1. Glasgow Council on Alcohol Resilient Communities Working together with the people of Glasgow to tackle the misuse of alcohol and drugs and encourage resilient communities

2. Alcohol and Pregnancy Setting the Scene

3. You have told us… 50% of you are not confident advising pregnant women on their alcohol use 37% of you believe that some alcohol is safe during pregnancy or are unsure 18% of you would advise moderate drinking during pregnancy of up to 2 units per week

4. Aim: To increase awareness and understanding of the key alcohol and pregnancy messages and be confident to discuss this with appropriate individuals. Objectives: Understand key alcohol and pregnancy messages: Preconception, Pregnancy, Post-natal Identify appropriate individuals Build confidence to raise subject with appropriate individuals

5. Women and Alcohol Around 82% of Scottish women drink some alcohol (Scottish Health Survey, 2014) 33% of women exceeding the government drinking guidelines (Scottish Health Survey 2014) 17% of women are drinking at hazardous/harmful levels (Scottish Health Survey, 2014) Increase alcohol related deaths in young working age females (aged 15-44) (GCPH, 2014)

6. Alcohol and Sexual Behaviour Complex relationship between alcohol, sexual behaviour and pregnancy Binge drinking is a common drinking pattern amongst sexually active men and women 1/3 of pregnancies proceeding to birth may be unplanned (Lakha and Glasier, 2006) (NHS Education Scotland, 2013)

7. Alcohol and Pregnancy 81% of mothers had previous drunk alcohol (previous two years) 40% of mothers drank during pregnancy 59% of women gave up alcohol completely 37% of women cut down alcohol use (UK Infant Feeding Survey, 2010)

8. Test Your Knowledge!

9. Question 1 Information about alcohol and pregnancy is only relevant to pregnant women? False

10. Influence - Partner, family and friends Previous Experiences Unplanned Pregnancies Wider Audience

11. It is best to avoid alcohol when planning a baby? True Question 2

12. Planning a Baby Alcohol can affect fertility Heavy drinking can increase the risk of miscarriage during the early weeks Early detection Recommended – both men and women should avoid alcohol if planning a baby

13. Question 3 It is okay to drink at low levels during pregnancy? False

14. Low Levels of Consumption No clear evidence of safe limit Linked to: o Risks of low birth weight, preterm birth and small for gestational age o Increase risk of miscarriage (in first 3 months) Under-estimate actual unit consumption Safest Option – Not to drink alcohol at all during pregnancy

15. Question 4 Its okay to drink wine/beer during pregnancy as long as you avoid spirits? False

16. Different Types of Drinks All alcohol causes a risks as it passes through the placenta into the unborn babies bloodstream Risk increases with increase volume (level in bloodstream) Alcohol is a teratogen – can trigger abnormal growth, development and movement of the cells

17. Question 5 What is the most critical time for a pregnant women to avoid alcohol? A – The First Trimester B- The Second Trimester C – The Third Trimester D - For the duration of the pregnancy

18. Development throughout Pregnancy The baby is developing throughout pregnancy therefore drinking at anytime during pregnancy could affect the baby Exposure during any time creates a risk factor Brain and CNS are developing intensely throughout pregnancy

19. Question 6 If a women drinks during pregnancy her baby is at risk of alcohol related harm? True

20. Affects on the Unborn Baby Alcohol passes through placenta into babies bloodstream The foetal liver is unable to effectively process alcohol (greater alcohol exposure) Nearly all aspects of normal fetal development can be disrupted Alcohol exposure during a particular point in pregnancy can result in facial, brain, organ and other abnormalities

21. FASD and FAS Foetal Alcohol Spectrum Disorder o Group of conditions – Varying degrees Foetal Alcohol Syndrome o Serious condition caused by drinking heavily during pregnancies o Restricted growth, facial abnormalities, learning and behavioural disorders

22. Question 7 What is the current advice (UK wide) given to pregnant women about alcohol ? A – To avoid alcohol if you are pregnant or trying to conceive B – One to two units per week C – One to two units per day D - As long as you do not get drunk

23. CMO Guidance (January 2016) The Chief Medical Officers’ guidelines: If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink the greater the risks (UK Chief Medical Officers’ Alcohol Guidelines Review, January 2016)

24. CMO Guidance (January 2016) The risk of harm to the baby is likely to be low if a women has drunk only small amounts of alcohol before she knew she was pregnant or during pregnancy. Women who find out they are pregnant after already having drunk during early pregnancy, should avoid further drinking, but should be aware that it unlikely in most cases that their baby has been affected. (UK Chief Medical Officers’ Alcohol Guidelines Review, January 2016)

25. GG&C Alcohol and Pregnancy Message It is best to avoid alcohol when trying for a baby and when you are pregnant. No alcohol, no risk. Avoid alcohol completely if trying for a baby or pregnant Drinking alcohol can affect your fertility Alcohol can interfere with an unborn baby’s healthy growth and development

26. Question 8 It is okay to drink alcohol post pregnancy? True and False

27. Alcohol and Baby Alcohol and breastfeeding Co-ordination, judgement and speed of reactions Alcohol and co-sleeping

28. Time for Workshops

29. GG&C Alcohol and Pregnancy Message It is best to avoid alcohol when trying for a baby and when you are pregnant. No alcohol, no risk. Avoid alcohol completely if trying for a baby or pregnant Drinking alcohol can affect your fertility Alcohol can interfere with an unborn baby’s healthy growth and development

30. Further Support and Resources Glasgow Council on Alcohol http://www.glasgowcouncilonalcohol.org/communities -2/alcohol-and-pregnancy/ Alcohol Guidelines Review www.gov.uk/government/consultations/health-risks- from-alcohol-new-guidelines NHS Education for Scotland Fetal Alcohol Harm E- Learning Resource www.knowledge.scot.nhs.uk/home/learning-and- cpd/learning-spaces/fasd.aspx GG&C Health and Well-being Directory infodir.nhsggc.org.uk

31. Contact Details Lorraine Thomson Resilient Communities Telephone: 0141 556 6631 Email: lorraine.thomson@glasgowcouncilonalcohol.org lorraine.thomson@glasgowcouncilonalcohol.org