When a couple is planning on having a baby, it’s often the woman who is seen as responsible for the health of the unborn child.
In the UK, the chief medical officer’s drinking guidelines recommend that women should abstain from alcohol consumption during pregnancy. This is because it’s known to increase the risk of miscarriage and foetal alcohol spectrum disorders (FASD).
The guidelines also recommend that if you’re planning to become pregnant, the safest approach is not to drink at all to minimise the risks to your pregnancy.
But evidence from large surveys shows that not all women stop drinking before pregnancy – whether the pregnancy was intended or not. In a 2017 study of 5,036 women in the US, the prevalence of alcohol consumption before pregnancy was similar between those with intended (55%) and unintended pregnancies (56%).
This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.
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In another 2015 study of 3,390 Swedish women, weekly alcohol consumption was not significantly different between women with a “very planned pregnancy” (11%) compared with women with a “very unplanned pregnancy” (14%).
And a 2013 survey of 258 Danish women found that although 77% of their pregnancies were “very” or “fairly well planned”, one out of five reported binge drinking early in the pregnancy. Among women with unplanned pregnancies, this rose to one out of three.
But while the focus tends to be on a woman’s relationship with alcohol before and during pregnancy, an increasing amount of evidence indicates that men’s alcohol use also plays a role when it comes to the health of the baby.
Why stop drinking?
Research shows that if couples are trying to conceive, it makes sense for them both to quit the booze at least six months before pregnancy. This helps to reduce the risk of potential negative outcomes for the baby such as congenital heart disease.
Research has also found that if a couple lives together and the male partner drinks, there is a higher chance that the woman will drink alcohol before and during the pregnancy.
One of the reasons why this might be the case is explored in another study where women said that drinking with a partner, whether before or during pregnancy, provided a sense of social connection.
The period before pregnancy, known as preconception, is a window of opportunity for would-be parents to improve their health and increase their likelihood of conceiving. And alcohol consumption should be thought about as part of this.
As part of our recent research, we reviewed the literature exploring people’s and health professionals’ views about information and support for reducing drinking in the period before getting pregnant.
We found that women were aware that lifestyle factors such as smoking or drinking alcohol can affect their pregnancy and increase the risk of poor outcomes for the baby. But there was a notable lack of awareness of the importance of men reducing their alcohol consumption when planning for pregnancy, too.
Indeed, men don’t usually go to clinics to get information about preconception health, as this is usually left to the woman.
While there is some indication that men, as well as women, are open to changing their drinking behaviour when planning for pregnancy, our literature review found that very few studies have explored men’s or partners’ views on preconception health.
And while there are promising results from interventions and approaches aimed at enhancing preconception health in men and women, such as alcohol screening followed by counselling and health education on changing behaviour, there’s still not enough emphasis placed on men’s health at the preconception stage. This needs to change because, as the research shows, a baby’s health is influenced by both mum and dad.
So if you are considering trying for a baby, now could be the time for both partners to set new goals and cut down on drinking together. And if you’re concerned about the amount you drink, or are dependent on alcohol, you should get professional advice and support on cutting down safely.
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We would like to thank Lisa Schölin, Queens Medical Research Institute, University of Edinburgh; Andrea Hilton, Department of Paramedical, Perioperative and Advanced Practice, University of Hull and Anand Ahankari, Faculty of Health and Medical Sciences, University of Surrey who are part of the research team and helped with writing and reviewing this article.
Lesley Smith received funding from the National Institute of Health Research, The Institute of Alcohol Studies, the former Alcohol Research UK (now Alcohol Change UK) and The Joseph Rowntree Foundation for alcohol-related research.
Jayne Walker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.