Dr C: “We need honesty about alcohol in pregnancy”

It’s possible that pregnant women’s alcohol consumption will be recorded in their child’s medical book. Dr C says that’s unfair on mums, potentially dangerous and totally unnecessary

The idea of noting down a pregnant woman’s alcohol intake in their baby’s red book is judgemental and invasive. It’s just a couple of steps away from a Game Of Thrones- style scenario, where we’re marching women down the streets, shouting “shame” at them. All it would do is encourage women to lie if they have drunk a little bit, which is terrible – there needs to be trust between doctors and their patients. Also, for those who have a genuine problem with alcohol, adding a layer of humiliation to their experience could be disastrous.

DON’T PANIC

Most pregnant women don’t have anything to drink, just like they avoid eating raw meat and shellfish and overdoing it on caffeine, which is great. But many women discover they’re pregnant unexpectedly and may have had some alcohol – I want those women to know they don’t need to panic. Around four in ten British women drunk some alcohol during pregnancy and yet we don’t have a huge problem with foetal alcohol spectrum disorder (FASD), which suggests we’re probably getting it right.

KNOW THE RISKS

Let’s be clear – heavy, regular drinking can lead to FASD, which occurs because the mother’s blood passes to her baby through the placenta, and babies can’t process alcohol as well as an adult, so it can damage cells in their brain, spinal cord and other parts of their body, which disrupts their development.

They could be left with lifelong problems, including poor growth, movement, balance problems and learning difficulties, as well as potential problems with their liver, kidneys, heart, hearing or vision. Babies of alcoholic women can also be born alcoholic, which is horrible to see, but is incredibly rare. I’ve genuinely only ever seen cases of FASD in specialist paediatric hospitals.

CHANGE HABITS

A lot of women find out they’re pregnant after three or four months, in which time they may have consumed alcohol because they were unaware. But after finding out, they change their habits and most children are born healthy. I have many friends who have done that and been on the phone to me at 2am, terrified they’ve damaged their baby. All have been fine. Of course, that isn’t “evidence”, but we also know we have low numbers of FASD. If I were talking to a pregnant woman, my advice would be to not drink – but if you have enjoyed a glass of champagne at a wedding, or a glass of wine at a celebration, don’t worry.

BE HONEST WITH YOUR DOCTOR

We want women to be truthful with their doctors, so if you tell them you had a glass of wine and it gets immediately recorded in your baby’s little red book – which is used to track their weight and height, note down vaccinations and record all other important information – that could feel horrible for a mother. The thinking behind it is that it will embarrass women, so they will therefore not drink, but I suspect it will simply encourage people to lie.

KEEP PERSPECTIVE

When it comes to alcohol, the NHS advice is “there is no proven safe level of alcohol in pregnancy”. That’s a true statement, but you need to look at the wording – there’s no “proven” safe level of alcohol, which basically means we don’t

have the research.

A recent British Medical Journal report into the potentially harmful effects of light or occasional drinking in pregnancy tried to look into just that, and found the evidence is “surprisingly limited”. That’s why we have this “better to be safe than sorry” approach. We know that a lot of alcohol is dangerous, and we know that steering clear of booze is good for you. What we don’t know – because we don’t have the evidence – is the impact of a glass here and there. We can’t say categorically that a small amount of alcohol is dangerous, because we don’t have that information. Everyone’s tolerance is different, so the easiest advice is to say don’t drink at all.

I’m not making light of women drinking in pregnancy, because it can cause horrible problems, but we shouldn’t make a woman who’s had one glass of wine at a wedding feel anxious about that – because that stress is far worse for the baby than the one glass of wine.

ASK FOR HELP

If you’re pregnant and you’re finding it hard to give up, you need to seek some help. Talk to your GP, midwife, health visitor, or contact Drink line on 0300 123 1110, chat online at We are with you. org.uk, or seek support from Families Anonymous at Famanon.org.uk.

EXPECT SUPPORT

As I’ve already said, I don’t think a woman’s drinking habits going down in their baby’s red book is fair – it’s a breach of confidentiality and that shouldn’t happen. If something is recorded in a book, which is taken with you every time you visit the baby clinic or GP for two years, that makes a woman feel judged, so you’ll create friction with healthcare advisors and encourage secrecy. We should be supporting mothers, not shaming them.