Policies meant to prevent drinking during pregnancy may actually be harmful to babies, a new study finds.
Past research has shown that drinking while pregnant can harm a developing fetus and lead to birth defects and behavioral problems commonly known as Fetal Alcohol Spectrum Disorders (FASD).
In an effort to stop these from occurring, several states have enacted policies to get women to stop drinking or to seek care if they already have.
But the new joint study, from the Public Health Institute and the University of California San Francisco, shows that these result in more preterm births and children born at low birth weights.
The researchers say pregnant women who drink are fearful of going to an OBGYN or that they’ll be charged with child abuse, so they do not receive sufficient prenatal care, which results in worse birth outcomes.
‘Usually, when we talk about substance use during pregnancy, we focus on harms from the substance use itself,’ co-author Dr Sarah Roberts, an assistant professor of obstetrics and gynecology at UCSF, told DailyMail.com.
‘But it turns out the policies itself often cause harm.’
There are 50,000 teratogens – pre- and post-natal agents – which can affect a fetus’s development. Alcohol is one of them.
The substance in the mother’s blood passes straight to the baby’s blood. Ethanol, found in most alcoholic beverages, is a toxic substance which can kill cells in developing fetuses.
Mothers-to-be who drinks can experience stillbirths or even miscarriages, according to the Centers for Disease Control and Prevention.
Then there’s FASD, which can result in physical, behavioral and intellectual disabilities.
Changes at the cellular level affect brain design, which impact memory storage, processing speed. and the ability to analyze or to make decisions.
About 21 percent of American pregnant women say they’ve used alcohol during pregnancy while about three percent said they’ve binge drank, which is drinking at least four drinks in one sitting.
There are 43 US states that have alcohol and pregnancy policies, according to a study published in November 2017.
They range from warning posters up in bars and restaurants to criminal prosecution.
Currently, 23 states consider substance use during pregnancy to be child abuse and three states ‘consider it grounds for civil commitment’, according to the Guttmacher Institute.
Dr Roberts said the study was inspired by work more than a decade ago with mothers who used alcohol and drugs.
She said they had many reasons for choosing not to seek care.
‘They feared they’d already irreversibly harmed baby so they were avoiding prenatal care, they were fearful of being judged, and they feared being reported to Child Protective Services judge, losing their children or going to jail.’
Dr Roberts said she wanted to see if these trends remained the same across geographical regions over a longer period of time.
For the new study, published in PLOS One – and first reported by Vox – the team looked at more than 155 million live births in the US between 1972 and 2015.
They looked at policies aimed at both punishing and helping pregnant women such as priority treatment for substance abuse and limiting criminal prosecution.
Researchers found that the policies – even those designed to help women with substance abuse – led to an increase of babies born with low birthweights or prematurely.
Dr Roberts admitted she was surprised that even the policies aimed to help women resulted in poor birth outcomes, but she had some theories.
‘When you let someone go to the front of the line, someone else is pushed down the line, which could then adversely impact people or could be stressful experience,’ she said.
‘Or you make it so women when not pregnant aren’t able to get treatment so they may then get pregnant without the treatment they wanted or needed.’
She urges lawmakers to ‘take a pause’ before moving ahead with policies that exist in other states.
‘ I think we need to step back and start again,’ Dr Roberts said. ‘Start with people who are using alcohol and drugs while pregnant to figure out what they need and talk to clinicians who are working with them to ask what they think.’
Dr David Jernigan a professor of health law, policy, and management at Boston University, who was not involved in the study, told Vox that he believes there are more effective polices than the ones in places.
He recommends raising alcohol taxes and reducing the hours when alcohol can be sold to the public.
‘At the end of the day, we’re all influenced by price,’ Dr Jernigan said.