Do Pregnant Women Heed Alcohol Warning Labels?

Fetal alcohol spectrum disorder (FASD) is the collective term for a range of conditions that can appear in children and adults whose mothers consumed alcohol while pregnant. Although these conditions are treatable, their basic effects last for a lifetime. In a study review published in 2014 in The International Journal of Alcohol and Drug Research, a team of Canadian researchers assessed the effectiveness of alcohol warning labels in reducing the number of people ultimately impacted by fetal alcohol spectrum disorder. The researchers concluded that such labels have only a modest direct influence on women’s likelihood of drinking during pregnancy.

Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder is a common term for the conditions that can appear in the children of pregnant women who drink, not a specific diagnosis issued by doctors. These conditions include alcohol-related birth defects (ARBD), characterized largely by damaging physical changes linked to alcohol exposure in the womb; alcohol-related neurodevelopmental disorder (ARND), characterized largely by damaging mental/intellectual changes linked to alcohol exposure in the womb and fetal alcohol syndrome (FAS), characterized largely by a combination of physical and mental/intellectual consequences of alcohol exposure in the womb.

Because of the risk for developing FASD, public health guidelines in the U.S. and throughout the world commonly call for pregnant women to avoid consuming alcohol in any form. Most American women follow these guidelines and stop drinking when they find out they’re pregnant. However, some women continue to drink during one or more trimesters of their pregnancy.

Alcohol Warning Labels

In the U.S., a federal statute called the Alcoholic Beverage Labeling Act legally mandates that the containers of alcoholic beverages carry a warning label designed to alert consumers about some of the most prominent dangers of drinking. Part of this label states that “According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects.” In addition, the label states: “Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.” The Alcoholic Beverage Labeling Act also mandates that the warning labels appear in formats that make them conspicuous to consumers. Steps taken to enforce this part of the statue include regulating the size of the text used in alcohol warning labels and regulating the types of backgrounds that manufacturers can place on the packaging beneath warning labels.

Impact on FASD Rates

In the study review published in The International Journal of Alcohol and Drug Research, researchers from the University of Victoria and two other Canadian institutions analyzed previously conducted research on the impact that alcohol warning labels have on the number of people diagnosed with fetal alcohol spectrum disorder. A total of 18 studies were included in the review. Most of these studies were conducted in the U.S.; other sources of studies included Canada, New Zealand and France. Factors considered by the researchers during the course of their analysis included the amount of attention pregnant consumers pay to alcohol warning labels, the relative clarity of the warnings, pregnant consumers’ relative ability to remember the warnings, whether or not alcohol warning labels help change pregnant consumers’ points of view about alcohol-related risk and whether alcohol warning labels lead pregnant consumers to avoid drinking.

At the end of their analysis, the researchers concluded that, while alcohol warning labels enjoy wide public support, they have a relatively small influence on consumers’ alcohol-related behavior (and therefore have a relatively small influence on the overall rate of fetal alcohol spectrum disorder). The pregnant women most likely to heed the warnings on alcohol labels are women who have little or no long-term risks for the development of diagnosable alcohol problems. On the other hand, pregnant women involved in risky practices such as binge drinking and excessive or heavy drinking do not typically modify their involvement after reading alcohol warning labels.

Despite the relatively minor direct effect of alcohol warning labels on the drinking practices of pregnant women, the study’s authors believe that such labels may potentially contribute to large-scale shifts in social expectations that make drinking during pregnancy less likely to occur. They note that direct decreases in pregnant women’s drinking involvement typically depend on several critical influences, including increased quality of care for alcohol-related issues and other issues known to affect women’s mental and physical health during pregnancy.

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