Research explores whether alcohol use prior to pregnancy awareness affects women’s decision-making

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Most women are aware that alcohol and other substance use can affect an unborn baby. Current medical advice supports abstaining from consuming alcohol during pregnancy as there is no known safe level of alcohol consumption.  However, we also know that approximately 1/3 to half of pregnancies are unplanned. And, in most Western countries, the majority of women drink alcohol. (According to the 2006 Canadian Maternity Experience Survey, 62% of women consumed alcohol in the three months prior to pregnancy. Other studies suggest that over 50% of women ages 18-24 drink at moderate to high risk levels).

As a result, some people have expressed concern or reported anecdotes about women who might seek an abortion due to fear or stress associated with drinking alcohol prior to becoming aware of their pregnancy and the harm they might have caused their baby.

A study published last year by Roberts et al called “Alcohol, Tobacco and Drug Use as Reasons for Abortion” examines some of these questions for the first time. The research team surveyed 956 women accessing abortion services in the USA to identify whether alcohol, tobacco or other drug use in the month prior to pregnancy awareness contributed to their decision to end their pregnancy. 25 women (2.6%) identified alcohol as a reason for seeking the abortion.

The majority (84%) of women who identified alcohol as a reason for seeking an abortion reported drinking at binge levels (5+ standard drinks per occasion) or having experienced alcohol-related problems such as blackouts. Around half of the women who reported binge drinking as a reason for seeking an abortion were binge drinking more than once a week and the median number of binge drinking sessions was five.

This study can be seen as reassuring in that a small number of women considered their alcohol use as a factor in ending an otherwise wanted pregnancy. It does raise questions about how we talk about FASD and the framing of messages about the potential harms of alcohol use during pregnancy.

Current guidelines by obstetrics and gynecology professional associations in Canada and the USA explicitly state that low levels of alcohol use in early pregnancy is not an indication to end a pregnancy.

For more on related topics, see earlier posts:

References

O’Leary, C. (2012). Alcohol and Pregnancy: Do Abstinence Policies Have Unintended Consequences? Alcohol and Alcoholism, 47(6):638-9. doi: 10.1093/alcalc/ags094

Roberts, S.C.M., Avalos, L.A., Sinkford, D., and Foster, D.G. (2012). Alcohol, Tobacco and Drug Use as Reasons for Abortion. Alcohol and Alcoholism, 47(6): 640–648. doi: 10.1093/alcalc/ags095. Download free full-text here.

Society of Obstetricians and Gynecologists of Canada. (2010). Alcohol Use and Pregnancy: Consensus Clinical Guidelines. Journal of Obstetrics and Gynaecology Canada, 32(8): S1-S32.

Walker, M., Al-Sahab, B., Islam, F., & Tamim, H. (2011). The epidemiology of alcohol utilization during pregnancy: an analysis of the Canadian Maternity Experiences Survey (MES). BMC Pregnancy and Childbirth, 11(1), 52. doi:10.1186/1471-2393-11-52. Download free full-text here.