Pregnancy and alcohol: 'My GP told me I could have an odd glass of wine'
Experts now recommend zero alcohol for pregnant women, but expectant mothers have long been given contradictory advice, writes Arlene Harris
There was a time, not so long ago, when it wasn't unusual to see a pregnant woman with a drink in her hand - and in fact, some advertising campaigns actually promoted a certain alcoholic beverage as being 'good for you' and your unborn baby.
But times changed as did medical advice which soon encouraged women to reduce or avoid alcohol intake for the duration of their pregnancy. And - as of yesterday - the HSE have stated that zero exposure is the only way to be sure your baby doesn't develop Foetal Alcohol Spectrum Disorder (FASD).
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It is estimated that Ireland has the third-highest rate of Foetal Alcohol Spectrum Disorder, including Foetal Alcohol Syndrome, in a global study including 187 other countries.
This is welcome news for many women who feel they have been given conflicting advice over the years with official guidelines changing from low levels of alcohol being acceptable to total avoidance being the only way, both when trying to conceive and during pregnancy.
Such has the confusion been that Irish women are still asking Dr Google whether or not it is safe to have a glass of wine during pregnancy and whether it is okay to have one in either the second or third trimester.
Jen Hogan, author of The Real Mum's Guide to (Surviving) Parenthood, drank very moderately while pregnant with all seven of her children but was given conflicting advice from experts.
"On my very first pregnancy, when I asked my GP if it was okay to have a glass of wine, she almost encouraged me to and said pregnancy was stressful enough without depriving myself," she says. "At that stage there was no mention of avoiding alcohol during the first trimester and so I didn't even take that precaution.
"With later pregnancies, the advice was to avoid alcohol during the first 12 weeks - which I did - but continued to have a glass of wine during the later stage of pregnancy. However, after the new recommendation I know if I were to become pregnant again in the future I would avoid alcohol entirely.
"This isn't about judgement or forcing pregnant women to abstain from alcohol and I am absolutely against any type of mum-shaming. The choice is still theirs - it's just about knowing what the recommendations are and making an informed choice."
Sarah Roche says she received very little advice when she was pregnant with her daughter 10 years ago and consequently had 'more than a few' nights out which involved a moderate level of drinking.
"I didn't realise I was pregnant until I was over 12 weeks so continued having a few glasses of wine every weekend," says the 39-year-old who is originally from London. "I had always had an erratic cycle so didn't really pay too much attention when my period was late but then when I did the test I realised that I had been to a few parties and drank more than I should have without realising I was pregnant.
"I was still living in the UK at the time and went to see my GP who reassured me that no damage was caused but I should cut my alcohol intake down now that I was officially pregnant. I remember being a bit surprised as I thought I would be told to cut it out completely, but the doctor said it was fine to have the odd glass of wine as long as I didn't go overboard."
The office manager, who has been living in Cork for the past six years, says while she didn't ever get drunk during her pregnancy, she often had a glass of wine after a hard day at work. She doesn't believe it harmed her child but says having read recent reports into the signs of FASD she sometimes wonders if her alcohol intake may have had some effect.
"When my daughter was born she was quite underweight and is actually still very small for her age," she says. "She was perfectly healthy and it was only when she started pre-school that we noticed that she never seemed able to concentrate on anything. Her teacher suggested that she have some tests done and a couple of years ago she was diagnosed with ADHD and we were told she may also be on the autistic spectrum.
"I know neither of these conditions are due to alcohol, but I have heard that FASD symptoms can sometimes seem like other behavioural and sensory issues.
My second daughter was born in Ireland and my doctor here was a lot stricter about alcohol intake during pregnancy and I guess because I was busier looking after a toddler, I didn't really drink anything for the nine months of my second pregnancy. My eldest girl is doing really well now and gets various therapies in school which are helping, but I do wish that the message 10 years ago about cutting out alcohol completely was as clear as it is today."
Anna O'Sullivan made the decision not to drink throughout her three pregnancies but she also says the advice she was given during each of them was conflicting.
"When I was pregnant with my first son 15 years ago, I just decided not to drink alcohol," she says. "It wasn't that I was told I should stay away, but I just felt instinctively that it was wrong. I didn't even take a paracetamol during the whole pregnancy, so drinking alcohol seemed on a par with smoking to me.
"My second son was born 13 years ago and I had decided myself that I was going to go down the same route and try to be as healthy as possible but I do remember the midwife saying that it was okay to have the odd glass of wine if we were celebrating or something.
"I stayed away from it, but some of the other women in the ante-natal group took the information at face value - as you would - and often had a glass or two of wine at the weekend. I remember one lady who continued to drink regularly right up to the end of the third trimester. Obviously I didn't say anything as it wasn't my place and the advice we had been given was that it was okay in moderation, but I really didn't think it was a good thing to be doing."
Broadcaster Maia Dunphy says she can't remember any doctor giving her advice about alcohol when pregnant.
"I had my son in the UK on the NHS, so saw a different doctor every time," she recalls. "I do remember one midwife telling me, 'You look like the sensible type who doesn't need the drill about alcohol and patê', which I took as some sort of a compliment. I had been told by friends that I wouldn't feel like drinking when I was pregnant and that alcohol would taste like vinegar.
"But this didn't happen to me, so I did have a few drinks throughout my pregnancy. When I say 'a few', I mean one glass of champagne on Christmas Day, another on New Year's Eve, and one small beer at a friend's 40th a few months later. And another glass of champagne a week before my due date - so the fact that I can count them on one hand puts me in the safe zone I think.
"I don't ever want to be flippant about drinking when pregnant, but as with all aspects of health and life, common sense should prevail," she continues. "While making a documentary on childbirth, I spoke to a doctor about the danger of drinking whilst pregnant and she told me that Foetal Alcohol Syndrome was a disorder based on women who had vastly exceeded recommended levels of alcohol and that a woman who had an occasional drink throughout her pregnancy was unlikely to cause any damage.
"I know many women would rather rule it out altogether and if in doubt, or unable to stick to a very occasional one, then I would say cut it out. But mental health whilst pregnant is important too, and if having one glass of champagne on New Year's Eve lifts your spirits and distracts you from your widening stretch marks, then I believe it's okay."
Dr Mary T O'Mahony, a HSE specialist in public health medicine, says: "Pregnant women receive conflicting advice about drinking during pregnancy, and are often assured by family and friends that an occasional drink won't do any harm.
"But the fact is that there is no proven level of safe drinking during pregnancy. FASD causes life-long problems for babies. However, if you are pregnant and have been drinking, just stop now as limiting the dose [of alcohol] will always be of benefit and will improve the baby's chance of not having FASD."