A review of policies on alcohol use during pregnancy in Australia and other English-speaking countries, 2006
Author: Sue Miers
Published online: 3 September 2007
To the Editor: I would like to put forward a consumer’s perspective in response to the recent article by O’Leary and colleagues.1
I am puzzled that they concluded that the National Health and Medical Research Council (NHMRC) guideline is in step with policies of the United Kingdom and Canada. My research of Canadian policy suggests that it is in direct contrast to current NHMRC guidelines. Health Canada states very clearly, “Whether you are trying to get pregnant or are pregnant already, stop drinking alcohol”,2 and “No amount or type of alcohol during pregnancy is considered safe”.3,4
The potential harm to the birth mother that results from an abstinence-based message was also raised by O’Leary and colleagues. Elizabeth Russell, the birth mother of two sons affected by prenatal exposure to alcohol, offers an alternative viewpoint:
By not discussing alcohol and pregnancy through misplaced compassion, we are hurting one person for the sake of another. Very few mothers would want that but that is exactly what is happening — children are being sacrificed to ensure that the anxiety level of a mother is kept within acceptable limits — neither mother nor child will benefit from this methodology.5
Many pregnant women give up eating shellfish and processed meats and drinking coffee but still continue to consume alcohol, thinking it is safe because they have not been told otherwise. I would like to pose the following questions.
What is the potential harm of not having an abstinence message? Might this prevent women who are alcohol-dependent from seeking help to alter their drinking behaviour when pregnant because they are not aware of the risks?
Should further research to “elucidate the true association between low to moderate alcohol consumption and fetal harm” really be a priority? What are the benefits to the unborn child of trying to ascertain a safe level of consumption of a teratogen and neurotoxin that is known to disrupt fetal development, particularly the fetal brain, throughout the three trimesters of pregnancy?6
While I acknowledge the importance of scientifically sound research on the risks of prenatal exposure to alcohol, I am concerned that this argument is diverting attention and dollars away from the urgent need for diagnosis and management of fetal alcohol spectrum disorder (FASD) in Australia.
The reality is that children, adolescents and adults with FASD are seldom recognised, seldom treated effectively, and seldom connected to service dollars. Addressing this situation needs to be the priority.
References
- O'Leary CM, Heuzenroeder L, Elliott EJ, Bower C. A review of policies on alcohol use during pregnancy in Australia and other English-speaking countries, 2006. Med J Aust 2007; 186: 466-471.
- Public Health Agency of Canada. Alcohol and pregnancy. http://www.phac-aspc.gc.ca/hp-gs/know-savoir/alc_e.html (accessed May 2007).
- Health Canada. Fetal alcohol spectrum disorder. http://www.hc-sc.gc.ca/iyh-vsv/diseases-maladies/fasd-etcaf_e.html (accessed May 2007).
- Health Canada. Message from Tony Clement, Minister of Health. International Fetal Alcohol Spectrum Disorder Awareness Day 2006. http://www.hc-sc.gc.ca/ahc-asc/minist/health-sante/messages/2006_09_09_e.html (accessed May 2007).
- Russell E. Alcohol and pregnancy. No blame — no shame. Gold Coast: Zeus Publications, 2007. 0_i1091833
- O’Malley KD. ADHD and fetal alcohol spectrum disorders (FASD). New York: Nova Publishers, 2007. 0_i1091835
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