Alcohol consumption is pervasive and socially accepted in many cultures and societies. Women are drinking more often and larger quantities than ever before. This is important, as women during their childbearing years do need to know the impacts of alcohol on their bodies and potential babies.
The advice on alcohol use in the perinatal period is simple. No level of alcohol use is seen as safe. So, it is advised that when trying to get pregnant, during pregnancy and breastfeeding women do not drink alcohol.
Many women will have been drinking alcohol before they find out that they are pregnant. If you are planning a pregnancy the safest thing to do is stop drinking alcohol. Once you know you are pregnant, the safest thing to do is stop drinking alcohol.
A big question for many women is how to refuse alcoholic drinks when you haven’t told people you are trying to get or are pregnant. As a society we really need to work on not questioning anyone who refuses an alcoholic drink. Until we master that, being prepared with an answer may help you to feel more comfortable. You could try “I drew the short straw and am driving”, “I’m not feeling to well”, or “I need to pace myself; I’ll sit this one out thanks”. If you feel like you will be called out, you can always carry a drink with you that looks alcoholic, for example, lemonade could be a gin and tonic. Try and get your partner on board with supporting you and finding ways to navigate these spaces. When you have told people that you are pregnant, let them know how they can best support you to avoid alcohol use. 
Alcohol may be used as a stress relief. If you are using it in this way, then you can investigate alternate ways to manage your stress. Speak to a health professional about ways to reduce drinking alcohol or a mental health professional about ways to manage stress or anxiety. There are many apps and online resources that can help with this (see resources below).
Using alcohol as a coping strategy is strongly linked to unhappy relationships, domestic violence, and other drug use. If you are experiencing these issues, please reach out to a health professional or someone you feel safe talking to, to get help.
Many women do continue to drink during pregnancy. If you are concerned about someone you know, offer them fact-based information about the harm it can cause, and encourage them to discuss it with their healthcare provider.
It is also advised that women abstain from all alcohol whilst breastfeeding or expressing milk for their child. Try to remember that your baby drinks what you drink. Babies will have the same blood alcohol level as you, but they can’t metabolise it as well as you can, so it remains in their system for longer. If you are going to drink alcohol, then plan ahead. Feed or express, then have a drink. It takes roughly two hours to metabolise a standard unit of alcohol, depending on your weight and health. The” feed safe” app has advice on how long alcohol may be in your system. You might also want to plan to ensure you baby is cared for by someone who is not intoxicated and that they will have a safe sleep environment.
You may have heard of the concept of pumping and dumping where if you have had alcohol, you express your milk and don’t feed it to your baby. While you have alcohol in your system any milk produced will contain alcohol, so it doesn’t relieve the issue to pump whilst drinking. It is better to try to plan ahead, but if you have had alcohol and your breasts are full then expressing can help to maintain your supply and ease discomfort in breasts. This milk will contain alcohol so should not be fed to your baby.
Alcohol use is an issue in many societies. Women are drinking more than they have before. It is advised that women do not drink alcohol whilst trying to get pregnant, being pregnant and when breastfeeding or expressing. If you have concerns about this, please discuss them with a healthcare provider.
Do you want to change your drinking?
Monitor your alcohol intake over a few weeks by counting the number of standard drinks you have each day. Also record the reasons for drinking on each occasion. Were you able to stop drinking at the point you planned to? How did you feel the next day, physically and mentally?
Do you want to make changes? If so please speak to your GP or access the resources below.
Resources
Alcohol and drug foundation 1300858584
Alcoholics anonymous 1300222222
National alcohol and other drugs hotline 1800250015
Stress or anxiety Apps: Calm, headspace, Stop panic and anxiety self-help
Australian Breastfeeding Association advice
WA Government domestic violence services
Alcohol and Drug foundation (2021) Spiking
Alcohol and Drug Foundation New Guidelines 2020
Alcohol and Drug Foundation Reasons for drinking
Australian Government list of resources
