Article in the NYT: The Weighty Responsibility of Drinking for Two

[scribblerpnp]

This article was in the NYT this week. It is about consuming alcohol in moderation while pregnant. Personally, I can't see taking the risk, but it looks like a practice that will be on the rise in the US. What do you guys think? Are you having pt's ask you about pregnancy and alcohol consumpton? It sounds like there isn't a lot of research despite the fact that in Europe it is fairly common.

Here is the link:

http://www.nytimes.com/2006/11/29/dining/29preg.html?_r=1&oref=slogin

[BSNtobe2009]

I personally, don't think OB-GYN's should even tell people that they can drink alcohol in "moderation"...it thins the blood, and I don't see the point.

I get chronic migraines and tension headaches, and I sit in alot of pain because my worse fear is to develop a tolerance to my pain meds. When they are really bad, I'll try to take a hot bath...anything to avoid taking a pill.

I did discover, that alcohol (WITHOUT the meds), didn't relieve the migraines but would relax my muscles and sometimes get rid of the tension headache at the top of my spine.

When I was pregnant, that was the only two glasses of wine I had b/c they prescribed Darvocit (sp?) for my headaches and I just didn't want to take anything that strong while pregnant, even though they said that was safe. I only had to drink a half-glass when the tension eased off, and then I stopped.

Other than that, I cannot see any reason why someone HAS to have a drink while pregnant. I didn't drink caffiene either.

[Elvish, BSN, DNP, RN, NP]

While it may be technically true that one drink here and there won't hurt the developing baby (how do we really know that??), I am not going to put my license on the line by telling a woman she can have X number of drinks per week.

I didn't drink at all while pregnant because I am one of those people that, had something untoward happened or ds be born w/ some problem, I would have pinned it on that. And human nature being what it is, some folks will take their OB's instruction that it's okay to have 2-3 drinks per week to mean that it's ok to drink, period, and won't limit themselves.

I realize that women in Europe drink during pregnancy and may not have any problems but I personally felt better abstaining and would feel better asking women to do the same were I an OB/midwife. Interesting article.

[midwife2b]

Abstinence is best.

Occasionally women who have a lot of uncomfortable BH contractions have found relief with a glass of wine. I actually had a couple of glasses of white wine at the end of my pregnancy.

I will not prescribe this to my patients; but it is a "remedy" in the most current issue of Varneys Midwifery.

I did let one of my ladies have a half glass of champagne during her wedding when she was 28 weeks. She looked at every website imaginable before she asked.

[JeanettePNP, MSN, RN, NP]

I don't believe that it's the midwife's job to "let" or "forbid" her clients to do anything during pregnancy. A midwife is there to educate and facilitate a safe birth, and to give the prospective parents the information and resources they need to make the best decision for themselves. If you know and trust your patients, you'll know what patient A means by "moderation" and what patient B means, and you'll know who is at risk of FAS and who isn't. I say give the mother the straight dope (pun intended) on whatever evidence is available about the potential risks of alcohol consumption during pregnancy and let her make her own decision. Tell her "I don't recommend even a sip of alcohol because it thins the blood" (and of course explain how even a single sip of alcohol might thin the blood so much that it would have an effect on the fetus.) Or "I'm afraid that one sip might lead to more drinking..." Remember that it's her baby and it's her risk. Of course if she has a particular condition that would make alcohol consumption even more risky for her that should also be discussed. Basically, pregnant women are adults and capable of making their own decisions about how much or how little alcohol to drink during pregnancy, if they are given the correct information.

[JeanettePNP, MSN, RN, NP]

While it may be technically true that one drink here and there won't hurt the developing baby (how do we really know that??), I am not going to put my license on the line by telling a woman she can have X number of drinks per week.

I don't see how you're putting your license on the line when you provide a client with all available information and then tell her that it's up to her to make the right decision.

I didn't drink at all while pregnant because I am one of those people that, had something untoward happened or ds be born w/ some problem, I would have pinned it on that.

According to the article in the OP, women in France are discouraged from eating fresh veggies during pregnancy. So maybe when a French woman has something go wrong during childbirth she blames it on the lettuce she once ate in a moment of weakness.

And human nature being what it is, some folks will take their OB's instruction that it's okay to have 2-3 drinks per week to mean that it's ok to drink, period, and won't limit themselves.

I thought midwifery was about providing one-on-one care and giving the advice that's appropriate for your client. If client has a history of drinking you obviously don't tell her that some alcohol is OK during pregnancy. If client's only experience with alchohol is a few occasional sips, that's not going to lead to non-stop drinking.