At FASD United, we are often approached about what to do when a person’s family member or loved one is pregnant and may be using alcohol.  We appreciate the instinct to help, and we empathize with the complex emotions that arise out of this situation. 

The question was recently raised in a widely-read advice column in The Washington Post.  A reader asked about their friend’s daughter, who is, in their words, “an alcoholic”, and recently announced her pregnancy. What to do?   

The advice columnist suggests joining a family support group and consulting SAMHSA’s treatment resources, as well as sharing the gift of friendship. This is good advice, though it is necessary to state clearly that no alcohol is safe during pregnancy. 

Supporting a loved one with an alcohol use disorder can be a challenging journey, especially when there is the added complexity of pregnancy.  The path to recovery and healing is not the same for everyone.   

A good first step is to identify treatment services in your community.  

There are facilities that treat pregnant patients both in-patient and out-patient. A call to one of your local treatment centers can help you to determine what services might be best for your loved one. 

Recovering Mothers Anonymous (RMA) is a support group for women with the experience of using a substance while pregnant. The group meets weekly on Zoom (Thursday 7PM EST) and attendees find great support and connections for services and resources there. The group is free, confidential and safe.  FASD United’s Family Navigators are also available to answer questions and are accessible with no fees and no referral required.  

An important fact to keep in mind is that about half of pregnancies are unplanned.   

When a person is struggling with an alcohol use disorder, an unplanned pregnancy is even more likely, and they may not be aware that no amount of alcohol is safe while pregnant.  For instance, there is a common misconception that beer or wine is safe, or that it’s safe to drink either early or later in pregnancy.  There is a lot of misinformation about this in our culture, so it’s important to get the facts out there: there is no safe time, no safe type, and no safe amount of alcohol during pregnancy. 

Rates of alcohol use disorder are rising, especially among women.  Educating ourselves about the process of addiction and recovery is very valuable.  A variety of support groups are available, including 12-step groups and recovery communities.  Alcoholics Anonymous and Narcotics Anonymous are 12-step groups that are free and open to anyone. There are also groups for families, such as Alanon. These supports are available in communities across the country and online.  Family Navigators can provide linkages to these resources. 

Addiction is a treatable disease.   

Understanding the realities of addiction — that recovery is a long process, that denial is an involuntary symptom of the disease, and that recovery is something that can’t be forced — are difficult but necessary truths to accept. 

Avoiding judgement and blame is critical.   

There is a huge stigma around alcohol and pregnancy, and this stigma makes the problem worse. Criticism and lecturing will only serve to push our loved ones away.  Offering support, encouragement, and love will lead to the best outcomes.   

Amidst the struggles, there is so much hope.  Recovery is possible, and millions of Americans in long-term recovery are living proof.  It is never too late, and every day matters.   

At any point during pregnancy, stopping alcohol use can improve outcomes.  

Pregnancy is a time of change and many will be open to receive support and services. It is best to seek out the help of a professional. Start with your local treatment centers or people living in recovery. 

For families affected by substance use, it can be helpful to take a break and step aside if we find ourselves emotionally overwhelmed.  In these times, it’s important to practice self-care.  Maintaining healthy boundaries and checking our own mental health is key.  We have to take care of ourselves before we can support our loved ones. 

Support can take many forms. 

As we consider what type of support to provide, we can ask our loved ones how we can best help and follow their lead.  Partners and families can support loved ones in recovery by not consuming alcohol around them and removing alcohol from the home. 

Our support can be as simple as providing contact information on where to get help and resources.  We may know someone with specialized knowledge that we can refer to, such as a therapist or treatment professional, or a woman who has been through a similar experience. We can help in various concrete ways, such as giving a ride to a treatment provider or 12-step meeting. 

Open communication and setting boundaries are crucial. 

It is so important to keep open lines of communication throughout the process.  Sometimes we can just sit still and listen to what our loved one has to say and how they feel.  Practicing active listening and validating feelings can speak volumes.  Pregnancy is a deeply sensitive and personal subject that often brings up intense emotions.  When we show up and make ourselves a safe and reliable presence, we open the door to further support. 

It is important to give our loved ones their space and the respect and privacy they deserve by respecting boundaries and avoiding gossip. If we’re not careful, we can find ourselves stuck in an unhealthy dynamic, such as codependency or enabling behavior.  Setting healthy boundaries is crucial.  Groups like Alanon can provide guidance on this sort of issue. 

Consider the role of mental health and overall pregnancy health. 

We are mindful that alcohol use disorders and alcohol and pregnancy often co-occur with other substance use and mental health challenges.  Alcohol use disorder is associated with many other issues that may be at play, including trauma, mental health, and life stressors like employment and housing.  Of course, pregnancy itself is a major life stressor. 

As we support our loved ones through the challenges related to alcohol, pregnancy, and addiction, we may be able to help with other important health considerations as well.  Nutrition, exercise, vitamins, healthcare access, and reducing stress are all very important when it comes to having a healthy pregnancy. 

In the end, the very best support that we can give to our loved ones is our love.  When we show our love through action, we can help them to feel loved and supported and to know that they are not alone in this journey. 

Consider connecting with Recovering Mothers Anonymous, which supports thousands of mothers with this living experience. There are mentors and support available, contact Kathy Mitchell at mitchell@fasdunited.org for more information. You can also contact a member of the FASD United Family Navigator program to talk and ask questions.