Health officials are advising women to avoid alcohol completely during pregnancy - and when they're trying to conceive, writes Róisín Ingle
EARLIER this week, sitting nervously in a Dublin GP's surgery, newly-pregnant Anne asked her doctor for his views on drinking alcohol during her pregnancy.
"He told me that one or two glasses of wine a week would be okay," says the 35-year-old, who is expecting her first baby in the spring.
"Then the next day I read in the paper that the government is advising women to stay away from alcohol completely while pregnant. So which one of them should I believe?"
It's a question many women find themselves asking when they first learn they are pregnant and one that was on the agenda again this week when International Foetal Alcohol Spectrum Disorder (FASD) Day was marked.
According to Dr John Devlin, deputy chief medical officer at the Department of Health, women should "avoid" - he doesn't like to use the words abstain from - alcohol completely during pregnancy.
"It's quite clear that with high levels of alcohol consumption there is a link with FASD. The risk at lower levels is not clear, so there is no safe lower limit when it comes to alcohol and pregnancy," he says, adding that the department is mindful of the rise in binge drinking, particularly among Irish teenagers. "In the absence of a safe lower limit, the public health message is that women should avoid alcohol completely during pregnancy and while trying to conceive."
In addition to the abstention message, the Government is currently preparing legislation which will oblige drinks manufacturers here to follow the example of the US and France in printing health warnings aimed at pregnant women on alcoholic drinks.
"We want women to know that all alcohol will reach their baby and that it's their choice whether this happens," says Michelle Savage, a campaigner for FASD Ireland, a group set up by carers who have worked with children affected by alcohol-related disorders.
"When you have seen how children can be affected, across such a range of areas, it really brings home the message that it is just not worth taking the risk."
The campaign to inform women about the risks associated with drinking alcohol was stepped up last year when a study published by the Coombe Hospital in Dublin found that two-thirds of women who attended there continued to drink while pregnant.
The study also found that one in 10 pregnant women drank more than six units of alcohol per week and that this pattern was more pronounced among those under the age of 25.
Speaking this week, the junior health minister, Mary Wallace, claimed that "everyone was aware of the advice not to smoke but there is much less awareness about the advice not to consume alcohol during pregnancy".
But with the days of doctors urging pregnant women to drink Guinness to increase iron levels long behind us, it seems unimaginable that most women are not aware of the risks associated with drinking while pregnant. The truth is that, just as some women continue to smoke, some women also choose to drink while pregnant.
At the Coombe Hospital,, it is hard to find a single woman who is not aware of the warnings around alcohol from health authorities. Heather (17), from Inchicore in Dublin, who has just given birth to a boy, said she tried two bottles of alcopops during her pregnancy. "I felt sick though, so I didn't drink again, and anyway I knew it wasn't good for the baby," she says.
Celine (23), who had just had her first baby by Caesarean section after 14 hours in labour, knew there were concerns but says she "wasn't bothered" about drinking while she was pregnant.
"I did have one or two drinks occasionally, but then I'd find myself getting drunk and I was worried I would slip and fall, so I would stop. You would definitely stand out as a pregnant woman in a pub with a drink in your hand. My mam drank as normal, out drinking every Saturday night, on me and my sister, and we turned out okay. I think the main thing is not to drink excessively," she says.
She doesn't believe putting warnings on alcohol products will make any difference because "if people are going to drink they will do it regardless. "If you believed everything you were told when you are pregnant you would wrap yourself up in cotton wool and never leave your house," she says.
After drinking up to one-and-a-half glasses of wine a week during her first pregnancy, lecturer Jane (38) has decided that for her next pregnancy she will not drink at all.
"When you have one glass of wine you really feel it in your body. It's a poison at the end of the day. I don't think I would take the risk the next time," she says. "I just think it's a small time out of your lifetime to give this little person a chance. You take vitamins, you keep yourself fit to give the best start to your baby, this is just another sacrifice you can make."
Jane says that, having been one herself at one point, a heavily pregnant woman drinking alcohol in a bar does get noticed. In the US there is an even more militant attitude towards pregnant women who allow themselves the odd glass of wine. If you are one of these women it's probably best to stay away from American message boards: "If you insist on being selfish go ahead and condemn your growing baby to the chance of being born 'different'. I'm sure you'll feel it was worth it for one or two drinks. Heck they'll thank you, right?" fumes one irate mother online.
But despite being aware of the risks, some women say they will still use their own judgment to decide whether they will drink while pregnant. Kildare businesswoman Sarah (37) is due to give birth in a few weeks and has been drinking "in moderation" throughout her pregnancy.
"I am aware of the risks, the information is widely available, but there is different advice depending on who you talk to or which books you read," she says.
"For most of my pregnancy I have had around four glasses of wine a week and around three times in the pregnancy I had four glasses at one sitting. If I lived in France, a glass of wine a day would not be frowned upon, so I've decided to become French for my pregnancy."
Sarah feels health advice for pregnant women should be more balanced, covering nutrition and exercise as much as advice around drinking.
"There are major risks associated with bad diet and yet a woman who goes to the chipper every day while pregnant will not be criticised," she says. "I have looked after myself very well, eaten a balanced diet and kept fit. The one thing I really like to do is have a few glasses of wine and I consider it my treat while pregnant. I am not treating myself by pigging out or becoming a couch potato the way some other women do."
Meanwhile, newly-pregnant Anne has decided that, despite the conflicting advice, she isn't willing to risk any harm to her baby for the sake of a couple of glasses of wine.
"I would just worry that after a couple of glasses I wouldn't want to stop, and anyway it's only nine months. There'll be plenty of time to enjoy alcohol when it's all over," she says.
Some names have been changed. For further information see the website of Fetal Alcohol Spectrum Disorders Ireland at fasd.ie