Surely you’ve heard that pregnant women should avoid alcohol. There are plenty of risks involved, including but not limited to fetal alcohol syndrome. However, this means a pregnant woman should not get drunk, right? Wouldn’t it be alright for her to have one, two, maybe three glasses of wine throughout the pregnancy? Obviously not all at once, but spread throughout? Maybe one glass per trimester?


The answer is an absolute no, and a team of researchers from Belgium and Australia recently explained why this is the case. They discovered that even extremely low exposure to alcohol as a fetus can cause changes in facial features.

Now, if you or someone you know is pregnant and you (or he or she) drank alcohol prior to discovering the pregnancy, do not panic. Simply refrain from here on out.

Let’s get in-depth with this recent study. Then let’s talk about some of the other major dangers of drinking while pregnant. From there we’ll discuss how alcohol consumption is currently an issue among expecting mothers, and the best practices regarding drinking while pregnant.

The JAMA Pediatrics Study

Because of the high possibility of facial deformities in children of mothers who drank heavily during pregnancy, the JAMA (Journal of the American Medical Association) Pediatrics research team had a question. In fact, the question begins the publication of their study.

“Is there an association between different levels of prenatal alcohol exposure and child craniofacial shape at 12 months?”

The word ‘craniofacial’ refers to the bones of the face. The team already knew that alcohol exposure can alter a baby’s face. This study was meant to figure out how much exposure it actually takes to cause such alterations. It turns out the answer is very little.

The JAMA study used a sample of 415 children, and their mothers, who drank various amounts of alcohol three months before and all during pregnancy. The sample was taken from a larger study, known as Asking Questions about Alcohol in Pregnancy, or AQUA, which includes approximately 1,600 similar children.

These studies are being performed mainly because, according to the AQUA website: “Currently we don’t know how much alcohol pregnant women can safely drink without harming the developing baby…”

The rest of that sentence reads: “…so avoiding alcohol entirely is the best option.” This is absolutely true, especially because we do know that large amounts of alcohol exposure can permanently affect an unborn child. What the JAMA research team discovered is that even one drink has the potential to cause permanent facial changes.

The Method

The 415 mothers were each given a questionnaire that asked about how often they consumed alcohol, and how many drinks, during the three months before being pregnant and also during each trimester. The research team analyzed the results and placed each mother’s drinking habits into one of three categories:

Low Alcohol Intake

  • 20 grams of alcohol or less per occasion
  • 70 grams of alcohol or less per week

Moderate Alcohol Intake

  • 21-49 grams of alcohol per occasion
  • 70 grams of alcohol or less per week

High Alcohol Intake

  • 50 or more grams of alcohol per occasion

The mothers involved in the study were recruited from maternity clinics in Australia between 2011 and 2014. Their alcohol intake ranged from very low to binge-level. After the questionnaires were complete, the next step involved a long wait. In fact, the wait was just over a year.

Once each of the 415 children, (195 girls and 220 boys), reached one year of age, facial imaging was performed. Modern technology allowed for extremely detailed images. As reported by Medical News Today, the imaging involved a “sophisticated 3-D facial analysis technique, mapping something like 7,000 individual dot points on the face,” as said by study co-author Harry Matthews of University of Melbourne.

The Results

For every single child, “a consistent association between craniofacial shape and prenatal alcohol exposure was observed at almost any level regardless of whether exposure occurred only in the first trimester or throughout pregnancy,” as written in the study, linked above and again here.

Changes occurred mostly midface, especially in the nose, lips, and eyes. What’s even scarier is that the midface changes, nasal changes in particular, “resemble midface anomalies associated with fetal alcohol spectrum disorder.”

Therefore, the research team concluded that any alcohol intake whatsoever will have consequences on craniofacial development. While the changes were relatively minor, the average alteration only 2 millimeters, the study showed that regardless of how much or how often a pregnant woman drinks, changes are going to occur in that baby during the first twelve months of his or her life.

Even Dr. Jane Halliday of the Murdoch Childrens Research Institute, which runs the AQUA study and is a world-leader in research and disease prevention for children, was shocked herself. Her reaction was printed in the above-linked Medical News Today article:

“We were surprised to see that these comparatively low levels of alcohol do have a subtle impact and our findings support national recommendations to abstain from drinking alcohol in pregnancy.”

The Dangers of Pregnant Drinking

When a pregnant woman consumes alcohol, the baby does too. The CDC (Centers for Disease Control and Prevention) recommends that pregnant women consume zero alcohol. Furthermore, it’s suggested that any sexually active woman who is not using birth control should avoid alcohol. This is because she could become pregnant and expose the baby to alcohol without even knowing it.

Most pregnancies are indeed not planned, and most women do not realize they are pregnant until at least a month after conception.

Through the umbilical cord, a pregnant woman’s baby receives everything the mother ingests. This includes alcohol, and any other substance. Drinking while pregnant can cause a miscarriage or a stillbirth. Also, it can cause a multitude of issues to a living baby, known together as FASDs, or fetal alcohol spectrum disorders. These include, but are not necessarily limited to:

  • Facial abnormalities (much worse than seen in the JAMA study)
  • Smaller-than-average head size
  • Shorter-than-average height
  • Lower-than-average weight
  • Speech problems
  • Attention deficit disorders
  • Sleep issues (as a baby)
  • Sucking issues (as a baby)
  • Vision problems
  • Hearing problems
  • Hyperactivity
  • Poor memory
  • Negatively affected cognitive skills
  • Heart, kidney, and/or bone problems

There is simply no safe amount of alcohol to drink while pregnant. A baby is developing throughout the pregnancy, and for years afterward. Introducing alcohol into his or her life before life even really starts is just unfair. Again, if you or someone who you know consumed alcohol while pregnant but before finding out, it is not the end of the world. It is never too late to quit.

Yet as bad as it obviously is for a pregnant woman to drink, many of them still do.

One out of Ten Pregnant Women

Yes, that’s right. As published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) back in September of 2015, approximately 10% of pregnant women consume alcohol. Carried out as part of the Behavioral Risk Factor Surveillance System, surveys by phone were conducted. Pregnant women between the ages of 18 and 44 were asked about their drinking habits over the previous 30 days. The results were shocking.

There is somewhere around 350,000 pregnant women in America on any given day, and apparently 35,000 of them are consuming alcohol while pregnant. Worse yet, of these women who drink pregnant, 30% of them binge drink. For a woman, binge drinking means four or more drinks in two hours or less.

Therefore, on any given Sunday, there are 10,500 pregnant women binging on alcohol. Perhaps the most shocking tidbit of information to come from the Weekly Report is that “the likelihood of pregnant women to be binge drinking was higher than that of non-pregnant women.” This is the case because pregnant binge-drinking women are more likely to become addicted to alcohol than non-pregnant binge-drinking women.

The September 2015 MMWR went so far as to provide statistics. Pregnant women who binge-drank reported over four-and-a-half occurrences during the previous thirty days, whereas non-pregnant women who binge-drank reported just over three occurrences. Also, among pregnant women, those aged 35 to 44 are most likely to drink, followed by college grads, and then by unmarried women.

Chances are it’s Worse…

There is evidence, and much reason to believe, that more than one out of ten pregnant women drink alcohol. First and foremost, underreporting is a major obstacle when it comes to survey-based studies. As stated in the MMWR, “Limitations to the study include the fact that self-reported alcohol use is generally underreported.”

To add to underreporting, an article published in 2007 in the Journal of Clinical Psychiatry (JCP) claims that as many as two in ten women drink while pregnant. The article calls pregnant drinking “a major public health problem and the focus of widespread media attention.” It goes on to say that about 15 percent of women drink, with recent self-reporting (in 2007) reaching 20 percent.

Risk Factors

The following is an incomplete list of risk factors for pregnant drinking. Please note that any woman anywhere has the capability of drinking while pregnant. Risk factors include:

  • Poverty
  • Homelessness
  • Spousal substance abuse
  • Substance abuse prior to conception
  • Psychiatric illness
  • History of sexual abuse
  • History of physical abuse

In fact, the last three factors mentioned are extremely indicative. The JCP article states that among pregnant women, “…between 56% and 92% of alcohol users have other psychiatric illnesses, and up to 70% have experienced childhood sexual abuse.” This suggests that all pregnant women should have regular doctor visits and be screened for such pre-existing conditions.

In Conclusion

It doesn’t matter whether one or two in ten pregnant women drink. One out of a million is too many. We as a people have known about fetal alcohol syndrome since 1973. Even way back in 1751 there was a painting called Gin Lane by William Hogarth which depicted, among other things, children drinking alcohol, and was meant to portray a scene of horror!

At this time, zero US states have laws banning substance abuse while pregnant. Perhaps that should be the first step taken. At the same exact time, all women who are pregnant or are trying to become pregnant should realize the extreme risk of consuming alcohol.

It isn’t just that the baby receives whatever alcohol the mother consumes. First off, women in general have a slower metabolism of alcohol, and effects are slightly quicker to take hold in women than in men. Second off, according to the JCP article, “…the fetus has less alcohol dehydrogenase to metabolize the alcohol than does the mother.”

Unborn babies are affected by alcohol quicker and with more effect than anyone else on the entire planet. Let’s not even mention the fact that alcohol consumption lowers the amount of breast milk post-pregnancy.

The ONLY way to ensure your baby has zero chance of experiencing any of the endless negative effects of alcohol is simple. Do not drink alcohol. If you or someone you know is pregnant and drinking, it’s time to stop. Do what you can. This time, an intervention would be for two.