Alcohol and Pregnancy

"Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who was exposed to alcohol before birth. FASDs have lifelong effects, including problems with behavior and learning as well as physical problems. FASDs are preventable if a developing baby is not exposed to alcohol.

There are resources available to help prevent alcohol use during pregnancy and provide care for children with FASDs and their families.

 In a 2022 Morbidity and Mortality Weekly Report (MMWR), CDC researchers found that nearly 1 in 7 pregnant people reported current drinking* and about 1 in 20 reported binge drinking** during the past 30 days. Pregnant people who experienced frequent mental distress (14 or more days of poor mental health in the past 30 days) and those who did not have a usual healthcare provider were more likely to report .

In a 2023 Morbidity and Mortality Weekly Report (MMWR), CDC researchers found that 80% of people who were pregnant were asked about alcohol use; however, only 16% of those who self-reported drinking within the past 30 days were advised to quit or reduce their use. These findings highlight missed opportunities to integrate alcohol screening and brief intervention (SBI) in practice, utilize strategies to address recognized barriers (e.g., improving reimbursement for alcohol SBI), and to help reduce alcohol use during pregnancy.

What Can Be Done?

Tools for Healthcare Providers

CDC and its partners have resources to help prevent alcohol use during pregnancy and provide care for children with FASDs and their families.

Tools are located here for healthcare providers working in

• family medicine,
• medical assisting,
• nursing,
• obstetrics and gynecology,
• pediatrics, and
• social work.."
  Alcohol and Pregnancy 

COVID-19 Vaccines While Pregnant or Breastfeeding

"What You Need to Know

• COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
• Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. These data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.
• There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

Pregnant and Recently Pregnant People Are at Increased Risk for Severe Illness from COVID-19

Although the overall risk of severe illness is low, pregnant and recently pregnant people are at an increased risk for severe illness from COVID-19 when compared with non-pregnant people. Severe illness includes illness that requires hospitalization, intensive care, need for a ventilator or special equipment to breathe, or illness that results in death. Additionally, pregnant people with COVID-19 are at increased risk of preterm birth and might be at increased risk of other adverse pregnancy outcomes, compared with pregnant women without COVID-19.

Data about the Safety and Effectiveness of COVID-19 Vaccination during Pregnancy

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy, although limited, has been growing. These data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.

• No safety concerns were found in animal studies: Studies in animals receiving a Moderna, Pfizer-BioNTech, or Johnson & Johnson (J&J)/Janssen COVID-19 vaccine before or during pregnancy found no safety concerns in pregnant animals or their babies.
• No adverse pregnancy-related outcomes occurred in previous clinical trials that used the same vaccine platform as the J&J/Janssen COVID-19 vaccine: Vaccines that use the same viral vector have been given to pregnant people in all trimesters of pregnancy, including in a large-scale Ebola vaccination trial. No adverse pregnancy-related outcomes, including adverse outcomes affecting the baby, were associated with vaccination in these trials. Learn more about how viral vector vaccines work.
• COVID-19 vaccines do not cause infection, including in pregnant people or their babies: None of the COVID-19 vaccines contain the live virus that causes COVID-19 so a COVID-19 vaccine cannot make anyone sick with COVID-19, including pregnant people or their babies.
• Early data on the safety of receiving an mRNA COVID-19 vaccine (Moderna or Pfizer-BioNTech) during pregnancy are reassuring:
  • CDC released the first U.S. data on the safety of receiving an mRNA COVID-19 vaccine during pregnancy. The report analyzed data from three safety monitoring systems in place to gather information about COVID-19 vaccination during pregnancy. These early data did not find any safety concerns for pregnant people who were vaccinated or their babies.¹
  • Another report looked at pregnant people enrolled in the v-safe pregnancy registry who were vaccinated before 20 weeks of pregnancy. Scientists did not find an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine during pregnancy.²
  • Many pregnancies reported in these safety monitoring systems are ongoing. CDC will continue to follow people vaccinated during all trimesters of pregnancy to better understand effects on pregnancy and babies.
• Early data suggest receiving an mRNA COVID-19 vaccine during pregnancy reduces the risk for infection: A recent study from Israel compared pregnant people who received an mRNA COVID-19 vaccine with those who did not. Scientists found that vaccination lowered the risk of infection from the virus that causes COVID-19.³
• Vaccination of pregnant people builds antibodies that might protect their baby: When pregnant people receive an mRNA COVID-19 vaccine during pregnancy, their bodies build antibodies against COVID-19, similar to non-pregnant people. Antibodies made after a pregnant person received an mRNA COVID-19 vaccine were found in umbilical cord blood. This means COVID-19 vaccination during pregnancy might help protect babies against COVID-19. More data are needed to determine how these antibodies, similar to those produced with other vaccines, may provide protection to the baby.⁴

Additional clinical trials that study the safety of COVID-19 vaccines and how well they work in pregnant people are underway or planned. Vaccine manufacturers are also collecting and reviewing data from people in the completed clinical trials who received a vaccine and became pregnant..."
COVID-19 and pregnancy 

Type 1 Diabetes and Pregnancy

"If you have type 1 diabetes and you’re thinking about having a baby, planning before you become pregnant is important. Learn how you can stay healthy and help prevent health problems for you and your baby before, during, and after pregnancy.

Deciding to start a family is an exciting time! It can also be overwhelming. It’s natural to have questions about how to keep yourself and your baby healthy during pregnancy, especially if you have type 1 diabetes.

Women with type 1 diabetes can have a healthy pregnancy. Having a plan to manage your diabetes before, during, and after your pregnancy will help keep you and your baby healthy.

Before You Get Pregnant

Use this planning checklist pdf icon[PDF – 887KB] to learn how you can boost your health and get ready for pregnancy. Being in good overall health before you become pregnant is important.

Manage your blood sugar. Many doctors will recommend that you reach and keep your A1C goal for a few months before becoming pregnant.

Review your medicines. Some medicines and supplements aren’t safe to use while pregnant. You should speak with your health care team about each medicine and supplement you take before you get pregnant. Don’t stop taking prescribed medicines without talking to your doctor first.

View this guide to planning a pregnancyexternal icon with type 1 diabetes for more info.

Your insulin needs may change throughout your pregnancy. Be sure to talk to your doctor about how to manage your blood sugar.

During Your Pregnancy

As soon as you find out that you’re pregnant, work with your medical team to manage your blood sugar and head off complications.

During your pregnancy, you and your doctors will adjust your diabetes management plan, so it’s important that you trust your team and feel free to reach out to them. If you don’t have these health care specialists as part of your diabetes care team already, consider looking for:

• An endocrinologist (a doctor who treats hormone conditions, including diabetes). You may want to find one who specializes in caring for pregnant women with diabetes.
• An obstetrician (a doctor who treats pregnant women). Your pregnancy may be considered high risk because of your diabetes. If that’s the case, you may want to find an obstetrician who takes care of women with high-risk pregnancies.
• A diabetes educator who can help you manage your diabetes during pregnancy.

Here are a few things to keep in mind:

Keep your A1C levels on target. Blood sugar levels that stay high during pregnancy may cause your baby to grow too large (macrosomia) or harm the early development of organs and lead to birth defects.

Know your risks. Women who have type 1 diabetes can have a safe pregnancy and a healthy baby, but it’s important to monitor diabetes complications that could worsen throughout pregnancy, such as high blood pressure, vision loss, and kidney disease. Other risks include:

• Preecalampsia – high blood pressure that can damage the liver and kidneys.
• Insulin resistance – when insulin is less effective at lowering your blood sugar.
• Miscarriage.
• Macrosomia – a larger-than-average baby. This can lead to a more difficult delivery.
• Birth defects that may affect your baby’s heart, brain, spine, kidneys, digestive system, limbs, and mouth.

Read more about possible risks during pregnancy.

Be aware of changing insulin needs. Your insulin needs may change throughout your pregnancy. Low blood sugar is common in women with type 1 diabetes. Check with your health care team about how much insulin you need and how often you need it..."
Diabetes and pregnancy 

Get the Whooping Cough Vaccine During Each Pregnancy

"Only you can give your baby protection against whooping cough (pertussis) before your little one is even born. Talk to your doctor or midwife about getting the whooping cough vaccine (called Tdap) during your third trimester.

Whooping cough is a serious disease that can be deadly for babies. Unfortunately, babies do not start building their own protection against whooping cough until they get vaccinated at two months old. This leaves babies unprotected in the first months of life when they are at highest risk of getting very sick if they get whooping cough.

Protect your baby before she is able to get vaccinated by getting a Tdap vaccine during the third trimester of your pregnancy. By doing so, you pass high levels of antibodies to your baby before birth. These antibodies help protect your baby against whooping cough in those first months of life.

CDC recommends all women receive a Tdap vaccine during the 27th through 36th week of each pregnancy, preferably during the earlier part of this time period. The following medical associations dedicated to the health of pregnant women or children support this recommendation:

• American College of Obstetricians and Gynecologistsexternal icon
• American College of Nurse-Midwivespdf iconexternal icon
• American Academy of Pediatricspdf iconexternal icon
• American Academy of Family Physicians,,"external icon
  Whooping cough and pregnancy 

Online Trainings on Alcohol-Free Pregnancy

"Fetal alcohol spectrum disorders (FASDs) are physical, behavioral, and intellectual disabilities that last a lifetime. FASDs are preventable if a developing baby is not exposed to alcohol. Educating healthcare professionals about FASDs can offer knowledge and skills to improve the delivery of care related to FASDs and their prevention.

Providers: Take free online trainings to learn about alcohol-free pregnancy!

The Centers for Disease Control and Prevention (CDC) and the Collaborative for Alcohol-Free Pregnancy announce the availability of free online courses for healthcare professionals on the prevention, identification, and management of FASDs.

Training Courses

• FASD Primer for Healthcare Professionals*
• Preventing Alcohol-Exposed Pregnancies*
• Diagnostic Overview of FASDs: Recognition and Referral*
• Implementing Alcohol Screening and Brief Intervention in Clinical Practice*
• Interprofessional Collaborative Practice as a Model for Prevention of Alcohol-Exposed Pregnancies*

Brief Supplemental Learnings

• How to Begin a Conversation about Alcohol Use
• Making a Referral for an FASD Assessment: How to Talk with Families.."
  Alcohol-free pregnancy

Healthy Pregnancy

"Learn what you can do before and during pregnancy to improve your chances of having a healthy baby.

What steps can I take to have the healthiest pregnancy possible?

• Be sure to take 400 micrograms (mcg) of folic acid every day.
  • Folic acid is important because it can help prevent some major birth defects of the baby’s brain and spine. These birth defects develop very early during pregnancy when the neural tube—which forms the early brain and spinal cord—does not close properly. Start taking folic acid at least one month before becoming pregnant and continue during pregnancy.
• Book a visit with your healthcare provider before stopping or starting any medicine.
  • Many women need to take medicine to treat a health condition during pregnancy. If you are planning to become pregnant, discuss your current medicines with a healthcare provider, such as a doctor or pharmacist. Creating a treatment plan for your health condition before you are pregnant can help keep you and your developing baby healthy.
• 
  
  Become up-to-date with all vaccinations, including the flu shot.
  • Vaccines help protect you and your developing baby against serious diseases. Get a flu shot and whooping cough vaccination (called Tdap) during eachpregnancy to help protect yourself and your baby.
  • Flu: You can get the flu shot before or during each pregnancy.
  • Whooping Cough: You can get the whooping cough vaccine in the last three months of each pregnancy..."
    Pregnancy

Pregnancy and Stroke: Are You At Risk?

"Stroke can happen to anyone at any time, even new moms. Learn more about the connection between pregnancy and stroke and what you can do to keep yourself and your baby healthy.

When Brooke Bergfeld developed an extreme headache about a week after giving birth, she assumed it was just another migraine, as she’d had during her pregnancy. When her left arm suddenly hurt, she figured it was due to muscle aches from carrying around a new baby.

But her mom noticed Brooke’s slurred voice and drooping face—two classic signs of stroke—and called 9-1-1 right away. At the hospital, doctors performed a thrombectomy, a surgery to remove a blood clot. Today, Brooke is still dealing with how the stroke changed her life and is working to educate others about stroke..."
Pregnancy and stroke

New Online Trainings on Alcohol-Free Pregnancy

"Fetal alcohol spectrum disorders (FASDs) are physical, behavioral, and intellectual disabilities that last a lifetime. They are completely preventable if a developing baby is not exposed to alcohol. Educating healthcare professionals about FASDs can offer knowledge and skills to improve the delivery of care related to FASDs and their prevention. Providers: Take free online trainings to learn about alcohol-free pregnancy!

The Centers for Disease Control and Prevention (CDC) and the Collaborative for Alcohol-Free Pregnancy announce the availability of free online courses for healthcare professionals on the prevention, identification, and management of FASDs.

Training Courses

Courses currently available are

• FASD Primer for Healthcare Professionals
• Preventing Alcohol-Exposed Pregnancies
• Diagnostic Overview of FASDs: Recognition and Referral
• Implementing Alcohol Screening and Brief Intervention in Clinical Practice.."
  Alcohol and pregnancy

Cigarette Smoking During Pregnancy: United States, 2016

"Key Findings:

• In 2016, 7.2% of women who gave birth smoked cigarettes during pregnancy.
• Prevalence of smoking during pregnancy was highest for women aged 20–24 (10.7%), followed by women aged 15–19 (8.5%) and 25–29 (8.2%).
• Non-Hispanic American Indian or Alaska Native women had the highest prevalence of smoking during pregnancy (16.7%); non-Hispanic Asian women had the lowest (0.6%).
• The prevalence of smoking during pregnancy was highest among women with a completed high school education (12.2%), and second-highest among women with less than a high school education (11.7%).

Maternal tobacco use during pregnancy has been linked to a host of negative infant and child outcomes, including low birthweight, preterm birth, and various birth defects (1–5). The 2003 revision of the U.S. Standard Certificate of Live Birth included new and modified items on maternal cigarette smoking before and during pregnancy. The 2016 natality data file is the first for which this information is available for all states and the District of Columbia (D.C.). This report presents the prevalence of cigarette smoking at any time during pregnancy among women who gave birth in 2016 in the United States by state of residence as well as maternal race and Hispanic origin, age, and educational attainment.."
Cigarette smoking and pregnancy

Pregnant? Get Tdap in Your Third Trimester

"Only you can give your baby protection against whooping cough before your little one is even born. Talk to your doctor or midwife about getting the whooping cough vaccine (called Tdap) during your third trimester.

Whooping cough is a serious disease that can be deadly for babies. Unfortunately, babies can’t get vaccinated and start building protection against whooping cough until they are two months old. Avoid this gap in protection by getting the whooping cough vaccine during the third trimester of your pregnancy. By doing so, you pass antibodies to your baby before birth. These antibodies help protect your baby in the first few months of life..."
Pregnancy & Whooping cough

Pregnant? Get vaccinated

"Learn about the vaccines you need before and during your pregnancy to help protect yourself and your newest family member from serious diseases.

Vaccines are an important part of planning and having a healthy pregnancy. If you are planning to get pregnant, check with your doctor to make sure you are up-to-date on your vaccines. If you are pregnant now, CDC, the American Academy of Pediatrics, the American College of Nurse midwives and many other professional medical groups recommend you get two vaccines during your pregnancy:

• Tdap to help protect against whooping cough (pertussis)
• A flu shot to help protect against influenza (flu)..."

Pregnancy and vaccination

Protect Your Baby from Group B Strep!

"All pregnant women should get a group B strep test when they are 35–37 weeks pregnant. Babies can get very sick and even die if their mothers pass group B strep bacteria to them during childbirth.

If you are pregnant, talk with your doctor or midwife about getting a group B strep (GBS) test. CDC recommends getting it when you are 35–37 weeks pregnant. The test shows if you are carrying group B streptococcal bacteria, which you can pass to your baby during childbirth. If you carry this bacteria, you need an antibiotic during labor to keep your baby from getting sick..."

Group B Strep

Medication Use During Pregnancy

"The safety of most medications taken by pregnant women is unknown and dependent on many factors. Talk with your doctor if you are pregnant or planning a pregnancy.

Talk with your doctor if you are pregnant and you have taken any medication or are thinking of taking any medication. This includes prescription and over-the-counter medications, as well as dietary or herbal products. Pregnant women should not stop or start taking any type of medication that they need without first talking with a doctor. Women who are planning to become pregnant should discuss the need for any medication with their doctor before becoming pregnant and ensure they are taking only medications that are necessary..."
Pregnancy and medication

Pregnant? Get vaccinated.

"Learn about the vaccines you will need before and during your pregnancy to help protect yourself and your newest family member from serious diseases.

Vaccines are an important part of planning and having a healthy pregnancy. If you are planning a pregnancy, check with your doctor to make sure you are up-to-date on your vaccines. If you are currently pregnant, doctors and midwives recommend you receive 2 vaccines during your pregnancy:

• Tdap to help protect against whooping cough, and
• The flu shot to help protect against influenza..."

Pregnancy and vaccination

EEOC Issues Updated Pregnancy Discrimination Guidance

"The U.S. Equal Employment Opportunity Commission (EEOC) today issued an update of its Enforcement Guidance on Pregnancy Discrimination and Related Issues (Guidance), along with a question and answer document and a fact sheet for small businesses.  All are available on the EEOC's website at http://www.eeoc.gov/laws/guidance/enforcement_guidance.cfm.

The updates to the Guidance are limited to several pages about the U.S. Supreme Court's recent decision in Young v. UPS, issued in March 2015. The updated Guidance reflects the Supreme Court's conclusion that women may be able to prove unlawful pregnancy discrimination if the employer accommodated some workers but refused to accommodate pregnant women. The Court explained that employer policies that are not intended to discriminate on the basis of pregnancy may still violate the Pregnancy Discrimination Act (PDA) if the policy imposes significant burdens on pregnant employees without a sufficiently strong justification..."

Pregnancy discrimination

Avoid Harmful Substances

"In honor of National Birth Defects Prevention Month, make a PACT to get healthy, physically and mentally, before and during pregnancy to increase your chances of having a healthy baby. Avoiding harmful home and workplace exposures is one important step.
Women can lower their risk of having a baby born with a birth defect by following some basic health guidelines throughout their reproductive years. This is important because many birth defects happen very early during pregnancy, sometimes before a woman even knows that she is pregnant. For this year's National Birth Defects Prevention Month, we encourage all women and their loved ones to make a PACT for prevention..."
Pregnancy and Eating

Diabetes and Pregnancy

"Diabetes can affect women during their childbearing years. Diabetes is a disease in which blood glucose (blood sugar) levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should."
Diabetes and pregnancy

Pregnant? Get a Flu Shot!

"If you're pregnant, a flu shot is your best protection against serious illness from the flu.
Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart and lungs during pregnancy make pregnant women more prone to severe illness from flu, which can lead to hospitalization or even death.."Pregnancy and Flu

Prepregnancy Contraceptive Use Among Teens with Unintended Pregnancies Resulting in Live Birth

"Approximately 400,000 teens aged 15–19 years give birth every year in the United States (1), and the teen birth rate remains the highest in the developed world (2). Teen childbearing is a public health concern because teen mothers are more likely to experience negative social outcomes, including school dropout (3). In addition, infants of teen mothers are more likely to be low birth weight and have lower academic achievement, and daughters of teen mothers are more likely to become teen mothers themselves(4–6)..."

Diabetes & Pregnancy

"...How can diabetes affect my health?
Controlling blood sugar is hard, especially during pregnancy, but it is important work at it. When blood sugar is high most of the time in a woman with diabetes, she might have certain health problems.

A woman with gestational diabetes whose blood sugar stays high has an increased chance of:

Preeclampsia (high blood pressure, protein in urine, increased swelling)
Preterm birth (baby born before 37 weeks)
C-section.."