Making the link between unintended pregnancies and FASD prevention

The Centers for Disease Control and Prevention (CDC) in the United States released two reports this month with new data on alcohol consumption during pregnancy and unintended pregnancies. It’s interesting to take a look at these reports side-by-side as they suggest completely different target groups for FASD prevention activities.

The first report looked at alcohol use and binge drinking among women of childbearing age. The researchers found that approximately 7.6% (or 1 in 13) of pregnant women consume alcohol during pregnancy and that 1.4% of pregnant women binge drink. Interestingly, non-pregnant women and pregnant women had similar patterns of binge drinking: about three times per month and approximately six drinks on an occasion.

Among pregnant women, the highest prevalence estimates of reported alcohol use were among those who were aged 35–44 years (14.3%), “white” (8.3%), college graduates (10.0%), or employed (9.6%).

In 2005, the Surgeon General issued an advisory urging women who are pregnant or who might become pregnant to abstain from alcohol use. Currently, the CDC advises: “Because no safe level of alcohol during pregnancy has been established and alcohol is known to cause birth defects, developmental disabilities, and other adverse pregnancy outcomes, women who are pregnant or who might become pregnant should refrain from drinking alcohol.”

It’s the last part of this advisory targeted at “women who might become pregnant” that leads us to the second report.

Generally speaking, it is believed that 1/3 to 1/2 of pregnancies are unintended. This report found that about 37% of births in the United States were unintended at the time of conception. While this statistic hasn’t changed much since the early 1980s, the groups with the highest rates of unintended pregnancies have changed (you can take a closer look at the report for more – see the link below).

Unintended pregnancies include both pregnancies that are unwanted, and those are mistimed, meaning the woman said she wanted to become pregnant at some point, but not at the time she did.

There’s a lot of reasons why a women becomes pregnant unintentionally and contraception use is one of them. The researchers found that 40% of women were using contraception and 60% were not. The researchers asked women who were not using contraception at the time they conceived about their reasons. They found that:

  • 35.9 percent said they did not think they could get pregnant
  • 23.1 percent said they would not mind if they became pregnant
  • 17.3 percent said they had not expected to have sex
  • 14.3 percent said they were worried about the side effects of using birth control

In terms of men, 8% said their male partner did not want to use birth control himself, and 5.3 percent said their male partner did not want them to use birth control.

So, it’s interesting to think about, right?

  • 52% of women of childbearing age consume alcohol
  • 37% of pregnancies are unintended (which means these women were unlikely to change their alcohol consumption)
  • Of women who become pregnant unintentionally, 60% were not using contraception.

These data suggest that we need to be looking at alcohol use, especially risky alcohol use like binge drinking, way before conception. It also suggests that many women need additional support around their fertility and finding contraception that works for them (and that perhaps their male partners might want to get involved in some of these issues??)

References

Marchetta, C.M., Denny, C.H., Floyd, L., Cheal, N.E., Sniezek, J.E., McKnight-Eily, L.R. (2012). Alcohol Use and Binge Drinking Among Women of Childbearing Age — United States, 2006–2010. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR), 61(28): 534-538.

Mosher, W.D., Jones, J. and Abma, J.C. (2012). Intended and Unintended Births in the United States: 1982–2010. National Health Statistics Reports, No. 55. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.