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Joint Call to Action on Alcohol and Pregnancy

Eliminating the Risk for Fetal Alcohol Spectrum Disorders
Background

Through its cooperative agreement with the Centers for Disease Control and Prevention (CDC) National Center on Birth Defects and Developmental Disabilities (NCBDDD) the AAP Division of Children with Special Needs Fetal Alcohol Spectrum Disorders (FASD) program staff convened an FASD Risk Communication Workshop from July 30–31, 2012 (executive summary). This workshop included representatives from primary care organizations and focused on the development of consistent messages for providers to share with patients addressing the ongoing inconsistencies being reported in the media about alcohol use during pregnancy.

As an outcome of the workshop, a joint call to action was developed and supported by all participating organizations; it is a call to provider organizations, healthcare professionals, and the public to work together to reduce the occurrence of FASDs. The call to action encourages the target audiences to increase awareness, engage in education, and improve public health efforts about the message that women who are thinking about becoming pregnant or who are already pregnant should abstain from alcohol. 

All of the organizations that participated in the FASD Risk Communication Workshop have approved the Joint call to Action and have committed to disseminating it through their communication channels:

American Academy of Pediatrics
American Academy of Family Physicians
American College of Obstetricians and Gynecologists
Association of Women’s Health Obstetrics, and Neonatal Nurses (AWHONN)
National Association of Pediatric Nurse Practitioners
National Organization on Fetal Alcohol Syndrome
Society for Physician Assistants in Pediatrics

Call to Action
The U.S. Surgeon General warns pregnant women and women who may become pregnant to abstain from alcohol consumption to eliminate the chance of giving birth to a baby with any of the harmful effects of fetal alcohol spectrum disorders (FASDs);1 yet it is estimated that 40,000 babies are born each year with FASDs, which describe a range of effects that can happen to a fetus when a woman drinks alcohol during her pregnancy.2 FASDs can impact children’s physical, mental, behavioral, or cognitive development. The most recognized condition along the FASD continuum, fetal alcohol syndrome (FAS), is characterized by growth deficiencies, central nervous system disabilities, and facial deformities and is the most preventable form of intellectual disability. The incidence of FAS is comparable to spina bifida and Down syndrome.3

Studies suggesting that low to moderate drinking (defined as 1–4 or 5–8 drinks per week, respectively) causes no serious effects on intelligence, attention, and executive function4 have stirred up confusion and controversy. Some media headlines have interpreted such findings as it being safe for mothers to consume alcohol during pregnancy; however, no study has definitively concluded this. While future studies may continue to examine thresholds of drinking during pregnancy and its effects on the unborn fetus, it is critical to continue to encourage the safest choice to women, which is to completely refrain from alcohol while pregnant or trying to get pregnant.

In light of increased misleading media reports and misperceptions about alcohol intake during pregnancy, several health care professional organizations gathered to address the issue and develop clear and consistent messaging for their membership and target audiences. As organizations dedicated to the health of individuals, we agree that drinking any type or amount of alcohol at any time during pregnancy has the potential to cause negative health consequences for the fetus, particularly FASDs, and therefore take a pledge to continue to work together to promote the soundest and healthiest choices for women, children, and families.

Further, we call organizations, health care professionals, and the public to action to work together to reduce the occurrence of FASDs by increasing awareness, becoming educated, and improving public health efforts about the message that women who are attempting to become pregnant or who are already pregnant should abstain from alcohol.

As health care professional organizations dedicated to the health and well-being of children and families, we urge

Organizations
  • To increase awareness among constituents by identifying and disseminating FASD resources, creating useful template materials, and participating in broader joint efforts.
  • To improve FASD knowledge and practice behavior among members through continuing medical, nursing, and midwifery educational opportunities.
  • To improve public health efforts by communicating consistent messages; working with federal-, state-, and community-level resources; and participating in advocacy and legislative efforts.
Health Care Professionals
  • To increase awareness about and how to perform universal alcohol use screening, learning about resources for positive screening results, and creating an environment of trust with patients to facilitate open conversations about alcohol use.
  • To educate themselves about FASDs, how to identify affected children and where to make the appropriate referral.
  • To advise patients prior to conception, about the risks of alcohol use during pregnancy and FASDs.
  • To improve public health efforts by communicating clear and consistent messages about alcohol use during pregnancy and FASDs in their health care settings and communities.
Women and Families
  • To increase awareness by learning about FASDs, locating reliable resources, and overcoming the stigma of talking to health care professionals about concerns.
  • To educate themselves about the risks of alcohol use during pregnancy and available resources prior to conception.
  • To improve public health efforts by learning from alcohol and pregnancy public health campaigns and educating friends and families about the risks of alcohol use during pregnancy.
We pledge to continue our joint efforts and are committed to educating our organizations, health care professionals, and the public about our unified message: “Alcohol and Pregnancy: It’s Just Not Worth the Risk.”

Download the PDF of the Joint Call to Action on Alcohol and Pregnancy
 

1US Department of Health and Human Services. US Surgeon General releases advisory on alcohol use in pregnancy. Washington, DC: US Department of Health and Human Services; 2005. Available at http://www.surgeongeneral.gov/pressreleases/sg02222005.html. Accessed January 10, 2013.
 
2May PA & Gossage JP. Estimating the prevalence of fetal alcohol syndrome: A summary. Alcohol Research & Health 2001;25(3):159–167.
 
3Bertrand J, Floyd RL, Weber MK, O'Connor M, Riley EP, Johnson KA, Cohen DE, NTFFAS/E. Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis. Atlanta, GA: Centers for Disease Control and Prevention; 2004.
 
4Kesmodel US, Bertrand J, Støvring H, Skarpness B, Denny CH, Mortensen EL, and the Lifestyle During Pregnancy Study Group. The effect of different alcohol drinking patterns in early to mid pregnancy on the child’s intelligence, attention, and executive function. BJOG 2012;119(10):1180–1190.
 
Funding support provided by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention
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