Why do we make alcohol-free pregnancy the exception rather than the rule?

We worry about bagged lettuce, we are fearsomely opposed to smoking during pregnancy; we gladly take soft cheese off the menu and share information about the dangers of listeria. Yet consider……

Summer 2017, Sydney, Australia. A group of upwardly mobile 30-somethings gather for a Christmas party. Plans to celebrate a year of campaigns, social media successes, work portfolio growth, and the benefits of quality education and living in a country like Australia.

The food on offer is the best that Australia can provide in this season – quality seafood, fruit, cheeses and meats – a wide variety with lots of alternatives. After all, some of the party attendees are pregnant and they need alternatives so that they can avoid raw seafood, camembert and the host of other items highlighted so that women who are pregnant won’t consume them. Even lettuce needs to be sourced, and the origin identified, to make sure that it didn’t come from a dreaded bag. Smokers of course won’t even make an appearance at this gathering and will be huddled outside in furtive groups.

Enter Nicole, a slight and well exercised woman, five months into her long-awaited pregnancy. Nicole is brimming with health and vitality, perhaps with the glow that pregnant women are often reported to have, as she awaits this much-anticipated birth. Nicole has private health insurance and access to the best medical care in Australia.

She did not receive any medical advice about alcohol and pregnancy until she was five months pregnant, and this was received in a package of information from her hospital. Finally, at this point, she was clearly informed that no alcohol is the recommended health advice for pregnant women; supported by the Australian government health guidelines, the World Health Organization, and most global health advisories.

Luckily, Nicole was aware of the risks of an alcohol-exposed pregnancy, so avoided alcohol from the moment she began planning her conception and throughout her pregnancy. She has confidence that she has given her tiny baby the best chance to develop and create the complex systems which are required to keep a human body going.

Nicole, at five months, is visibly pregnant and her series of Christmas parties was a series of opportunities to refuse alcohol. Everyone offered alcohol, at every event, and when she declined she was encouraged to “have just one”. Sometimes comments bordered on ridicule for her choices, while others offered ‘researched’ advice that a small amount of alcohol is good for you.

We don’t force cigarettes on people, we don’t encourage people to ignore risks with soft cheese, we don’t try to convince someone to eat just one piece of sushi – so why do we encourage and support alcohol in pregnancy?

Why don’t we think of interesting alcohol-free choices?

Why do we make alcohol-free the exception rather than the rule?

Does it matter if people don’t understand what happens when a pregnancy is exposed to alcohol?

Does it matter that there is no known safe limit of alcohol which can be consumed during pregnancy?

Does it matter that children risk a lifetime of disability and challenges?

It does matter because Fetal Alcohol Spectrum Disorder (FASD) is the most prevalent, preventable disability in the world.

Studies in mainstream populations in the US and Canada point to conservative estimates that between 2 – 5 % of the population is affected by FASD, with higher numbers evident in at-risk communities.

We don’t know how many people have FASD in mainstream Australia – it hasn’t been researched. However, newspaper headlines document increased incidence of serious behaviour issues in schools, increased occurrence of emergency room incidents, unacceptable growth in prison populations, falling education standards and increases in disability numbers.

Australia needs to undertake effective FASD screening, or we will never prevent FASD and will never know the role which FASD has in these figures.

Finally, Australia needs to be serious about pregnancy warning labels on packaged alcoholic beverages. It would be impossible to find another product which causes such harm and is sold so widely without a clear warning and reminder.

Mandatory labels are needed. It is negligent and irresponsible for Australia to remain complicit in a situation which exposes unborn children to unacceptable risk.

Author: Louise Gray, Executive Officer, NOFASD Australia

This article was originally published on Drink Tank in July 2018

If you have questions or concerns please call NOFASD’s hotline on 1800 860 613.

Postscript – Nicole (not her real name) gave birth to a healthy baby girl and was grateful she understood that alcohol should not be consumed when planning a pregnancy and during pregnancy.

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