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The Use of Alcohol and Other Drugs During Pregnancy

Adoption Date:
November 1, 1988

Public Policy Statement on the Use of Alcohol and Other Drugs During Pregnancy

**Note: This historical policy statement is available as part of ASAM's Policy Archives, but it is no longer considered current ASAM policy. Please contact ASAM's advocacy staff at advocacy@asam.org for questions related to ASAM's position on this topic.


Background of the Problem

The human fetus is entirely dependent on the maternal environment for its safety, health, growth, and development. Alcohol and other drugs ingested by a pregnant woman may damage the developing fetus by a variety of mechanisms:

1. Alcohol and other drugs cross the placenta and enter the fetal bloodstream, interfering with growth and development both physical and mental, causing reduced birth weight, birth defects, learning and behavior disorders, and newborn distress. The developing fetus cannot detoxify these drugs because of immature enzyme systems.

2. Alcohol and other drugs may interfere with the normal physiological processes of pregnancy, causing fetal loss, prematurity, and obstetrical complications threatening to both maternal and infant health.

3. Acute intoxication due to alcohol or other drug use during pregnancy is associated with motor vehicle accidents, falls, or other trauma to mother and fetus.

4. Alcoholism and other drug dependence during pregnancy, by interfering with nutrition and other health-related behaviors, increase the risks to fetal and maternal health.

5. Physical dependence on alcohol or other drugs at the time of delivery may lead to an alcohol or drug withdrawal syndrome in the newborn infant, as well as to a postpartum withdrawal syndrome in the mother.

6. Alcoholism and other drug dependence in pregnancy, by interfering with interpersonal, occupational, and social functioning, damage the adequacy of the family unit to nurture the resulting infant. Child neglect or abuse may accompany family dysfunction. Alcoholism and other drug dependence may interfere with parent-infant bonding.

Policy Recommendations

In order to prevent harm to mothers and infants, ASAM recommends the following:

1. Widespread and continuing programs to educate the public about the effects of alcohol and other drugs, including tobacco, in pregnancy. These programs should include:

a. Warning labels in prominent places on alcoholic beverages, nicotine-containing products, over-the-counter drugs, and prescription medicines.

b. Warning posters at point of sale of alcoholic beverages, nicotine-containing products, and medicines.

c. Age-appropriate education in elementary and secondary schools, colleges, graduate and professional schools, based on the best available scientific knowledge.

d. Patient and family education in primary care settings, obstetric-gynecological practices, and in alcoholism and other drug dependency treatment programs.

e. Public education through community councils on alcoholism and drug dependency and other agencies.

2. Educational materials recommending abstinence from alcohol, for pregnant women, women planning pregnancy and nursing mothers.

3. Improved professional education aimed at early diagnosis of alcoholism and other drug dependence in women in health care settings; and appropriate treatment and referral, including treatment for nicotine dependence.

4. Improved screening for alcoholism and other drug dependence in obstetric practice.

5. The development of close working relationships between obstetric practices, and alcoholism and other drug dependence treatment services, including services for nicotine dependence.

6. Education for obstetricians, pediatricians, family practitioners, and other health professionals, in the management of alcohol and other drug dependent women during pregnancy and delivery, and in the care of infants born to such women, including management of the neonatal withdrawal syndrome.

7. Increased public and private support for research into the effects of alcohol and other drugs on pregnancy and fetal development.