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The Dangers of Alcoholism & Pregnancy

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When you’re pregnant, anything you put in your body doesn’t just affect you—it can also impact the health of your unborn child. This includes alcohol, and it’s extremely important to understand what the implications are for you and your baby.

Alcohol abuse during pregnancy can lead to serious problems, like fetal alcohol spectrum disorder (FASD). Even small amounts of alcohol can lead to lifelong disabilities.

It’s important to note that alcohol addiction is the most common substance abuse problem in the United States, with an estimated 16 million people struggling with alcoholism.1 If you’re struggling with problematic drinking and you are thinking of getting pregnant or just found out that you’re pregnant, you may want to seek professional assistance. It’s not too late to get help, even if you’re already pregnant; the sooner you stop drinking, the better the outcome for you and your unborn child. Detox and addiction treatment services can help you withdraw safely and obtain and maintain sobriety.

Pregnancy & Alcohol Use Statistics

If you have been abusing alcohol while pregnant, it may help to know that you are not alone. There are other pregnant women out there struggling with alcohol abuse. Consider the following statistics:2,3

  • About 10% of women report consuming alcohol during pregnancy.
  • An estimated 3% of women report binge drinking during pregnancy.
  • Drinking during pregnancy is more common in women with college degrees than those with a high school diploma or less.
  • Unmarried women are more likely to drink during pregnancy than married women.
  • Pregnant women between the ages of 35 and 44 have a higher alcohol consumption rate than pregnant women of other age groups.
  • As many as 5% of first graders may have a fetal alcohol spectrum disorder.

Regardless of what you may have heard, no amount of alcohol is safe to consume during pregnancy.

Why is Alcohol Dangerous?

Alcohol affects your baby’s ability to develop normally. It is a serious concern for many women with unplanned pregnancies, because damage can be done even in the first few weeks. About half of all pregnancies in the U.S. are unplanned, and women who aren’t expecting a pregnancy are less likely to notice that they are pregnant for several weeks.4 This is dangerous because by the time a woman realizes she is pregnant, fetal organ development is already underway.

When you drink during pregnancy, the alcohol in your blood passes to your baby through the umbilical cord. This means that the alcohol enters your baby’s blood stream. Drinking while pregnant significantly increases the chance of stillbirth, miscarriage, and a variety of intellectual, behavioral, and physical impairments or disabilities.5

Alcohol can damage your baby’s cells throughout several stages of development. There are two main stages of prenatal development. The first is the embryonic stage, which consists of the first 8 weeks after fertilization. The second stage is called the fetal stage, and it comprises the rest of development. During the embryonic stage, the body lays out the blueprints for organ development. Alcohol can severely affect these cells at various points over the course of their development, which can lead to miscarriage or serious birth defects.6

Weeks 3 to 6 of the embryonic stage encompass a critical period of early nervous system development. Alcohol can significantly disrupt this process anywhere from the third week through the third trimester, leading to a range of problems, such as a reduction in the brain’s white matter (leading to cognitive deficits) and hindrances in the creation and survival of brain cells.6

During the 3 to 6 week period, the basic structure of your baby’s face is developing. Alcohol can damage this process, causing permanent facial abnormalities. Further, by the fourth week, the heart has already begun to beat. Consuming alcohol can lead to improper valve formation and abnormal development of the ventricles and atria, which may have significant cardiac consequences later in life.6

It doesn’t matter which type of alcohol you drink, as anything alcoholic can harm your fetus. This includes beer, wine, and liquor. There are no established safe amounts of alcohol for a pregnant woman to consume.5 Also, there is no known safe time to drink throughout the pregnancy; drinking at any time during the baby’s development can cause critical and irreversible damage.

Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder (FASD) is a group of disorders caused by exposure to alcohol in utero. The effects can include physical deformities, developmental disorders, and behavioral problems, although FASD affects everyone differently.4

It is difficult for researchers to determine exactly how many babies are born with FASD. Estimates suggest that anywhere from 2% to 5% of children may have symptoms of FASD.3 The most severe form of FASD is known as fetal alcohol syndrome (FAS). Studies by the Centers for Disease Control and Prevention (CDC) suggest that between 0.2 and 1.5 infants have FAS for every 1,000 live births.3

Children with a FASD can show any of the following characteristics and behaviors:4

  • Coordination issues.
  • Hyperactive behavior.
  • Attention impairments.
  • Memory problems.
  • Learning disabilities.
  • Language and speech delays.
  • Low IQ or intellectual disability.
  • Impaired judgment and reasoning skills.
  • Below average height.
  • Low weight.
  • Hearing or vision problems.
  • Problems with bones, kidneys, or heart.
  • Abnormal facial features.
  • Small head size.

Some of the most recognizable characteristics of FAS, the most pronounced end of the spectrum, are certain facial deformities. These may include:7

  • Extremely small head.
  • Flat nose.
  • Thin upper lip.
  • Flattened face.
  • Small eyes.
  • Low-set or disfigured ears.

The chance that your fetus will have serious disabilities increases if you binge drink or otherwise drink heavily. Drinking 4 or more drinks in one sitting and drinking often will both increase your baby’s risk of FAS.8

Some women are more likely to use alcohol during pregnancy than others. Risk factors include:7

  • Mental health problems.
  • A history of physical or sexual abuse.
  • A history of substance abuse.
  • Poverty.
  • Homelessness.
  • Partner substance abuse.

How Does Alcohol Abuse Affect the Mother?

Drinking while pregnant doesn’t just pose risks to the unborn baby; it can also be risky for the mother, leading to serious physical and psychological consequences that significantly impair her ability to function and care for a child.

Consequences of alcohol abuse include:9

  • Cognitive impairments.
  • High blood pressure.
  • Irregular heart rate and/or rhythm.
  • Cardiomyopathy, or stretching and weakening of the heart muscle (potentially leading to heart failure).
  • Stroke.
  • Cirrhosis.
  • Alcoholic hepatitis.
  • Fatty liver.
  • Liver cancer.
  • Pancreatitis.
  • Mouth and throat cancer.
  • Breast cancer.
  • Weak immune system.

Long-term alcohol abuse can cause lasting changes in the drinker’s brain that can make it more difficult to quit. Someone who abuses alcohol may become dependent on alcohol, which means that they have to drink to avoid or alleviate unpleasant withdrawal symptoms. Dependence alone is not the same as addiction, as addiction also comprises a set of problematic behaviors, but continuing to drink once dependence has been established can eventually lead to alcoholism. Once someone develops an alcohol addiction, they will demonstrate compulsive and uncontrollable use regardless of the negative ramifications they experience.

Quitting Drinking

Quitting drinking is a great idea if you are pregnant or planning to become pregnant. A supervised, medical detox is the safest setting to go through withdrawal, which can be uncomfortable and even life-threatening. If you have an alcohol addiction, then you should not try to quit drinking on your own. Quitting cold turkey can put both you and your baby at risk. A detox center for pregnant women can help you manage the symptoms of withdrawal and reduce the risk of fatal seizures for both you and your baby.10

Alcohol withdrawal symptoms are different for everyone, but pregnant women have unique concerns. One of these concerns is that alcohol withdrawal, which involves increased glutamate neurotransmitter activity and NMDA receptor-mediated excitation within the central nervous system, can impact fetal brain cell health and development. Excessive NMDA receptor activation can lead to brain cell death and other developmental abnormalities than may translate into behavioral deficits later in life.10

The safest way to go through withdrawal is under close medical supervision. Alcohol withdrawal symptoms could include any of the following:11

  • Tremors.
  • Increased blood pressure and heart rate.
  • Lack of appetite.
  • Nausea and vomiting.
  • Anxiety, irritability, and agitation.
  • Insomnia.
  • Nightmares.
  • Sensitivity to sound, light, and touch.
  • High fever.
  • Impaired judgment, focus, and memory.
  • Hallucinations.
  • Delusions.
  • Grand mal seizures.

One of the specific concerns for alcoholic pregnant women is that their baby could be born addicted to alcohol. If you’ve developed significant physiological alcohol dependence, your baby will have, too. When your baby is born and no longer has access to the alcohol in your bloodstream, he or she can go into withdrawal.10

Signs and symptoms of alcohol withdrawal in newborns include:10

  • Tremors.
  • Muscle tension.
  • Irritability.
  • Rapid breathing.
  • Sleep disturbances.
  • An increased sensitivity to noise.
  • Arching of the back.
  • Vomiting.
  • Bloating.
  • Seizures.

In order to prevent any potential harms to your baby, including withdrawal symptoms, it’s important to seek formal treatment that can help you quit drinking safely and effectively.

Detox and Alcoholism Treatment

Alcohol detoxification is the process during which your body rids itself of alcohol and re-adjusts to its sudden absence. When your body is dependent on alcohol, it must relearn how to function without it. As the body makes these adjustments, you will experience symptoms of alcohol withdrawal. Alcohol detox programs provide monitoring and are able to administer medical care during this time, helping to ease the discomfort and prevent complications.

Alcohol detox programs are available in several different settings, including the following:

  • Hospital: Patients with a history of severe withdrawal complications, such as seizures and delirium tremens, may be safer in a hospital setting. If you have a high-risk pregnancy, you may want 24-hour access to an OBGYN.
  • Inpatient detox program: Specialized inpatient detox programs are often useful for pregnant women who would like around-the-clock support and care. Patients live at the facility for several days or weeks and are regularly monitored by medical professionals.
  • Outpatient detox program: Good candidates for outpatient detox have a sober support system at home and have been assessed by an addiction professional who has confirmed that the patient has little to no risk of experiencing a complicated withdrawal.

If needed, medical detox protocols will include the administration of certain medications to alleviate withdrawal symptoms and prevent or treat complications. Psychopharmacologic treatment of some comorbid mental health issues—such as mood and anxiety disorders—may also be recommended for pregnant women. A medical detox program may provide you with the following medications to manage withdrawal and prevent seizures:7

  • Continuous (possibly hourly) doses of short-acting benzodiazepines.
  • Clonidine.
  • Antidepressants or anxiolytics.

Detox is only the first step on the road to recovery. Getting through withdrawal safely is important for pregnant women, but it won’t help you stay sober. An addiction treatment program can give you the support you need to stay sober throughout your pregnancy and once your baby is born.

Ongoing substance abuse treatment can be a huge help to pregnant women and new mothers. Treatment programs offerings may consist of individual counseling, peer-to-peer support groups, and group therapy sessions. At the start of and throughout the treatment duration, compassionate and nonjudgmental professionals will provide evaluations to screen for comorbid psychiatric conditions, suicidality, and any thoughts about harming the child, while meeting the pregnant woman wherever she is in the process and providing emotional support.7 The most beneficial rehab options may include those that specialize in treating pregnant women and/or have daycare facilities.

Rehab centers for pregnant women and mothers offer special services that help you deal with the stresses of parenting. You will meet other women who understand what you are going through and can help you prepare for your new baby. Rehab centers for pregnant women may offer services, such as:

  • Pregnancy education and counseling.
  • Parenting classes.
  • Prenatal care.
  • Individual, group, and family therapy.
  • Life skills workshops.
  • Job training and placement.

Substance abuse treatment can take place in a variety of different settings. Which one is right for you will depend on factors like cost, length, intensity, and location. Common treatment settings include:

  • Inpatient treatment: Residential programs that provide 24-hour support, counseling, and medical care.
  • Outpatient treatment: Specialty treatment centers that offer intensive behavioral counseling on both an individual and group level, while allowing you continue living at home.
  • Specialized treatment: Inpatient or outpatient programs that cater towards the specific needs of a population, such as women-only or expecting mothers.
  • Luxury treatment: Inpatient programs that provide upscale facilities and amenities, like swimming pools and massage, for a higher cost.
  • Holistic treatment: Focuses on healing the whole person, through a variety of natural interventions, such as meditation, yoga, and acupuncture.
  • Executive treatment: Designed for the busy lives of working professionals.

Once you’ve completed detox and alcohol abuse treatment, it’s important to continue receiving ongoing support and treatment to prevent relapse. Support groups, such as Alcoholics Anonymous (AA) or Sober Mommies, can help you to remain focused on your recovery. Other common aftercare options include group counseling, individual therapy, and sober living homes.

Sources

  1. National Institute on Alcohol Abuse and Alcoholism. Alcohol Use Disorder.
  2. Centers for Disease Control and Prevention. (2015). Morbidity and Mortality Weekly Report.
  3. Centers for Disease Control and Prevention. (2017). Fetal Alcohol Spectrum Disorders: Data and Statistics.
  4. Centers for Disease Control and Prevention. (2017). Fetal Alcohol Spectrum Disorders: Facts about FASDs.
  5. Centers for Disease Control and Prevention. (2016). Alcohol Use in Pregnancy.
  6. O’Neil, E. (2011). Developmental Timeline of Alcohol-Induced Birth Defects. Embryo Project Encyclopedia.
  7. Bhuvaneswar, C. G., Chang, G., Epstein, L. A., & Stern, T. A. (2007). Alcohol Use During Pregnancy: Prevalence and Impact. Primary Care Companion to The Journal of Clinical Psychiatry, 9(6), 455–460.
  8. National Institute on Alcohol Abuse and Alcoholism. Fetal Alcohol Exposure.
  9. National Institute on Alcohol Abuse and Alcoholism. Alcohol’s Effect on the Body.
  10. Thomas, J.D. and Riley, E.P. (1998). Fetal Alcohol Syndrome Does Alcohol Withdrawal Play a Role? Alcohol Health and Research World, 22 (1).
  11. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment.

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