Five Things Social Workers Need to Know About Alcohol and Pregnancy

According to the Centers for Disease Control and Prevention (CDC), about one in nine pregnant women say they have  had at least one drink in the past 30 days, and about one third who have had alcohol report binge drinking, which, for women, is having four or more drinks at one time. These statistics are especially concerning since prenatal alcohol  exposure is the most common preventable cause of intellectual and developmental delay and disabilities in the United  States. 

September is Fetal Alcohol Spectrum Disorders (FASDs) Awareness Month — an opportunity for social workers to take the lead in primary prevention of FASDs, the range of birth defects and developmental disabilities that can occur in an individual who was exposed to alcohol before birth. From conducting alcohol screening and brief intervention to participating in FASD assessment and referrals, social workers across practice settings play an integral role in protecting the health of the women and families they serve.

Here are five facts that can help social workers reduce the prevalence of FASDs:

1. There is no known safe amount, no safe time, and no safe type of alcohol to drink while pregnant. Leading medical organizations agree: There is no known safe amount of alcohol to drink while pregnant, and alcohol can cause problems for the developing baby throughout pregnancy. In addition, all types of alcohol are equally harmful, including wines and beer.

2. Fifty percent of pregnancies are unplanned. About half of pregnancies in the United States are unplanned, and most women will not know they are pregnant for up to four to six weeks. Drinking in the first three months of pregnancy can cause the baby to have abnormal facial features, and growth and central nervous system problems can occur from drinking alcohol at any stage of pregnancy. Alcohol use during pregnancy can also lead to miscarriage and stillbirth.

3. Up to one in 20 U.S. school children may have FASDs, which include a range of physical, behavioral and learning problems that may not be detectable when the child is born. While FASDs may include abnormal facial features, there are many other effects that are not easy to see, including some that may not be known until a child is in school. For instance, people with FASDs can have learning disabilities, hyperactivity, difficulty with attention, speech and language delays, and poor reasoning and judgment skills. They can also have problems with their vision, hearing, heart kidneys, or bones.

4. Screening and brief intervention is a proven way to prevent alcohol use during pregnancy and FASDs. More than 30 years of research support alcohol screening and brief intervention (SBI) as an effective clinical tool to reduce risky drinking, and a recent literature review by the U.S. Preventive Services Task Force found that pregnant women who received counseling interventions were more than twice as likely to abstain from alcohol as those who didn’t receive counseling.

5. Alcohol screening and brief intervention should be routine practice for all adult clients, including those who are pregnant. The U.S. Preventive Services Task Force recommends alcohol screening and brief intervention for all adults 18 years or older, including pregnant women. However, less than 14 percent of women who binge drink were advised to cut back on drinking by a healthcare provider, according to the CDC.

Social workers can make a difference by screening all adult clients for risky alcohol use, talking to women about risky drinking, and reinforcing the key message: No amount of alcohol is known to be safe during pregnancy. 

NASW, the NASW Foundation and the Health Behavior Research and Training Institute at the University of Texas at Austin’s Steve Hicks School of Social Work have partnered with the Centers for Disease Control and Prevention in the Collaborative for Alcohol-Free Pregnancy, a cross-discipline public health initiative to encourage health professionals to incorporate proven prevention strategies into practice.

Visit NASW’s pages on Behavioral Health and Supporting Clients During the Coronavirus Pandemic for resources.  Additional clinical resources are available through our Collaborative partners:

• Centers for Disease Control and Prevention, Fetal Alcohol Spectrum Disorders (FASD) Training and Resources

• American Academy of Pediatrics, Fetal Alcohol Spectrum Disorders Toolkit

• American College of Obstetricians and Gynecologists, Fetal Alcohol Spectrum Disorders (FASD) Prevention Program

By Diana Ling, MA, Outreach Program Coordinator, Health Behavior Research and Training Institute, Steve Hicks School of Social Work, University of Texas at Austin, and Takia Richardson, LICSW, LCSW, NASW Senior Practice Associate, Behavioral Health