In general, pregnant people and their partners want clear information about alcohol use during pregnancy. Healthcare providers need to be confident and ready to deliver this message clearly and without judgment.

Sometimes people tell us they were advised that 'alcohol in moderation is fine' – or received no advice on the subject at all. This might stem from a lack of up-to-date knowledge on the part of the healthcare provider, concern over causing guilt or anxiety, or assumptions about which demographics are at risk. 

Harmful effects from PAE have been consistently recognised by researchers since the 1960s. All major global medical groups, including Te Whatu Ora / Health NZ in Aotearoa, recommend completely abstaining from alcohol during pregnancy or when planning a pregnancy.

People consume alcohol while pregnant for many reasons—and it's never because they want to harm their baby. Reasons include:

• Not knowing they were pregnant due to using contraception incorrectly, or not at all – it's estimated that 50% of pregnancies in Aotearoa are unplanned / accidental.
• Feeling pressured to drink in social settings.
• Self-medicating to cope with stress or other problems.
• Unawareness of the current evidence on the risks of drinking during pregnancy.

Trust between the pregnant woman and healthcare provider plays a key role. Because of the stigma around drinking in pregnancy, some women may downplay or avoid disclosing their alcohol use altogether. Without trust, correct assessment may not eventuate – and early intervention that can mitigate harm will not happen.