What is the role of women’s experiences of violence and trauma on alcohol use during pregnancy?

Image credit: Eric Parker, via flickr (creative commons)
Delft, Cape Town, South Africa (Image credit: Eric Parker, via flickr)

The reasons why a woman may drink alcohol during pregnancy can vary enormously. That said, research has consistently shown two strong associations with alcohol use during pregnancy: (1) women’s alcohol use before pregnancy (especially for women who drink heavily before pregnancy) and (2) past or current experiences of violence, trauma, and abuse.

The relationship between alcohol use during pregnancy and women’s experiences of violence, trauma, and abuse was recognized in early research with women who have children with FASD. For example, in a study in 2000 with 80 mothers of children with FAS,  95% of the women had been seriously sexually, physically, or emotionally abused at some point in their lives and 72% of them reported that they felt unable to reduce their alcohol use because they were in an abusive relationship.

A recent longitudinal study looked at both of these factors, alcohol use before pregnancy and experiences of trauma, in a group of 66 pregnant women in Delft, Cape Town, South Africa. The researchers found that:

  • Similar to previous research, women’s drinking levels before pregnancy were generally predictive of drinking levels during pregnancy. Most women significantly decreased their drinking after pregnancy recognition.
  • Women who reported no trauma history seemed to drink proportionally to the levels that they did before pregnancy recognition, i.e., higher-risk drinkers continued to drink at high levels, while lower-risk drinkers maintained their low drinking levels.
  • However, women who reported a history of trauma tended to drink at higher levels, regardless of prior drinking levels and even if they were low risk drinkers beforehand

The study findings suggest that there are two groups of pregnant women that may benefit from special attention from an FASD prevention perspective: (1) women are already drinking at risky levels before pregnancy, and (2) women who report a history of trauma, regardless of how much they were drinking prior to pregnancy.

To learn more about trauma-informed approaches to FASD prevention, visit the Coalescing on Women and Substance use website and check out the section on Alcohol and Pregnancy.

To learn more about alcohol and pregnancy in South Africa, see earlier posts:


Astley, S.J., et al. (2000). Fetal Alcohol Syndrome (FAS) primary prevention through FAS Diagnosis: II. A comprehensive profile of 80 birth mothers of children with FAS. Alcohol and Alcoholism,  35(5): p. 509-519. (Free full-text available here).

Choi, K.W., Abler, L.A., Watt, M.H., Eaton, L.A., Kalichman, S.C., Skinner, D., Pieterse, D., and Sikkema, K.J. (2014) Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences. BMC Pregnancy and Childbirth, 14: 97.  doi:10.1186/1471-2393-14-97. (Open access – free full text available).

Skagerstrom J, Chang G, Nilsen P (2011).  Predictors of drinking during pregnancy: a systematic review. Journal of Women’s Health (Larchmt), 20(6): 901–913. (Open access – free full text available).

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