Alcohol, drugs and planning a pregnancy

Alcohol and illegal drugs can affect fertility and cause problems in pregnancy.

Should I drink if I’m trying to get pregnant?

There is no known safe level of alcohol in pregnancy. We know that drinking large amounts of alcohol increases the risk of:

  • miscarriage
  • premature birth (where the baby is born before they are fully formed)
  • low birth weight
  • learning difficulties and behavioural problems in later life for the baby.

Doctors are not sure about the effect of small amounts of alcohol, because the way the body handles alcohol is different for different people. However, we do know that alcohol crosses the placenta, so being alcohol-free is safest.

This is especially true during the first three months of pregnancy as this is when the baby’s brain is developing.

Because you’re will not know you’re pregnant for the first few weeks, the safest thing to do is not drink any alcohol at all if you’re trying for a baby. This is what doctors advise.

You may find it hard if you go month after month without getting pregnant and you feel that you are missing out on good times for nothing, but try to think that it is only temporary and that when you do get pregnant you will have peace of mind knowing that you were alcohol free. It may take much less time than you think to get pregnant, around1 in 3 women conceive within a month.

The more you drink the bigger the risks. So try to reduce your drinking if you are a heavy drinker or get drunk regularly. 

There are many reasons why some women may find it difficult to stop drinking, but there is support available if you need it.

What is heavy drinking and binge drinking?

Heavy drinking means drinking a lot of alcohol (more than 14 units a week) regularly. Binge drinking means drinking a lot of alcohol at the same time (six or more units if a woman).

The safest thing to do if you’re trying to conceive is to stop drinking alcohol altogether.

Find out more about units here.

Alcohol and fertility

Drinking alcohol is linked to fertility problems in both men and women. If you drink a lot and often, you may find it more difficult to get pregnant.

For women, heavy drinking may also contribute to period problems, such as heavy, irregular or no periods. This means you are less likely to ovulate (release eggs), which is needed for pregnancy.

Men, alcohol and fertility

In men, drinking too much alcohol can cause:

  • loss of interest in sex
  • problems with having an erection
  • less testosterone (a hormone that is important for conceiving)
  • problems with the amount of sperm
  • problems with the quality of sperm.

The good news is that stopping or cutting right back on alcohol can solve these problems.

Read more about men and fertility

I’ve been drinking alcohol but think I’m pregnant. What do I do?

Try not to worry. The risk of harm to the baby is likely to be low. The important thing is to stop drinking now.

Talk to your doctor or midwife If you are worried about alcohol use during pregnancy, especially if you’re concerned you can’t stop. Remember they are there to support you and not judge you, so try to be honest about your drinking habits. They can refer you for specialist support if you need it.

Alcohol dependency

If you find it difficult to enjoy yourself or relax without having a drink, you may be ‘dependent’ on alcohol, which means you might feel you ‘need’ it. Other signs of alcohol dependence may include:

  • worrying about where to get your next drink
  • making sure there is alcohol at all your social events
  • finding you have a need to drink and finding it hard to stop once you start
  • drinking when you wake up – or feeling the need to have a drink in the morning.

Speak to your GP if you are concerned you have a serious drinking problem. There are also a number of alcohol support services listed below.

Drugs

Using illicit (illegal) drugs, such as cannabis, synthetic cannabis (known as spice), cocaine and other drugs such as ecstasy, ketamine and amphetamines may contribute to fertility problems. This means that if you or your partner take drugs, you may find it more difficult to get pregnant. Illegal drugs can also cause serious problems in pregnancy.

Cannabis is the most commonly used drug. In women, heavy cannabis use can cause hormone dysregulation (unbalanced hormones) so women who use it are likely to have problems getting pregnant, compared to those who don’t.

Other legal drugs such as diazepam and opiate painkillers (whether prescribed or not) may also cause problems. If you're trying for a baby it is important to check with your doctor or pharmacist before taking any medications.

Drugs, men and fertility

In men, cannabis can cause:

  • low testosterone
  • problems with the quality of sperm.

Cocaine is another commonly used drug. When used by men, it can cause:

  • less enjoyment of sex
  • difficulty having erections and sex
  • being less able to produce sperm

Drugs and pregnancy

In pregnancy, cannabis use can cause problems with the baby’s development and even stillbirth. In pregnant women, cocaine may cause:

Opiates such as methadone and heroin can also mean difficulty getting pregnant.

In pregnant women, heroin may also cause:

Do I have to stop taking drugs before I get pregnant?

Yes. If you take any illegal drugs the best thing you can do for yourself and your baby is stop.

Some women may be able to stop taking drugs without help. Others may find it more difficult because of other problems, such as mental health issues, lack of family support, or long term problems like homelessness.

If there is any reason why you’re finding it difficult to stop taking illegal drugs and you want to start trying for a baby, it’s important that you get advice and support. Your GP can refer you to a specialist service or you can find services that suit you online (jumplink to more information and support)

It’s best to keep using contraception until you have stopped using drugs. Your doctor give you advice about this if you need it.

Alcohol, drugs and mental health

Both alcohol and non-medical drug use can be bad for your mental health. Some people may also use alcohol or drugs because they have mental health problems. You will not be judged if you speak to a doctor about using alcohol or drugs. They are there to help and support you.

Talk to your GP if you have mental health problems. They will be able to refer you to specialist services. 

Find out more about general mental wellbeing and planning a pregnancy

Find out more about specific mental health conditions and planning a pregnancy

More information and support

NHS Choices provides advice and information on alcohol and offers a database of support and treatment services

Drinkline is the national alcohol helpline. If you're worried about your own or someone else's drinking, call this free helpline on 0300 123 1110 (weekdays 9am - 8pm, weekends 11am - 4pm).

The Drinkaware Trust provides information and advice about alcohol consumption, including ways to monitor your alcohol intake

Frank provides free, confidential advice about drug taking and gives information about local support services.

Alcoholics Anonymous (AA) is a free self-help group. Its "12-step" programme involves getting sober with the help of regular support groups.

Are you ready to conceive? Use our tool to find out.

Sources

1. NHS Choices (accessed 01/04/2018) Drinking alcohol while pregnant Page last reviewed: 14/01/2017 
Next review due: 14/01/2020.  https://www.nhs.uk/conditions/pregnancy-and-baby/alcohol-medicines-drugs-pregnant/

2. The Royal College of obstetricians and gynaecologists (2018) Alcohol and pregnancy https://www.rcog.org.uk/en/patients/patient-leaflets/alcohol-and-pregnancy/

3. Department of Health (2016) UK Chief Medical Officers’ Low Risk Drinking Guidelines https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf

4. NICE Guideline (2013) Fertility problems: assessment and treatment National Institute for Health and Care Excellence

5. British Medical Association (2016) Preventing and managing fetal alcohol spectrum disorders https://www.bma.org.uk/collective-voice/policy-and-research/public-and-population-health/alcohol/alcohol-and-pregnancy

6. A. Emanuele & NV Emanuele. ‘Alcohol’s Effects on Male Reproduction.’ Alcohol Health Research World 1998; vol.22, No.3,pp195-2011

7. Drinkaware Alcohol dependence and withdrawal https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/mental-health/alcohol-dependence/

8. DrugWise (accessed 01/05/2018 Which drugs are used most? Updated January 2018) www.drugwise.org.uk/which-drugs-are-used-most/

9. Rekesh, S et al (2013) Lifestyle factors and reproductive health: taking control of your fertility Reproductive Biology and Endocrinology 2013 Jul 16;11:66. doi: 10.1186/1477-7827-11-66.

10. Clinical Knowledge Summaries (Aug 2017) Pre-conception advice and management www.cks.nice.org.uk/pre-conception-advice-and-management

11. National Institute for Health Research (2017) Better beginnings Improving health for pregnancy https://www.dc.nihr.ac.uk/themed-reviews/health-in-pregnancy-research.htm

 

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Last reviewed on June 5th, 2018. Next review date June 5th, 2021.

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