A significant factor when considering alcohol use in pregnancy is that nearly 50% of women in Aotearoa NZ, and indeed around the world, have unplanned pregnancies. This means that many women may still be drinking socially before they know they are pregnant – sometimes for several months. 

Binge drinking of alcoholism is often assumed to be the cause of FASD, but even small amounts of alcohol can cause it.

For this reason it’s recommended that providers routinely ask patients of childbearing age whether or not they want to become pregnant within the next year.

If a patient does want to become pregnant, you can advise them on choices they can make to start preparing for a healthy pregnancy. This should include avoiding alcohol and other teratogens (substances that interfere with normal fetal development and cause congenital disabilities), taking folic acid or other supplements, and ensuring they have the right immunisations. It’s a good time also to speak to partners: recent research is showing that male use of alcohol pre-conception can harm the baby. More information here.

If a patient does not wish to become pregnant, you can help your patients select an effective form of contraception that fits with their lifestyle will help them prevent unwanted pregnancy.

It’s generally recommended that providers should include information about long-acting, reversible contraception (LARC) like intrauterine devices (IUDs) and implants, which have higher efficacy and higher continuation rates compared with short-acting contraceptives.

Patients could be directed to the Sexual Wellbeing Aotearoa website here for much more information.