British Pregnancy Advisory Service reports an increase in women considering an abortion due to binge drinking prior to pregnancy awareness

'Media scare stories over drinking during pregnancy are causing women to ask for abortions

BBC, The Independent, The Telegraph, and a number of other media sources are covering a recent report from the British Pregnancy Advisory Service.

The British Pregnancy Advisory Service provides help to women with an unplanned pregnancy or a pregnancy they choose not to continue with.

The organization recently reported an increase in the number of women considering an abortion because of fears about the possible harms of binge drinking prior to knowing they were pregnant. The organization is quoted as saying:

“Warnings that even one episode of binge drinking by a pregnant woman can cause lifelong damage to her baby are causing serious and unnecessary distress.  We are now regularly seeing women so concerned that they have harmed their baby before they knew they were pregnant they consider ending what would otherwise be a wanted pregnancy.”

The Telegraph interviewed experts and government officials to explore issues related to “pre-pregnancy test binge drinking.” Some of the issues discussed in the media coverage is the ambiguity in the research evidence about low levels of alcohol use during pregnancy, reassurance for women who are considering an abortion due to drinking prior to pregnancy awareness, and the reality that almost 50% of pregnancies are unplanned.

Binge drinking and pregnancy_ 5 myths busted - Telegraph'

Official advice on alcohol use during pregnancy in the United Kingdom, from the National Health Service, recommends that pregnant women should avoid alcohol altogether. However, if women choose to drink, they should drink no more than one or two units of alcohol (equivalent to a glass of wine) once or twice a week.

The British Pregnancy Advisory Service suggested that women’s concerns were spurred by a recent study stating that one episode of binge drinking was enough to cause considerable harm to a fetus. This type of reporting relates to ongoing discussions in the field of FASD prevention about the framing of messages about the potential harms of alcohol use during pregnancy. Some individuals and groups in the field are concerned that strongly worded messages (e.g., “Pregnant women should NEVER drink alcohol”) and the use of shocking or threatening images (e.g., a baby in an alcohol bottle) can have unintended consequences – such as unnecessary worry and fear throughout pregnancy or considering having an abortion.

While it’s important to inform women about the dangers of alcohol use during pregnancy, some researchers are suggesting that it might be helpful to be honest with women about the ambiguity in the academic research about low levels of alcohol use – rather than discouraging abstinence, this might help women to understand why official guidelines suggest that “the safest option is to not drinking during pregnancy” and that “there is no known amount of alcohol use during pregnancy that has been shown to be safe.”

For more on this issue, see an earlier post: Do concerns about alcohol use during pregnancy lead women to consider having an abortion? (February 1, 2013)

 

Do concerns about alcohol use during pregnancy lead women to consider having an abortion?

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.