Alcohol abuse is a serious public health concern. Did you know that alcohol can harm a fetus at any point in its development,

often before a woman knows she’s pregnant?

“Fetal alcohol spectrum disorders” (FASD) is an umbrella term describing the range of effects that

can occur in an individual whose mother drank alcohol during pregnancy. These effects may include

physical, mental, behavioral, and/or learning disabilities with lifelong implications. The term FASD

is not intended for use as a clinical diagnosis. It refers to conditions such as fetal alcohol syndrome

(FAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects

(ARBD).

If women do not drink alcohol during pregnancy, FASD is 100 percent preventable. The Surgeon

General issued an advisory in February 2005 to help share this important message and to urge health

professionals to identify and assist women who are drinking or at risk of drinking during pregnancy.

WHO IS AT RISK?

Any pregnant woman who drinks alcohol is at risk of having

a child with an FASD, regardless of her education, income,

or ethnicity. Women who are at particularly high risk of

drinking during pregnancy and having a child with an FASD

include:

• Women with substance abuse or mental health problems

• Women who have already had a child with an FASD1,2

• Recent drug users

• Smokers

• Women who have multiple sex partners

• Recent victims of abuse and violence

Alcohol is a potent teratogen, a substance that can damage

a developing fetus. There is no known safe level of alcohol

use during pregnancy, so pregnant women or women who

may become pregnant should not drink any alcohol from

conception to birth.

TREATMENT FOR WOMEN

Many women who need alcohol treatment may not receive

it due to lack of money or child care, fear of losing custody

of their children, or other barriers. For successful recovery,

women often need a continuum of care for an extended

period of time, including:

• Comprehensive inpatient or outpatient treatment for

alcohol and other drugs

• Case management

• Counseling and other mental health treatment

• Medical and prenatal care

• Child care

• Transportation

• Followup pediatric and early intervention services for

children

• Services that respond to women’s needs regarding

reproductive health, sexuality, relationships, and

victimization

PREVENTING FASD: HEALTHY WOMEN, HEALTHY BABIES

WHAT YOU NEED TO KNOW

Surgeon General’s Advisory on

Alcohol Use in Pregnancy

• A pregnant woman should not drink alcohol during

pregnancy.

• A pregnant woman who has already consumed alcohol

during her pregnancy should stop in order to minimize

further risk.

• A woman who is considering becoming pregnant

should abstain from alcohol.

• Recognizing that nearly half of all births in the United

States are unplanned, women of childbearing age

should consult their physician and take steps to reduce

the possibility of prenatal alcohol exposure.

• Health professionals should inquire routinely about

alcohol consumption by women of childbearing age,

inform them of the risks of alcohol consumption

during pregnancy, and advise them not to drink

alcoholic beverages during pregnancy.

—Surgeon General Richard Carmona,

 February 2005
DHHS Publication No. (SMA) 07–4253

Printed 2007

Stop and think. If you’re pregnant, don’t drink.

For more information, visit fasdcenter.samhsa.gov or call 866-STOPFAS.

www.stopalcoholabuse.gov

• Other support services, such as housing, education and alcohol use during pregnancy. Primary care providers, such

job training, financial support services, parenting education, as obstetricians/gynecologists and family doctors, play a key

legal services, and aftercare3role in preventing FASD. They should:

Research shows that residential substance abuse treatment • Talk to their patients about the dangers of drinking alcohol

designed specifically for pregnant women and women with during pregnancy

children can have substantial benefits in terms of recovery, • Identify women who are at risk by using screening

pregnancy outcomes, parenting skills, and women’s ability to tools such as T-ACE and TWEAK, which ask

maintain or regain custody of their children.4

specific questions about drinking habits7,8

T W T P FASD • Refer to treatment and other support services HREE AYS O REVENT women with drinking problems, pregnant women

There are three main approaches to preventing FASD:5

who drink, and women who are at risk of an alcohol-

• Increase public knowledge about FASD through general exposed pregnancy

education, public service announcements, media attention, A woman’s partner, other family members, and friends can

alcohol warning labels, posters, pamphlets, and billboards. also help prevent FASD by:

• Target women at risk by screening pregnant women and • Sharing information with her about FASD and the

women of childbearing age for alcohol use, and by providing importance of not drinking during pregnancy

interventions with pregnant women who drink and with

• Modeling safe behavior by not drinking themselves women who drink and do not use birth control. Brief

• Encouraging her to talk about problems in her life that interventions such as motivational interviewing may be

may lead her to drink effective at reducing risk.6

Target women at highest risk through treatment of alcohol •• Helping her find treatment if she cannot stop drinking

problems and strategies to encourage pregnancy prevention. CONCLUSION

Women at risk include those who abuse alcohol while

Drinking during pregnancy can cause permanent damage to pregnant or who are at risk of becoming pregnant, particularly

a fetus. However, FASD is 100 percent preventable. The only women who have already given birth to a child with

cause of FASD is prenatal exposure to alcohol. If a woman does an FASD.

not drink alcohol while she is pregnant, her baby will not have

All three strategies are important, but targeting women at an FASD. Health care providers, families, friends, and other

increased or highest risk may be more effective in reducing community members all have a role in addressing FASD.

REFERENCES

1. Project CHOICES Research Group. 2002. Alcohol-exposed pregnancy: Characteristics associated with risk. American Journal of Preventive

Medicine 23(3):166–173.

2. Astley, S.J.; Bailey, D.; Talbot, C.; et al. 2000. Fetal alcohol syndrome (FAS) primary prevention through FAS diagnosis: I. Identification of highrisk birth mothers through the diagnosis of their children. Alcohol and Alcoholism 35(5):499–508.

http://alcalc.oxfordjournals.org/cgi/content/full/35/5/499?ijkey=c42ab8b64760a79a7445ab6ef918dc01a3c78acb

3. Astley, S.J.; Bailey, D.; Talbot, C.; 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 & Alcoholism, 35(5):509–519.

4. Center for Substance Abuse Treatment. 2001. Benefits of Residential Substance Abuse Treatment for Pregnant and Parenting Women: Highlights

from a Study of 50 Demonstration Programs of the Center for Substance Abuse Treatment. Rockville, MD: SAMHSA.

5. Stratton, K.; Howe, C.; and Battaglia, F., eds. Fetal Alcohol Syndrome: Diagnosis, Prevention, and Treatment. Washington, DC: National Academy

Press, 1996.

6. Handmaker, N.S.; Miller, W.R.; and Manicke, M. 1999. Findings of a pilot study of motivational interviewing with pregnant drinkers. Journal

of Studies on Alcohol 60(2):285–287.

7. Alvik, A.; Haldorsen, T.; and Lindemann, R. 2005. Consistency of reported alcohol use by pregnant women: Anonymous versus confidential

questionnaires with item nonresponse differences. Alcoholism: Clinical and Experimental Research 29(8):1444–1449.

8. Moraes, C.L.; Viellas, E.F.; and Reichenheim, M.E. 2005. Assessing alcohol misuse during pregnancy: Evaluating psychometric properties of

the CAGE, T-ACE and TWEAK in a Brazilian setting. Journal of Studies on Alcohol 66(2):165-173.