What Are the Risks of Drinking Alcohol While Pregnant?

For over 40 years, public health agencies and doctors have warned women not to drink alcohol while pregnant. The warnings began in 1973, when researchers at the University of Washington identified what’s known as fetal alcohol syndrome — a group of physical and mental birth defects caused by alcohol consumption. Since then, women have been strongly advised to avoid any amount of alcohol while pregnant. 

But what exactly are the risks involved, and what effect can alcohol have on a developing fetus? Let’s take a closer look.

How Alcohol Affects a Fetus 

Anything we consume during pregnancy — whether food or drink — goes to the fetus via the umbilical cord. When we eat a meal, the food is digested into nutrients that are sent throughout our body and to the baby. This is what helps our baby grow and develop. If we drink alcohol, the alcohol will also be digested and sent to our baby as well. This is particularly problematic because alcohol is a toxin that essentially poisons our body. 

Whenever we drink alcohol while pregnant, our baby’s growing tissues and organs are exposed to this harmful substance. Not only that, but alcohol is broken down more slowly in the developing fetus than it is in the body of an adult, causing alcohol levels to remain high and stay in the baby’s body longer. 

Alcohol hurts the baby by damaging cells that help form important parts of their body. While many organs can be affected by alcohol — including the intestines, kidneys, and heart — the organ most affected is the brain. For instance, alcohol can damage or destroy the glial cells that help neurons stay healthy and functional. Damage to glial cells is one reason that parts of a baby’s brain may not form correctly, which can lead to learning, behavioral, and developmental issues. 

Risks Associated With Drinking Alcohol While Pregnant

Research shows that drinking alcohol while pregnant increases the risk of miscarriage, stillbirth, premature birth, and sudden infant death syndrome. One study noted that each week a woman drinks alcohol during the first five to 10 weeks of pregnancy is associated with an incremental 8 percent increase in risk of miscarriage. Another study found a 40 percent increase in likelihood of stillbirth for women who consumed any amount of alcohol compared with those who didn’t consume any alcohol. 

Drinking alcohol while pregnant can also cause a life-long condition called fetal alcohol spectrum disorder (FASD), marked by a range of physical, behavioral, and intellectual disabilities and disorders. In fact, drinking alcohol while pregnant is the leading preventable cause of birth defects in a fetus. The following condition are on the FASD spectrum:

• Fetal alcohol syndrome (FAS). This is the most severe problem that can happen when a woman drinks alcohol while pregnant. Infants born with FAS have a variety of symptoms, such as abnormal facial features and problems with learning and behavior. 
• Alcohol-related neurodevelopmental disorder (ARND). Children with ARND might not have full fetal alcohol syndrome, but they still have learning and behavioral problems caused by exposure to alcohol in the womb. For instance, they might have trouble with math, problems with attention, impulse control or judgment, and poor school performance. 
• Alcohol-related birth defects (ARBD). Children with ARBD can have abnormalities in the heart, kidneys, bones, hearing, or a combination of these.

Children with FASD can have a variety of characteristics and behaviors, such as poor physical coordination, hyperactive behaviors, learning problems, facial abnormalities (such as small head size, eyes and thin mouth), low body weight, developmental disabilities, low IQ, poor reasoning and judgment skills, and vision or hearing problems. 

People with FASD often need support with motor skills, physical health, learning, communication, emotional regulation, and social skills. Long-term problems in children with FASD can include psychiatric problems, criminal behavior, and unemployment.

Is Any Amount of Alcohol Safe To Consume? 

Simply put, there is no safe amount of alcohol to consume while pregnant. Any amount of alcohol can be harmful to the fetus. Even drinking low to moderate amounts of alcohol while pregnant can lead to miscarriage or problems. In fact, one study found that children whose mother drank any amount of alcohol during pregnancy were more likely to have difficulty paying attention, impulsiveness, and a mental health diagnosis, such as separation anxiety or oppositional defiant disorder.

However, research indicates that heavy drinkers (those who drink more than two alcoholic beverages a day) are at a greater risk of giving birth to a child with fetal alcohol syndrome. Similarly, binge drinking — defined as four or more drinks in one sitting — can increase a baby’s chance of developing alcohol-related damage. So even if we don’t drink often, drinking a large amount at one time can harm the baby. 

Okay, so what about the type of alcohol: can you drink wine while pregnant? No. Any amount of alcohol and any type of alcohol can be harmful. 

What Is the Worst Time To Drink During Pregnancy? 

Similarly, there is also no safe time to drink alcohol during pregnancy. While some research suggests that alcohol use is most harmful during the first three months of pregnancy, drinking alcohol at any point during pregnancy can be harmful. Some people mistakenly believe that it’s okay to drink later in the pregnancy when the unborn baby is nearly completely formed, but alcohol exposure has adverse effects on brain development throughout pregnancy. 

Does Alcohol Affect Plan B?

Now, for those of us trying to prevent pregnancy, you may be wondering about Plan B — the “morning-after pill.” Plan B is a form of emergency contraception designed to prevent pregnancy after unprotected intercourse or contraceptive failure. 

Its primary ingredient, levonorgestrel, works by delaying or inhibiting ovulation, the release of an egg from the ovaries, which is essential for fertilization to occur. Additionally, it can alter the cervical mucus and uterine lining, making it more challenging for sperm to reach and fertilize an egg.

So does alcohol affect Plan B? Simply put, it can. Here’s how: 

• Metabolism and absorption. Alcohol is primarily metabolized in the liver by enzymes. Consuming alcohol can affect the liver's ability to metabolize other substances, potentially altering how Plan B is processed in the body. However, there is limited research on the specific interactions between alcohol and levonorgestrel.
• Reduced effectiveness. Some studies have suggested that excessive alcohol consumption may reduce the effectiveness of hormonal contraceptives, such as birth control pills. While Plan B is a single-dose emergency contraception, and the impact of alcohol may not be as pronounced, it's essential to consider this potential interaction.
• Delayed decision-making. Alcohol can impair judgment and decision-making. If you find yourself in a situation where you need to take Plan B after a night of drinking, impaired decision-making could lead to delays in obtaining and using the medication, potentially reducing its effectiveness.

Keep in mind that we can always consult a healthcare provider if we ever have concerns about the potential impact of alcohol on our contraception. That’s what they’re there for! 

The Bottom Line

Drinking alcohol at any point during pregnancy brings with it significant risks, from miscarriage and premature birth to a range of lifelong physical, cognitive, emotional, and mental disabilities. We can prevent these things by not drinking any alcohol while pregnant. If we’re even planning to become pregnant, it’s wise to eliminate alcohol from our life. 

If you’ve already consumed alcohol during pregnancy, it’s not too late to stop. Some women report drinking in early pregnancy without knowing that they’re pregnant. But as soon as you find out, it’s important to stop drinking. Brain growth in the fetus takes place throughout pregnancy, so stopping alcohol consumption as soon as possible can make a difference. 

If you’re having trouble quitting alcohol while pregnant, reach out to a doctor or mental health professional for help right away. There’s no shame in asking for help — it’s not only for your benefit, but for the new life growing inside you. But you don’t have to do it alone: at Reframe, we’re here to help support you and cheer you on.