The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Alcohol is risky – whether you’re pregnant or not. Alcohol affects every organ in your body. Regular or heavy use raises the risk of injuries and illnesses like breast cancer, high blood pressure, depression, liver disease and relationship/financial stress.
Globally, alcohol contributes to millions of deaths each year and is a leading cause of premature illness in people 20–39 years old. The same is true for South Africa. South Africans who consume alcohol do so heavily, placing us among the world’s heaviest drinking nations.
ALCOHOL AND PREGNANCY IN SOUTH AFRICAN WOMEN
- Alcohol use in pregnancy: A nationally representative analysis found 3.7% of South African women reported alcohol use during pregnancy, with higher levels in Free State, Northern Cape and Western Cape. As this data was self-reported, it is likely actual consumption was underestimated.
- High-risk communities: In the Western Cape, a rigorous 2022 community study estimated Foetal Alcohol Syndrome (a condition in a child that results from alcohol exposure during the mother’s pregnancy) at 310 per 1 000 children (about 31%)—the highest documented prevalence globally.
- Recent South African studies continue to flag high rates of substance (including alcohol) use in pregnancy.
While many women in South Africa do abstain during pregnancy, some communities face very high risk. The safest choice for you and your baby is no alcohol at all during pregnancy and while trying to conceive.
WHY ALCOHOL IS EXPECIALLY DANGEROUS IN PREGNANCY
There is no known safe amount, no safe time, and no safe type of alcohol in pregnancy. The most high-risk time in pregnancy is early in the first trimester—often before you know you’re pregnant—alcohol can disrupt foetal development. Major risks include miscarriage, stillbirth, preterm birth, low birthweight and long-term brain and organ damage in the child. Health agencies worldwide advise complete abstinence during pregnancy.
FOETAL ALCOHOL SYNDROME (FAS)
Foetal Alcohol Spectrum Disorders (FASD) are lifelong conditions caused by prenatal alcohol exposure. Foetal Alcohol Syndrome (FAS) is the most severe form. Children may have:
- Learning and attention difficulties
- Problems with memory, planning and impulse control
- Speech and language delays
- Growth restriction and distinctive facial features (in FAS)
- Heart, kidney and other organ problems
These challenges can affect schooling, employment and independence in adulthood. FASD is 100% preventable—by avoiding alcohol in pregnancy.
WHAT TO DO IF YOU’RE PREGNANT (OR TRYING) AND CURRENTLY DRINK
- Stop now. Quitting at any stage of pregnancy can improve outcomes; brain and organ development continue throughout pregnancy. (There’s no safe “small amount”.)
- Tell your antenatal provider. Ask for screening and support—brief counselling and evidence-based referrals are part of routine care.
- Plan for tricky moments. Avoid drinking situations; ask your partner/friends to support your choice; swap to alcohol-free options.
- Avoid alcohol while breastfeeding. Alcohol passes into breast milk and can affect your infant’s sleeping, feeding and development.
WHAT TO DO IF YOU THINK YOU HAVE A DRINKING PROBLEM
You’re not alone, and help is available (confidentially):
- 24-hour Substance Abuse Helpline (Department of Social Development): 0800 12 13 14 or SMS 32312 for a call-back.
- SANCA (South African National Council on Alcoholism and Drug Dependence): Find your nearest service for counselling and treatment.
- Talk to your clinic/GP/midwife. Ask about brief interventions, referral to treatment, and support groups.
If stopping suddenly feels hard, don’t wait—call the helpline or speak to your provider about supported, safe reduction and treatment options.
PRACTICAL TIPS TO STAY ALCOHOL-FREE DURING PREGNANCY
- Make your decision public: Tell your partner, family and friends you’re not drinking.
- Change your cues: Avoid bars/braais where drinking pressure is high; arrive later, leave earlier, or host at home with alcohol-free options.
- Swap the ritual: Keep a favourite alcohol-free drink (sparkling water, cordials, alcohol-free beer/wine) on hand.
- Manage stress differently: Try short walks, stretching, breathwork, prayer/meditation, or a quick call with a supportive friend.
- Track your wins: Note alcohol-free days and how you feel—better sleep, less heartburn, and fewer headaches are common.
- Seek community support: Antenatal classes, mothers’ groups and counselling can reduce isolation and cravings.
FURTHER READING
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