Medical texts lack direct messages
on alcohol's threat to pregnancy

American Journal of Preventive Medicine
Volume 23, Issue 2 (August 2002)

Obstetrical textbooks: Recommendations about drinking during pregnancy Karen Q. Loop BA, and Mary D. Nettleman MD, MS


Background: For the past 2 decades, public health authorities have recommended that pregnant women abstain from alcohol. We reviewed obstetrical textbooks published over the last 4 decades to identify trends in recommendations for drinking during pregnancy. The study was begun in 2000 and completed in 2001.

Design: Eighty-one texts were identified from a national listing service (n =51) and local library shelves (n =30).

Results: Only 14 (17%) of the texts contained a consistent recommendation that pregnant women should not drink alcohol. Although there was a slight upward trend toward recommendations for abstinence in more recent texts, only 24% of the 29 texts published after 1990 were in this category. Fifty-three percent of all texts and 52% of texts published after 1990 contained a sentence condoning drinking at some level. The remaining texts (30%) contained no recommendations.

Conclusions: Many texts, even those published recently, have not embraced public health recommendations and, in some instances, contradict them.

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