The Real Risk of Drinking Before You Know You're Pregnant

Many people drink alcohol without knowing they’re pregnant—and it often ends up fine. Here's more information about your risk of fetal alcohol syndrome while expecting.

Nearly half of all pregnancies are unplanned in the United States, so it's not surprising to learn that many people have enjoyed a few adult beverages at some point after sperm meets egg. And while drinking early in pregnancy is never recommended, there's little reason to panic if you had a few cocktails. Lots of people have been in the same boat and have given birth to healthy babies.

Accidents like these happen more often than you may think, so don't add stress and misery to your pregnancy because of an early slip-up. Instead, talk to a health care provider about your concerns, as they can help you understand your risks of fetal alcohol syndrome. You should also refrain from drinking again while expecting.

Keep in mind, too, the Centers for Disease Control and Prevention (CDC) has a clear stance: There's no known safe amount of alcohol use during pregnancy. Because alcohol passes directly from the parent's bloodstream to the fetus through the umbilical cord, alcohol use during any point in the pregnancy can result in a range of issues known as fetal alcohol spectrum disorders (FASD). Alcohol use during pregnancy has also been linked to miscarriage and stillbirth.

Keep reading to learn more about drinking in early pregnancy without knowing you're expecting, with advice on handling the situation.

What Is Fetal Alcohol Syndrome?

Fetal alcohol syndrome (FAS) is one of the most complex disorders under the FASD umbrella and can result in serious issues with the central nervous system, developmental problems, and specific physical characteristics. Some kids may have subtle damage that isn't even noticed until they begin school, when learning and behavior problems become apparent.

Friends Toasting alcohol with Wine glasses In Restaurant
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Many People Drink Before Knowing They're Pregnant

Although having a couple of drinks before you knew you were pregnant isn't ideal, it's somewhat common. "Half the women in the U.S. drink alcohol and half of all pregnancies are unplanned, so there are many cases of women realizing they drank before discovering they're expecting," says Robert Sokol, MD, professor of obstetrics and gynecology at Wayne State University School of Medicine in Detroit.

In fact, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicates about 20% to 30% of pregnant people reported drinking during pregnancy, and more than 8% reported binge drinking. Both instances happened most often during the first trimester. (Binge drinking is consuming a large amount of alcohol in a short time period—usually four or more drinks within about two hours for those with ovaries, says the NIAAA.)

It may be difficult not to worry, but do your best not dwell on the past. "Once you're pregnant, stop drinking," says Dr. Sokol. The CDC notes that if the pregnant person stops drinking, the baby will likely do better.

Understand the Risks of Fetal Alcohol Syndrome

Some organizations estimate 40,000 babies are born with a FASD each year—and anywhere from 800 and 8,000 babies might have FAS, according to the American Academy of Pediatrics (AAP).

Not every person who drinks during pregnancy will birth a child with fetal alcohol syndrome. In fact, some people may have a genetic predisposition that decreases the vulnerability of their fetus to alcohol damage, and others may experience the opposite (in other words, certain people may have genes that increase the risk of an FAS-related birth). Those of advanced maternal age are in the latter category.

"Older women tend to be heavier, so the more body fat one has, the faster the blood alcohol content rises because fat doesn't absorb alcohol like muscle does," says Dr. Sokol. Other factors—like your environment, nutrition, and smoking habits—can also affect your odds of fetal alcohol syndrome.

Another important influence is how much and how often you drank alcohol. The more alcohol you drink, the higher the risk for the fetus to develop alcohol-related brain and organ damage, according to the AAP. Binge drinking and regular heavy drinking is the most risky behavior.

FASD Disabilities in Children

According to the CDC, people born with FASD might have the following characteristics:

  • Small head
  • Short height
  • Smooth ridge connecting the nose and lip
  • Low body weight
  • Poor coordination, attention, and memory
  • Hyperactive behavior
  • Learning and intellectual disabilities
  • Delays with speech and language
  • Sleep problems as a baby
  • Issues with vision or hearing
  • Problems with the bones, heart, or kidney

I Drank in Early Pregnancy Without Knowing — Now What?

Ideally, you should assess your health before conceiving so you can start your pregnancy on the best foot possible. This means taking preconception folic acid (400 mcg) for at least a month to reduce the chance of a neural tube defect, as well as cutting out smoking and drinking.

Some studies suggest the most severe damage happens while drinking in the first three months of pregnancy, so abstinence is recommended when trying to conceive, says David Garry, DO, a spokesperson for the American Congress of Obstetricians and Gynecologists (ACOG) and a maternal fetal medicine specialist at Montefiore Medical Center in Bronx, NY.

And if you did drink while pregnant? Don't hesitate to talk openly with your health care provider so you can understand your real risks—and hopefully put your mind at ease. Depending on your circumstances, it may be helpful to know that FASDs include a range of disabilities—both physical and intellectual—that may not even be visible when your child is born. While there is no known cure for FASDs, research shows that early intervention therapies may help improve a child's development.

Also, ask for help if you're having trouble eliminating alcohol from your diet. Your health care provider can direct you to support and resources.

The Bottom Line

Drinking during pregnancy isn't a guarantee that your child will be affected. The best advice is also the simplest: For the healthiest baby, stop drinking the moment you decide you'd like to get pregnant. Contact a health care provider if you consumed alcohol before knowing you were expecting.

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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Alcohol Use During Pregnancy. Centers for Disease Control and Prevention. Reviewed 2022.

  2. Fetal Alcohol Spectrum Disorders. National Institute on Alcohol Abuse and Alcoholism. Updated 2023.

  3. Declines in Unintended Pregnancy in the United States, 2008-2011. N Engl J Med. 2016.

  4. Fetal Alcohol Exposure. National Institute on Alcohol Abuse and Alcoholism. Updated 2021.

  5. Fetal Alcohol Spectrum Disorders: FAQs of Parents & Families. American Academy of Pediatrics. Updated 2019.

  6. Fetal Alcohol Spectrum Disorders: FAQs of Parents & Families. American Academy of Pediatrics. Updated 2019.

  7. The impact of maternal age on the effects of prenatal alcohol exposure on attention. Alcohol Clin Exp Res. 2010.

  8. MedlinePlus. Alcohol and pregnancy.

  9. FASDs: Treatments. Centers for Disease Control and Prevention. Updated 2023.

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