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Competency 1: Introduction to FASD

Historic Findings Related to Alcohol Use by Pregnant Women

Gin Lane, a painting depicting effects of the Gin Epidemic

Throughout history, women generally have used alcohol. Women now account for an estimated one-third of Americans with alcohol abuse or alcohol dependence disorders.1 Research over the past two decades shows that women respond to alcohol differently than men do. Differences are found in:

  • Predisposing factors contributing to the development of alcohol abuse
  • Patterns of alcohol abuse
  • Context within which the alcohol abuse is initiated and maintained
  • Problems and consequences ensuing from alcohol abuse
  • Co-occurring problems and issues interacting with alcohol abuse

Based on epidemiologic factors, physiologic effects, and psychosocial and medical factors, women experience the damaging consequences of chronic alcohol use more severely and rapidly than men.

A major issue related to alcohol and women is alcohol use during pregnancy. Drinking during pregnancy is associated with a variety of health consequences for the woman and her child. Current estimates indicate that 5 percent of women of childbearing age are heavy drinkers (five or more drinks on the same occasion on 5 or more days within a 30 day period). Nearly one-quarter of women of childbearing age engage in binge drinking (four or more drinks in about two hours).2 Both heavy and binge drinking increase the risk of harm to a fetus.

For centuries, people have known that alcohol can harm a fetus. In the 17th century, Sir Francis Bacon warned women against drinking alcohol while pregnant. Since then, knowledge about alcohol and pregnancy has increased, leading to preventive measures such as government warnings about the dangers of alcohol use during pregnancy. As far back as the 18th century, the British government recognized the impact of alcohol on pregnancy outcomes and took steps to reverse dangerous trends.

The Gin Epidemic in England in the 1700s is believed to have led to alcohol-related birth defects. When the gin tax was lifted, the price went down. Drinking went up, and so did infant deaths.3 In 1751, the government imposed sales restrictions.

In time, the problem was more widely recognized. In 1834, a British House of Commons report stated that "infants of alcoholic mothers often have a starved and imperfect look."4 About 30 years later, a French physician described children exposed to alcohol as having small heads, peculiar facial features, and "nervousness."3

Near the end of the 19th century, many researchers began to examine the effects of alcohol on the fetus. For example, in 1899, Dr. William Sullivan compared the pregnancy outcomes in 120 alcoholic prisoners with 28 of their blood relatives. The infant death rate was 20 percent higher among the women with alcohol problems.3 Such studies continued into the early 20th century.

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