- Samantha McKenna
To what extent does drinking alcohol while pregnant affect the life of an unborn child?
“In Australia, alcohol is responsible for a considerable burden of death, disease and injury” (Alcohol guidelines: reducing the health risks, 2015). “The Australian Institute of Health and Welfare report that 38% of Australian women consume 3 or more drinks per day” (Pyettfor, 2007). Thorough research has shown that there are many biological impacts on the fetus caused by alcohol consumption during pregnancy, which result in further impacts placed upon them as they go through life. Consuming any sort of alcohol while pregnant, including beer, wine and spirits, are all linked to the cause of Fetal Alcohol Spectrum Disorder (FASD) (Womens and Childrens Health Network, 2014).
Alcohol affects a fetus as the harmful substances can pass the placental barrier. This can occur very quickly because a fetus is nourished by the mother’s bloodstream, which results in the baby having the same alcohol blood levels as the mother (British Columbia Ministry of Education, 2010). Prenatal Alcohol exposure can affect the way a baby develops during all stages of the pregnancy, which can lead to biological anomalies for the child which effects are continuous (British Columbia Ministry of Education, 2010). Abnormalities in the fetus can include problems in the central nervous system, growth deficiency and abnormal facial characteristics, all as a result of alcohol consumption during pregnancy (Webb, 1991). This is because the development of the baby’s cells and organs can be disturbed. In particular, growth and development of the head are a common result of FASD. A person with FASD can have a smooth philtrum (no groove between upper lip and nose), a thin upper lip and a small eye opening (Telethon Kids, 2011). An interview conducted with a midwife who wishes to remain anonymous has seen the effects of FASD firsthand, also supports this theory regarding the facial features of a person with FASD (Anonymous, 2015).
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There is also mild to severe brain developmental delays due to abnormalities in the brain cells (Jean, 2012). The cells are affected because “alcohol is so small in size so it can enter the developing cells and change the growth and migration of the cells, which reduces the number of pathways or connectors and alter the neurochemistry of the cells” (National Organisation for Fetal Alcohol Spectrum Disorder, 2013). This can produce permanent brain damage. The damage caused by the alcohol exposure results in problems with storing and retrieving information, problem solving, focus and verbal memory, due to the brains corpus callosum being damaged (Robinson, 2013). Issues from the brains cerebellum being damaged also create problems with controlling movements, maintaining balance and fine motor skills (National Organisation for Fetal Alcohol Spectrum Disorder, 2013). There are also possible heart damages (which are particular in the ventricular septum), low birth weight, genital defects, kidney problems and cerebral palsy. As well as limb anomalies such as curved little fingers, extra fingers or toes, or additional creases in hand (Telethon Kids, 2011). Some babies who are exposed to very high levels of alcohol as a fetus can possibly die due to the prenatal exposure (Womens and Childrens Health Network, 2014).
“Data suggests that for every 10g of alcohol taken in daily during pregnancy the risk of developmental anomalies rises by 1.7% and fetal growth is reduced by 1% “ (Cornwell, 1993). Although there is no safe amount of alcohol to drink, the more consumed the higher the risk will be any of the above effects impacting the child. Figure 1 shows how the damages to the brain compare to a brain with no prenatal alcohol damage. This shows the extent of how much damage occurs to the brain from alcohol consumption and how evident it is when compared to a brain not exposed to alcohol.
Figure 1- brain scans showing the difference between two 6 week old babies brains.
Social and behavioural impacts
As stated above the consumption of alcohol while pregnant results in many biological impacts on the fetus; however, this also results in a range of social and behavioural issues on a child with FASD. As a consequence from the biological damages, this can result in the child’s difficulty in planning, setting goals, being on time and complying with legal obligations. Other complications can possibly include; issues at school, multiple foster care placements, reduced self esteem and depression, inappropriate sexual behaviour, inability to live independently, unemployment, poverty (Telethon Kids, 2011). “Often people who are born with FASD will show no outward signs and they may be misjudged for inappropriate actions, which can then be interpreted as bad behaviour” (Provicial Outreach Program for Fetal Alcohol Spectrum Disorder, 2013), whilst the real cause is the unfortunate brain damage. FASD children, or adults, have ‘challenging behaviour’s’; as their actions seem impulsive, defiant or poorly thought out, and it is evident they struggle socially as they have difficulty making friends (FASD Characteristics across the Lifespan). People with FASD struggle linking their actions to possible outcomes, predicting outcomes, generalizing information, staying still, paying attention, have poor memory and language, and uneven maturation (Telethon Institute for Child Health Research, 2009). All of these conditions may not be noticed or observable as a baby and “only noticed when the child reaches school age, where the child’s behaviour and learning difficulties are problematic” (Pyettfor, 2007). Professor Elliot, the Professor of Pediatrics and Child Health at the University of Sydney supports these findings as she states “At the end of the day these children have problems with learning, behaviour and developmental growth”. Sue Miers also supports this theory as she says her daughter who has FASD “could not learn from her mistakes”. Her daughter is now 30 and still requires ongoing support (Jean, 2012). According to the Australian Journal of Advanced nursing, “pregnant women who are know to use illicit drugs face consequences that can include sometimes removal of children following birth” (Miles). This shows how alcohol consumption during pregnancy can have a great impact on the child, not only biologically, but also socially due to behavioural characteristics that last throughout their whole life.
Prevalence of disorders
Many surveys have been completed within Australia to measure the prevalence of disorders of FASD and the percentage of women who drink alcohol while pregnant. “A 2014 Australian survey estimates of people with FASD arrays from 0.006 to 0.068 per 1,000 live births” (Callinan, 2014). Another survey found that 81% of the participants of the survey reported to drinking alcohol during pregnancy, and 0.2% of the sample drank more than 20 units of alcohol a week. As well as 71% of the sample reporting 0 to 5 units per week (Callinan, 2014). Studies also show that younger women are more likely to stop drinking alcohol when they are aware of their pregnancy but are more likely to drink prior to their knowledge of the pregnancy (Breen, 2013).
Another survey conducted by researchers found that 37.6% of the 1,633 women surveyed had consumed alcohol while pregnant during 2003-2004 (Callinan, 2014). This research also shows that younger women haven been exposed to different and more information on the pressures of drinking while pregnant than older women, resulting in a lower prevalence of alcohol consumption during pregnancy by younger women. A respondent by an individual who participated a survey produced for this research supports this theory. Respondent 9 wrote about being pregnant 39 years ago and how people were unaware of the dangers of drinking alcohol during pregnancy during that time, as she is currently 69 years old, “there were no warnings that come to mind about “drinking alcohol” while pregnant” (FASD community survey, respondent 9, 2015). The graph pasted below (figure 2) also presents the decrease in women’s alcohol consumption from 2001 to 2007. In 2001 44% of the surveyed women drank whilst pregnant, in 2004 33% reported drinking, and in 2007 only 25% of the women reported alcohol consumption while pregnant. It also shows in 2010 49% of the women drank prior to their knowledge of pregnancy, but only 20% of the women drank once they were aware of there pregnancy (Callinan, 2014).
Strategies implemented to reduce disorders
As there is no cure for FASD, many prevention strategies are put into place in order to reduce the risk and prevalence of FASD and to stop women from drinking alcohol at risky levels during pregnancy, as well as plans to help the children affected by prenatal alcohol exposure. The Australian Government as well as local communities have implemented strategies to reduce the impact of FASD. The Government scheme was introduced in 2013, which will last to 2017. The aim of this plan is stated below:
- Enhancing efforts to prevent FASD
- Secondary prevention targeting women with alcohol dependency
- Diagnosis and management
- Targeted measures supporting prevention and management of FASD within Indigenous communities and families in areas of social disadvantage
- National coordination, research and workforce support
(Australian Department of Health, 2014).
Australian institutes have also produced prevention advertisements in order to educate the community and publicize the effects of FASD, as seen below (figure 3).
(FASD prevention, 2010)
In 2007, The Marulu strategy has also been implemented into the community of Fitzroy, WA, which has high rates of alcohol use. The Marulu strategy tactics are; prevention through education, diagnosis, treatment, and support (Variety Charity, 2003). The Anyinginyi Health Aboriginal Corporation created the Fetal Alcohol Spectrum Disorder Project in 2011. This projects aim is to raise awareness, educate, prevent and support children with FASD (National Organisation for Fetal Alcohol Spectrum Disorder). Even though government strategies are implemented, these local projects are also essential for rural areas to become educated in the problem.
Opinions of drinking alcohol while pregnant on mothers within society
A survey conducted for the purpose of this research uncovered the opinion that women in Kensington Park, Adelaide, have on drinking alcohol while pregnant. The survey was completed by mothers in the community, due to the respondents needing to be women who have had children. Although, it was difficult to receive a large quantity of replies. 16 replies were collected and the context in each were of great standard, providing a strong understanding on their opinions of drinking alcohol whilst pregnant and the knowledge they obtained regarding this issue. Out of the 16 replies, 75% of respondents believed that no alcohol was an appropriate amount to be consumed during pregnancy, as they understood the possible risks (FASD community Survey, 2015). The other 25% stated they understood the risks but believe a small amount of alcohol during pregnancy was fine to consume (FASD community survey, 2015) (see appendix for further evidence). Keeping in mind if this survey were to be conducted in a different suburb (e.g. with a lower socio-economic status) the results may vary.
To conclude, there is much scientific research and evidence to support the negative outcomes of drinking throughout pregnancy as it has a potentially detrimental effect on the life of an unborn child. As addressed above, the biological impacts such as cell migration that effects the overall development of the child’s brain and significantly affects the life of the child. Facial anomalies are also evident with prenatal alcohol exposure. The potential significant brain damage is the cause of unintentional negative social and behavioural effects on the child that affects them for their whole life. The statistics which state the prevalence of disorders and women who drink alcohol during pregnancy supports, along with the opinions women have towards drinking alcohol, supports how damaging this condition can have on the community and child as it’s a serious disorder which is not publicized to the community as often as it should. As stated above, a mother drinking alcohol while pregnant has a very large effect on the life of the child exposed physically, biologically, socially and behaviourally.
Alcohol guidelines: reducing the health risks. (2015, March 24). (A. Government, Producer) Retrieved April 10, 2015, from National Health and Medical Research: http://nhmrc.gov.au/health-topics/alcohol-guidelines
Australian Department of Health. (2014). Responding to the impact of Fetal Alcohol Spectrum Disorders in Australia. Retrieved March 28, 2015, from Australian Government – Department of Health: http://www.health.gov.au/internet/main/publishing.nsf/Content/0FD6C7C289CD31C9CA257BF0001F96BD/$File/FASD%20-%20Commonwealth%20Action%20Plan%20MAY%202014%20(D14-1125690).pdf
Breen, D. L. (2013). Its time to have the conversation: Understanding the treatment needs of women who are pregnant and alcohol dependent. NSW, Australia: University of New South Wales.
British Columbia Ministry of Education. (2010). Alcohol effects on the developing brain. Retrieved Feburary 25, 2015, from FASDoutreach: http://www.fasdoutreach.ca/elearning/understanding-fasd/alcohol-effects-developing-brain
Callinan, S. (2014, March 17). Trends in alcohol consumption during pregnancy in Australia 2001-2010.
Cornwell, A. (1993). Drugs, Alcohol and Mental Health (Vol. 2). Cambridge, Great Britain: Cambridge University Press.
FASD Characteristics across the Lifespan. (n.d.). Retrieved April 2, 2015, from nofasd Australia: www.nofasd.org.au/_…/FASD_-_Characteristics_across_the_Lifespan
FASD prevention. (2010, October 1). Wallet Card: Say No to Alcohol When You Are Pregnant. Retrieved April 1, 2015, from Girls, Women, Alcohol and Pregnancy: https://fasdprevention.wordpress.com/2010/10/01/wallet-card-say-no-to-alcohol-when-you-are-pregnant/
FASlink. (2014). Fetal Alcohol Spectrum Disorders. Retrieved March 31, 2015, from FASlink: http://www.faslink.org/fasmain.htm
Jean, P. (2012, September 12). Alcohol in pregnancy warnings. Canberra times .
Miles, M. Challenges for midwives: pregnant women and illicit drug use (Vol. 1). Adelaide, SA, Australia: Australian Journal of advanced nursing.
National Organisation for Fetal Alcohol Spectrum Disorder. (n.d.). Current FASD projects. Retrieved March 25, 2015, from National Organisation for Fetal Alcohol Spectrum Disorder: http://www.nofasd.org.au/research-library/current-fasd-projects
National Organisation for Fetal Alcohol Spectrum Disorder. (2013). What is FASD? Retrieved March 25, 2015, from National Organisation for Fetal Alcohol Spectrum Disorders Australia: http://nofasd.org.au/resources/what-is-fasd-1
Provicial Outreach Program for Fetal Alcohol Spectrum Disorder. (2013). What is FASD? Retrieved March 3, 2014, from Provicial Outreach Program for Fetal ALcohol Spectrum Disorder: https://www.fasdoutreach.ca/elearning/understanding-fasd/what-is-fasd
Pyettfor, P. (2007). Fetal Alcohol Syndrome: A literature review for the ‘Healthy pregnancies, Healthy Babies for Koor Communities Project. Melbourne, VIC, Australia: State of VIctoria .
Robinson, M. (2013). How the first 9 months shape the rest of our lives. Australian Psychologist , 239-245.
Telethon Institute for Child Health Research. (2009). Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: A resource for Health Professionals (Vol. 1). Perth, WA, Australia: Telethon Institute for Child Health Research.
Telethon Kids. (2011). Alcohol, Pregnancy, & FASD. Retrieved March 31, 2015, from Fetal Alcohol Spectrum Disorders: http://alcoholpregnancy.telethonkids.org.au/understanding-fasd/what-is-fasd/
Variety Charity. (2003). Supporting the Marulu Strategy . Retrieved March 25, 2015, from Youtube: https://www.youtube.com/watch?v=cegTvwWJjpY#action=share>
Webb, I. (1991). Alcohol. Essex, Englans: Hodder Wayland.
Womens and Childrens Health Network. (2014). Pregnancy and Alcohol- risks and effects on the developing baby. Retrieved March 31, 2015, from Womens and Childrens Health Network: http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=122&id=1950
Anonymous midwife. (2015, March 20). FASD interview. (S. McKenna, Interviewer) Adelaide, SA, Australia.
FASD Community Survey, 2015.
Some of the replies to “What is your personal opinion on drinking alcohol while pregnant? Do you think it’s acceptable to an extent? Why?”
“I am a doctor, I strongly oppose drinking alcohol during pregnancy. I think it is totally unacceptable to any extent if you would expect to have a healthy baby”
“It is not safe for any women to drink at any time in her pregnancy. No, it is not acceptable at any time/extent, due to the effects on the fetus. It is unclear just how much alcohol can cause problems with a fetus + when it would be safe to drink. So none is the best advice”
“I was drinking alcohol throughout my pregnancy. I have 3 children with university degrees. 2 have a 4-year Industrial design degree. The 3rd has 2 degrees, a commerce degree and a 6-year bachelor of Psychology degree. Its not the alcohol but the abuse of alcohol that causes problems.
I believe in everything in moderation. Was told I could drink 1-2 standard drinks per week by my obstetrician so still think that’s okay.
(FASD community survey, respondent 14, 9, 13, 4, 2015)
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