Alcohol And Pregnancy

Alcohol addiction is dangerous not only for the individuals drinking it, but also for babies whose mothers drink while they are pregnant. There is an increased risk of complications such as developmental and behavioural problems. The more heavily you drink, the higher the risk. There is no safe amount of alcohol to drink while you are pregnant, but quitting or reducing your consumption at any point can reduce the associated risks. If you have an alcohol addiction, you will experience withdrawal symptoms when you try to quit. These can be extremely unpleasant and even fatal, it is, therefore, important to seek professional help rather than quitting alone.

It is socially acceptable to drink alcohol in most countries in the world, but this does not mean that it is safe. Alcohol use can cause increased risk-taking and mental health issues. With long-term use, it can lead to dependence and once this has developed, it is very difficult to quit. There are 600,000 dependent drinkers in the UK and one in thirty women show signs of alcohol dependence.

How Does Alcohol Work?

Though alcohol is generally a socially acceptable substance, it is in fact a psychoactive drug. Ethanol is the active alcohol in all legal alcoholic drinks. It primarily works by increasing the effects of γ-aminobutyric acid (GABA). GABA is the main inhibitory neurotransmitter in the brain; therefore, by increasing its effects ethanol suppresses the activity of the central nervous system. This causes sedation, impaired cognition, memory, and sensation. Ethanol also increases dopamine and endogenous opioids in the brain’s reward pathways, which cause the pleasant effects of happiness, decreased anxiety, and increased sociability.

What is Alcohol Addiction?

Developing a physical or psychological dependence on alcohol is a giveaway sign of addiction. These conditions generally develop slowly, starting by drinking socially and then the amounts and times increase with time. Other side effects of alcohol addiction in mothers include:

• Feeling unable to function or survive without alcohol
• Prioritising drinking over other activities or responsibilities
• Needing more drinks to get the same effect
• Continuing to drink despite knowing the negative consequences for the baby
• Experiencing withdrawal symptoms

It is not always so easy to know if you or someone else has an alcohol addiction. Functioning alcoholism, where you are able to perform in society so that people do not realise you have an alcohol problem, may allow you to work or study and carry out familial responsibilities as normal.

Risks of Alcohol Addiction During Pregnancy for the Mother

The main risks of alcohol addiction during pregnancy for the mother relate to both physiological and mental health. The Confidential Enquiries into Maternal Deaths have shown that women who abuse alcohol when they are pregnant and into the first year after giving birth, are more likely to die from suicide and physical health complications. This could relate to alcohol-caused depression or underlying mental health problems. At first, you might drink alcohol to self-medicate when you are feeling low or depressed. However, because alcohol is a depressant, this can lead to an endless cycle; you drink to feel better, you feel worse after you drink, and you drink again to feel better.

Another potential factor is that there is an increased risk of miscarriage in women who drink when they are pregnant. Since women who miscarry are more likely to experience depression following this, there is a greater risk of depression and potentially suicidal thoughts.

Social factors can also lead to problems for women who have an alcohol addiction while pregnant. People with alcohol addiction can experience the breakdown of their close relationships. There is often shame and stigma associated with addiction which can lead to people withdrawing from loved ones. This means that women with alcohol addiction who are pregnant may not have the support they need during the pregnancy and once their baby is born.

Another social factor is that people with alcohol addiction often have financial difficulties. Maintaining your consumption of alcohol is expensive and getting and holding down work can be difficult if you have an addiction. Getting pregnant and having a baby puts even more financial pressure on the mother. This could increase the risk of mental health problems developing.

Risks of Alcohol Addiction During Pregnancy for the Baby

Adults can break down alcohol within hours, however, your baby will struggle much more. Alcohol travels through the bloodstream to your foetus through the umbilical cord which supplies them with oxygen and nutrients. The liver is one of the last organs to develop so it is very difficult for your baby to break down alcohol meaning that it remains in their system a lot longer. The longer the alcohol remains in their system, the more damage it causes.

Birth defects often form in the first trimester, and this impacts how your baby’s body looks and functions. Birth defects can include heart problems, cleft lip, spina bifida, down syndrome, and clubfoot. Some of these can be treated with surgery or medicine, however, others will be a life-long issue. While some will be visible from birth, others may not manifest for years.

There are a group of conditions known as foetal alcohol spectrum disorders (FASDs) which are caused by the mother drinking during pregnancy. They occur in one of every thirteen babies born to mothers who drink during pregnancy. If you drink more heavily and regularly, your baby is more likely to develop more severe symptoms. Symptoms include:

• Abnormal facial features, such as a smooth ridge between the nose and upper lip
• Low birth weight, small head size
• Developmental delays
• Problems with joints, bones, muscles, and some organs
• Vision or hearing problems
• Spontaneous abortion, preterm birth
• Poor coordination and memory
• Learning problems
• Problems with communication
• Problems managing emotions and developing social skills
• Hyperactivity and problems with impulse control

Drinking while pregnant also increases your chances of having a miscarriage or stillbirth. A miscarriage is the loss of a pregnancy during the first twenty-three weeks of birth, whereas a stillbirth is the loss of a pregnancy after this. The risk of miscarriage is especially high in the first trimester, so it is particularly important not to drink in this period. Women who reported having four drinks a week were almost three times more likely to miscarry than those who did not drink. The more you drink, the higher your risk of miscarriage is.

Should You Stop Drinking When You Know You Are Pregnant?

If you have an addiction to alcohol you may not simply be able to stop drinking by yourself. Your dependency on alcohol will cause you to experience withdrawal symptoms which can be dangerous and even fatal. It is therefore important to speak with a specialist, either a doctor or a midwife.
Withdrawal symptoms include:

• Shaking
• Sweating
• Nausea, vomiting
• Increased heart rate
• Headaches
• Loss of appetite
• Depression
• Anxiety
• Irritability, restlessness
• Insomnia

Severe symptoms:

• Hallucinations
• Seizures
• Delirium tremens (DTs)

Withdrawal symptoms will usually begin within twenty-four hours of your last drink and decline after forty-eight hours.

Delirium tremens

Delirium tremens is a disorder that is characterised by severe disorientation, increased heart rate and blood pressure, breathing problems, and uncontrollable restless behaviour. One in ten people who experience withdrawal symptoms will have seizures. If they remain untreated, up to one in three of these people will experience delirium tremens.

Treatment for Alcohol Addiction Withdrawal

Withdrawal symptoms from alcohol occur because your brain chemistry has changed and is now used to the increased activity of GABA. The way that this is treated is by replacing alcohol with another GABAergic substance and then reducing the dose of this until you are clean of both. The most common replacements used are benzodiazepines.

However, benzodiazepines can also cause an increased risk to your baby. Addiction and dependence on benzodiazepines can develop quickly. Benzodiazepines pass through the placenta to the baby and can cause facial abnormalities such as cleft palate. Moderate to high amounts of benzodiazepines during pregnancy can cause your baby to experience withdrawal symptoms when they are born.

While benzodiazepines carry their own risks, it is the protocol to use them for alcohol withdrawal when you are pregnant as the associated risks are thought to be less dangerous than continuing to drink. Benzodiazepines are prescribed at a low dose and for a short period of time in order to reduce the risk to your baby.

Seeking Help When You Realise You Are Pregnant

Many people deny that they have an addiction to protect themselves and others. You might not realise that you have an alcohol addiction. It is usually friends and family who first recognize potential drinking problems. They may be able to help you understand the effects of your drinking on yourself, on them, and on your baby. Accepting that you have a problem is the first step toward seeking help.

When you are ready to seek help, there are a number of places you can go. To get specialised support for alcohol addiction when pregnant you may want to reach out to your midwife and doctor. They should be able to get you the support you need even if it means changing to a different midwife having more experience with alcohol addiction.

You can also look for more general support to help with your addiction. Some places you might approach are Drinkline, We Are With You (formerly Addiction), Alcoholics Anonymous (AA), and Drinkchat.

If you find out that you are pregnant in the early stages and manage to quit with the help of a specialist, there is a high chance that your baby will be healthy. You should therefore not berate yourself for your drinking. While there is a lot of shame surrounding addiction and stereotypes of people being weak-willed, there is no evidence of this. Addiction is a chronic brain illness with factors that increase your risk of developing it.

Taking Care of Yourself After You Give Birth

It is important that you continue to take care of yourself after you give birth. Relapsing will negatively affect yourself and your baby after birth. Your baby’s brain develops very fast in the first year, and since alcohol passes into breast milk, drinking could affect their brain development. Looking after yourself is key to preventing relapse.

For the health of your baby, you should visit a paediatrician regularly after you have given birth. Since there is a risk that your child will present with developmental difficulties later, regular visits will help you to keep on top of things and to catch things early so that you can give your child the best support possible.

Reducing Stress and Developing New Healthy Habits

Being a new mother is a very stressful and tiring experience. Stress is one of the main relapse triggers for people with addiction. Make sure that you set clear work and personal boundaries so that you do not add any extra stress. You can also take up stress-relieving activities such as yoga, meditation, and exercise.

Setting healthy routines is also very important for avoiding relapse and for improving your mental health. New healthy habits will help you to avoid your old habits which kept you in addiction. While it may be very difficult, a part of this could involve withdrawing from friends who are still drinking heavily and may convince you to have ‘just one drink’. Making sure that you have a healthy lifestyle with friends who do not drink can help this process and replace your old drinking habits with new sober ones.

Continued Professional Support

It is important that you continue getting professional support after you have given birth. You may consider support groups such as Alcoholics Anonymous or local community support groups. These can help you to feel less alone and give you tips to avoid relapse.
If you do experience guilt and shame due to your drinking, you might want to consider getting support from a mental health professional. Therapy could help you work through your guilt, the factors which contributed to your addiction, and give you the chance to accept your past and reduce your chances of relapsing. While alcohol consumption during pregnancy increases the risk of health problems for your baby, it is likely that you will give birth to a healthy child.