Detoxing from Alcohol During Pregnancy

By: Emmalynn Pepper Clemmensen, MS, LPCC, CRC  

With unplanned pregnancies, these concerns may be even more prominent, as the mother might not be aware of the pregnancy during the time when the fetus is especially vulnerable. However, if you are addicted to alcohol and pregnant, it is extremely important that you do not quit cold turkey and that you do not quit alone. It is crucial to seek the help of a medical professional.2 
Approximately half of pregnancies in the United States are unplanned, meaning that they are either unwanted or mistimed.1 An unplanned pregnancy can be a complete shock and cause a lot of anxiety in the expecting parents. In this article we will review alcohol dependence, with an emphasis on drinking while pregnant. We will explore the risks of detoxing on your own and the safe management of alcohol withdrawal. Lastly, we will review the serious risks and consequences associated with alcohol use during pregnancy.  

Alcohol Dependence & Its Implications

An alcohol use disorder, or alcohol addiction, may be present when someone spends much time and effort obtaining and consuming alcohol and continues to use despite negative consequences, such as job loss, relationship issues, financial stress, or legal problems.3 In the United States, approximately 4.6% of 12- to 17-year-olds have an alcohol use disorder, and approximately 8.5% of adults 18 years and older have an alcohol use disorder.3 Chronic alcohol abuse can lead to physiological dependence, which occurs when the body adjusts to the presence of a substance. When dependence develops, the individual will experience uncomfortable and sometimes dangerous withdrawal symptoms when they abruptly quit drinking. Dependence is a physical adaptation but its presence can contribute to the development of the larger, more complex condition of addiction. For example, continuing to drink to avoid or alleviate distressing withdrawal symptoms associated with dependence can ultimately lead to alcoholism.  

Alcohol withdrawal symptoms can range from mild to life-threatening, depending on the severity of your addiction, the duration of drinking, the average amount consumed, individual physiology, age, co-occurring mental or physical conditions, etc. Therefore, cold turkey withdrawal could be dangerous to both you and your unborn child. Because of this, professional support during the detoxification process is strongly recommended.2  

If you are trying to get pregnant or already are pregnant and struggle with alcohol abuse, please seek help from an addiction specialist or your primary care physician, as there are serious risks associated with detoxing on your own.  

The Risks of Detoxing on Your Own

 

Some of the most serious withdrawal symptoms are depressed mood, hallucinations, and severe confusion, as these symptoms could lead to erratic behavior, self-harm, suicidal thoughts, or suicide attempts. Seizures, especially grand mal, are also especially dangerous as they could lead to serious complications, or accidents that could even be fatal (i.e. falling, head injury). Furthermore, experiencing these symptoms during pregnancy could place undue stress on the unborn baby and could lead to fetal death.2 If you have developed a significant amount of alcohol dependence, it is crucial that you seek professional medical assistance when quitting alcohol to reduce the risks to you and your baby. 

Management of Alcohol Withdrawal 

Detoxification is the process of eliminating all harmful substances from the body. In some cases, detox may occur in a variety of professional settings. However, when detoxing from alcohol while pregnant, it is recommended that the process takes place in an inpatient or hospital setting where you will receive 24-hour support to ensure safety.2  

In many instances, medications such as benzodiazepines and antipsychotics may be used during the detoxification process to ease the symptoms of withdrawal.2 However, in pregnant women extra precaution needs to be taken. Research seems to be mixed regarding whether or not benzodiazepines are safe during pregnancy, so each case needs to be considered carefully. If it seems as though the potential benefits of using benzodiazepines to manage alcohol withdrawal during pregnancy outweighs the potential risks then, on a case-by-case basis, they may be used during the detox process.2  

Medical staff provide around-the-clock supervision and treatment in the event that any complications arise, due to withdrawal or co-occurring medical conditions. You will receive mental health support as well, from a therapist or psychologist, which can help you through this trying process. Detox treatment provides you with a safe environment while ultimately aiming to achieve stabilization.  

After the detoxification process occurs, it is important to then transition to an alcohol abuse treatment program. Participating in such a program can help you identify factors that lead to alcohol use and how to work through and cope with such factors in healthier ways. Building a solid foundation of coping skills will help reduce the likelihood of relapse, and lead to successful recovery, all of which can happen with the support of a professional treatment program.  

Consequences of Continued Drinking

Again, continuing to consume alcohol while pregnant can be detrimental for both you and your baby. Continued use can impair the development of the fetus and lead to serious long-term problems. Furthermore, if you drink throughout your pregnancy your baby may become dependent on alcohol and experience withdrawal symptoms once born. Withdrawal symptoms may be delayed in newborns since they metabolize alcohol slower than adults do.5 Such symptoms include:5 

• Abdominal distention. 
• Vomiting. 
• Tremors. 

• Excessive muscle tension. 
• Irritability. 
• Increased breathing rate. 
• Poor sleep. 
• Increased sense of hearing. 

• Spontaneous seizures accompanied by apnea, or stopping of breathing. 

Some of the neonatal alcohol withdrawal symptoms can lead to death, which is why it is so important to seek professional help as soon as possible so you can help to reduce the risks associated with withdrawal, as well as development problems that can occur due to fetal alcohol exposure. 

Fetal Alcohol Spectrum Disorders 

The risks and consequences of drinking while pregnant can be very severe and dangerous.

• Alcohol-Related Neurodevelopmental Disorder (ARND): ARND is characterized by potential intellectual disabilities and behavioral and learning impairments, as well as impulse control problems. 
• Alcohol-Related Birth Defects (ARBD): ARBD is often characterized by bone, kidney, or heart problems, or a combination of these. 
• Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): ND-PAE is marked by cognitive problems and memory deficits, behavior issues, such as mood swings or tantrums, and impaired ability to carry out day-to-day tasks, such as bathing or dressing. The mother must have consumed more than 13 drinks per month during pregnancy or more than 2 drinks per sitting. 

Whenever a mother drinks during pregnancy her baby may be at risk of developing a FASD. However, there are factors that increase the risk, such as how much, how often, and in what stage the mother consumes alcohol.8 More specifically, drinking early on in pregnancy, consuming more than 4 drinks at once (i.e. binge drinking), and regular heavy drinking put the fetus at the greatest risk for developing severe problems.8  

The risks and consequences of drinking while pregnant can be very severe and dangerous. Therefore, if you are trying to get pregnant or are already pregnant, and addicted to alcohol, it is critical that you quit drinking as soon as possible. Lastly, it is extremely important that when quitting you seek the support and assistance of professional, medical help to ensure both you and your baby’s safety and overall wellbeing.  

Sources

1. Centers for Disease Control and Prevention. (2015). Reproductive Health: Unintended Pregnancy Prevention. 

1. Heberlein, A., Leggio, L., Stichtenoth, D., & Thomas, H. (2012). The Treatment of Alcohol and Opioid Dependence in Pregnant Women. Current Opinion in Psychiatry, 25(6), 559–564. 

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Association Publishing.  

1. U.S. National Library of Medicine. (2018). Alcohol Withdrawal.  

1. Thomas, J.D. & Riley, E.P. (1998). Fetal Alcohol Syndrome: Does Alcohol Withdrawal Play a Role? Alcohol Health & Research World, 22 (1), 47-53. 

1. Centers for Disease Control and Prevention. (2017). Fetal Alcohol Spectrum Disorders (FASDs). 

1. U.S. National Library of Medicine. (2018). Fetal Alcohol Spectrum Disorders.  

1. National Institute on Alcohol Abuse and Alcoholism. (N.D.). Fetal Alcohol Exposure.