alcohol a day. Six units equates to two large glasses of wine, 3 cans of beer or three double measures of spirits.

What is fetal alcohol effect?
Fetal alcohol effect is a lesser-form of fetal alcohol syndrome. These infants have more problems with language (including learning to talk), hyperactivity and a shorter attention span than babies of mothers who didn’t drink. Women at risk of FAE are those who drink more than 1-2 units once or twice a week. Two units equates to a pint of low-strength beer, or one double measure of spirit.

Can I drink anything at all?
Current NICE Guidelines recommend that alcohol is completely avoided during pregnancy, especially in the first 3 months due to the increased risk of miscarriage.

However.
Some women will choose to drink alcohol during pregnancy. For these women, the advice given by NICE is to drink no more than 1-2 UK units once or twice a week, to avoid causing harm to the unborn baby.
Getting drunk and binge drinking (more than 7.5 UK units on a single occaision) is considered harmful, and should be avoided.

What is a UK unit?
10ml of pure alcohol, equal to:

• Half a standard glass of wine at 11.5% Alcohol By Volume (175ml)
• A single measure of spirit (e.g. gin, rum, vodka, whisky) at 40% ABV (25ml)
• Half a pint of beer, lager or cider at 3.5% ABV

The average units contained in several drinks such as alcopops, glasses of wine, beers and spirits can be found here.