Policy Resource

FASD Awareness Day: Not Drinking During Pregnancy Crosses One Worry Off the List

Sep 18, 2013

It’s axiomatic that “When you’re pregnant, you worry about everything.” At the top of the list of pregnancy anxieties is “will my baby be healthy?”

Today, the ninth day of the ninth month, is Fetal Alcohol Spectrum Disorders (FASD) Awareness Day. It’s a good time to realize that with one decision, we can cross off a major cause of birth defects from our worry list. FASD, which can haunt a baby prenatally exposed to alcohol for the rest of his life, is totally preventable just by foregoing drinking alcohol during pregnancy.

Why should we care about FASD? Birth defects related to prenatal alcohol exposure are diagnosed in approximately 1% of all U.S. newborns. Think that’s not enough to urge widespread behavior changes? FASD affects more children than autism, and the number of new cases each year is greater than the cases of muscular dystrophy, spina bifida, and Down syndrome combined. (Herrick, et al.) And experts believe many cases go undetected.

Granted, abstaining from alcohol in our culture isn’t easy. Most Americans drink: 61% of women and 72% of men. Ads inundate us with the message that drinking is cool, especially for younger people. These young drinkers are also the fathers and mothers of tomorrow’s children. There also is growing evidence that alcohol has some effect on sperm that is produced while a man is drinking. Women often drink to keep their partners company.

The debate over whether it’s ok to drink alcohol during pregnancy has raged for years. Most recently, a Harvard economist has weighed in, urging women to take back their pregnancies and concluding, after training her analytical skills on the research, that “The evidence overwhelmingly shows that light drinking is fine.” But each woman is different in the way she metabolizes alcohol or is able to control the circumstances of drinking.

The bottom line is that no amount of alcohol consumption can be guaranteed to have no effect. But we do know how alcohol works on the developing fetus, every part of which is affected by prenatal alcohol exposure (PAE). Alcohol is a teratogen—in plain English, a poison—that passes right through the placental barrier. Just one drink a day throughout pregnancy means the fetus has been exposed to 15 baby bottles full of absolute alcohol. (Burd, n.d.) The alcohol isn’t diluted before it reaches the fetus. The alcohol levels are about the same as for the mother, but they take twice as long to be eliminated from the fetus and the amniotic fluid. (Burd, 2006)

Alcohol affects the developing embryo and fetus in several ways:

*It damages cells during their differentiation into cells specific to parts of the body (e.g. brain, heart, lung, etc.),

  • It impedes cells from moving into their correct anatomical locations, and
  • It kills other cells.

This exposure can have life-long consequences. While Fetal Alcohol Syndrome (FAS) is the most commonly known and most readily diagnosed part of the FASD spectrum, less severe effects may not manifest themselves until later in a child’s life, especially if a clinician doesn’t know to look for the signs. Some deficits may not become noticeable until a child reaches school age, as problems with abstract reasoning, understanding cause and effect, reading other people’s facial and conversational cues, monitoring time and memory, become more apparent. Yet, for children born with PAE, early diagnosis is the single most important factor in limiting the severity of their disabilities. If you work with parents and young children, know the symptoms of PAE and encourage families to disclose PAE so that appropriate help can be provided.

It’s ironic that the latest round of second-guessing about abstaining from alcohol during pregnancy was set off by an economist. An economic analysis should surely take into account the costs of PAE’s consequences. FAS alone is estimated to have financial impacts in the billions of dollars. Leading FASD expert Dr. Larry Burd flatly states that “On the day before the child with FASD is born we need to deposit over $540,000 in the bank to cover the lifetime cost of care.” (Burd, n.d.) So, encouraging women to engage in behavior that will increase the risk of birth defects does not make good economic sense.

There are few instances in life where we can reduce risk down to zero. This is one of them. FASD is 100% preventable. So rather than looking at not drinking during pregnancy as mindless obedience to rules laid down for pregnant women, why not look at it as an affirmative action we can take to give our babies a healthy start in life? Then we can cross that worry completely off the list.


Herrick, K., Burd, L., Hudson, L.(2011)“The Elephant in the Cradle: Fetal Alcohol Spectrum Disorders.” ZERO TO THREE Journal, Vol. 31, No. 3. Washington, DC: ZERO TO THREE.

Burd, L. (n.d.) Fetal Alcohol Spectrum Disorders: Recent Developments. Power Point Presentation.

Burd, L. (2006) News You Can Use: Getting an Early Start on Fetal Alcohol Spectrum Disorders. HHS/ACF/OHS/EHSNRC. 2006. Updated 2013.

  • Author

    Patricia A. Cole

    Senior Director of Federal Policy


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