Answer to a question from a reader

How can I help my pregnant wife to stop drinking alcohol?

The short answer

Your wife may need to join an organisation that helps alcoholics and educates people about the dangers of drinking during pregnancy.

The whole question

Dear Athalie

How can I help my wife who is about to give birth in a week or so but has been going out and drinking alcohol with her family, even though she had promised she would be responsible about consuming alcohol? 

The long answer

I am very sorry to hear this. Consuming alcohol at any stage of pregnancy can lead to the child having Foetal Alcohol Syndrome Disorder (FASD), as the alcohol will go straight to the unborn baby’s bloodstream through the placenta. The effects can be very serious, including brain damage and developmental disabilities, which may at best be managed, but there is no cure.

Very few people with FASD show physical signs, says Aware.Org, but affected children will commonly show the following behaviours: 

  • Delayed development;

  • Hyperactivity;

  • Attention problems;

  • Difficulty in understanding the link between the cause and effect of behaviour;

  • Impulse control challenges which might lead to impulsive behaviour;

  • Interpersonal relationship problems.

It is the leading global cause of preventable birth defects and developmental disabilities and, sadly, South Africa has the highest rate of FASD in the world, with some 3 million or more people estimated to suffer from FASD. The Western Cape has the highest rate in South Africa, due to the fact that wine farmers used to pay their workers in "dop". A 2019 study published in the International Journal of Environmental Research and Public Health that looked at the prevalence of drinking during pregnancy in two rural Western Cape communities found that in one community, up to 74% of pregnant women drank during pregnancy.

But even with these horrific numbers, there is no specific government policy on FASD. It is known to be a problem by various different government departments and the need for education about the dangers of consuming alcohol during pregnancy and helping people with alcohol problems is widely known, but the different government departments are not working collectively as they must do, to be effective.

In an article for Frontiers in Health 2021, the three authors from the University of the Western Cape, Babatope O. Adebiyi, Ferdinand C. Mukumbang and Anna-Marie Beytell, recommend that the departments of Health, Education, Social Development, Labour, Trade and Industry, Justice, and Correctional Services work on FASD collectively to be effective and need to have a multi-sectoral policy. They say that the development of such a multi-sectoral policy must include researchers, service providers, policymakers, as well as people with the condition, and their parents and caregivers. 

They also recommend routine FASD screening of babies who have had confirmed exposure to alcohol in pregnancy, as the earlier a diagnosis is made the more help a child can receive to learn to walk, talk and interact with other children. As FASD is a permanent condition, there needs to be training for teachers in classroom management to cope with affected children.

They also say the following: “We also argue that the South African government should replicate the success recorded in managing HIV and AIDS. A specific policy was developed – based on goals set by the United Nations – that set a target known as 90–90–90. The aim was that by 2020 90% of everyone with HIV must know their status, 90% of those diagnosed with HIV must receive antiretroviral therapy, and 90% of people receiving antiretroviral therapy must be virally suppressed.”

In a 2018 article on fetal alcohol syndrome for the Guardian, a social worker with the Worcester-based NGO, FASfacts, Sudene Jeftha, is quoted as saying, “It’s a development issue. You can’t necessarily see it when the child is born, only later when the child isn’t talking or crawling or walking like other children.”

FASfacts runs awareness courses in at-risk communities and "mentor mother" programmes, which rely on local mothers going door-to-door to speak to pregnant women about drinking. FASfacts was founded in 2002 by Francois Grobbelaar, whose father used to pay his workers in dop. He says that the mentor mothers’ approach has been very successful in convincing a lot of pregnant women not to drink alcohol.

Presently, the organisation in South Africa that has done the most research on FASD, and education and awareness about birth defects and mental disabilities caused by alcohol consumption in pregnancy, is an NGO called the Foundation for Alcohol Related Research (FARR). It has been active since 1997. 

For help, support or more information, you can contact FARR here:


Tel: 021 686 2646

The Western Cape government advises that a person should speak to their healthcare worker at their nearest clinic and ask that their child is assessed if they’re worried that their baby or child may have FASD. They also provide the following organisations’ telephone numbers:

Wishing you the best,

Answered on April 5, 2023, 9:38 a.m.

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