Treated like an alcoholic by midwife?

[MyMabel]

Anyone else been in this situation?

Ok our telephone consultation appointment I was asked how much I drink prior to finding out I was pregnant - I said (honestly) I had about one or two gins every night, the occasion glass or two of wine instead. Couldn’t tell them in units as I have no idea.

I was never drunk, never drank until DP was home as we have a toddler DD so wanted to make sure if anything happened one of us can drive, plus I wouldn’t drink while solely responsible for her. - again, never drunk or even dizzy. Just a glass or two while watching telly before bed. I suppose with COVID and all I was just bored?

Anyway, was asked if I drank since finding out- said no, because I haven’t.

Come to my face to face appointment; Midwife explains that due to my alcohol intake before being pregnant I’ve been referred to speak to someone. I was in a bit of shock to ask questions and just said ok. But after I left I felt mortally embarrassed and now a bit worried they think I’ve got a drinking problem?!

Maybe I’m not BU in the sense that they could perhaps help someone who struggled with alcohol by doing this routinely.. but AIBU to think I really don’t need to speak to someone regarding what I drank in the evenings?

Did I really drink THAT much too much? I get it was too much and probably not healthy for my body.. but I don’t think it’s that bad?!

@Supergirl1958. Sorry if I come across as having to be right - that’s not my intention, but from my point of view there are a lot of people on this thread who insist on either not reading my posts properly or misinterpreting what I’m saying. And I think I covered upthread, the fact that it’s not always alcohol that causes liver damage - LFT ‘s can differentiate. That’s not what we’re talking about here. The OP not only posed a question about drinking during pregnancy, but she also asked whether people thought she was drinking too much - she also clearly stated in the first post that she had one or two home measures EVERY night, and then corrected this down thread.

Alcohol consumption is always an emotive subject and I think it’s partly because when there’s a discussion like this, a lot of people recognise their own habits from the information that flows back and forth. And a lot are reluctant to admit it. I do think it’s understandable because people - myself included - enjoy a drink and don’t like to think that what they see as something pleasant to look forward to, as actively harming them. This is where I have the problem, and am possibly coming across as judgemental because having been through this myself and having had it explained to me in clear terms, I attempted to post factual information and got flamed for it. I’m not suggesting even for a moment that anyone who enjoys a couple of drinks at home is an alcoholic, by any stretch of the imagination.

What I am saying is that home measures are not reliable and it’s easy to end up drinking at a level which will start off liver damage, without even realising it. I did it myself - I only ever had a maximum of two drinks, and looking back, it probably wasn’t every night, but it WAS most nights. They were my own measures and I ended up with Steatosis after a relatively short space of time. My GP obviously recognised a pattern and her concern was enough to prompt her to refer me for a scan, which bore out her suspicions. She wasn’t just concerned about the levels of alcohol consumption, she was also concerned about the habit that was forming, and looking back I realise that if the problem hadn’t been recognised at that point, I probably would have carried on oblivious to the harm I was doing. Someone upthread highlighted the difference between looking forward to a treat, and that treat becoming a habit which becomes hard to break, and I think this is the key. There’s a difference between alcohol abuse and alcohol dependence. If you regularly drink even a little too much you are abusing alcohol, and forming a habit which could possibly then lead to alcohol dependence.

I attempted to educate myself after that because it scared me how easy it was to do damage without realising it. I know a bit more about how the liver and the digestive system works, and how alcohol affects blood pressure, and through that I now know how little it takes to put the liver in mild distress. Your metabolism, your weight, your diet, whether you’re male or female and whether or not you take drugs - particularly opiates - all affect how alcohol is metabolised. But however loud people shout and protest, it remains a fact that there is no safe level of alcohol intake and the recommendations are only based on minimising the damage caused by alcohol. It also remains a fact that one or two drinks a day can and does cause liver damage - reversible in the early stages, but that one or two drinks over a long period of time, has a cumulative effect. It’s also not a good idea to drink every day because it doesn’t allow your liver time to recover before you throw the next lot at it - and the mild distress becomes worse over time. People tend to forget that the liver is part of your digestion system, so it’s busy with other things too.

I’m also not saying that no-one should drink. I drink myself, but knowing what I know now, I’m much more careful. And in the end it’s down to personal choice, but to my mind, loading all the blame onto the NHS for being careful, using language like ‘policing of womens bodies’ and calling the approach a waste of money is at the very least unhelpful and attempts to detract from the issues that make people uncomfortable. I think the midwife, like all NHS professionals, has a responsibility for the well-being of her patient and she took appropriate action based on the information given by the OP - which, if you read the original post - WAS that she drank every day.

There are some really excellent posts on this thread, but to some I would say that just because you want something to be a certain way, doesn’t make it so, and you are posting incorrect and misleading information.

@Qwerty789 * Drinking does not affect breastfeeding unless you're drinking so much you'll drop the baby while doing it.
Midwife was wrong and so are you*

Breast milk is affected by alcohol. One study found that babies who had alcohol via breast milk slept for 25% less time than those who didn't. Alcohol also disrupts the hormone that controls the let-down of breast milk. Babies take around 20% less milk in the three to four hours after alcohol is consumed, and compensate by feeding more often. The levels transferred to breast milk from even moderate to low drinking may lead to drowsiness and deep sleep. Weakness and decreased linear growth in the infant are reported with higher levels of alcohol consumption while breast feeding.

@pam290358

You can't argue with ignorance.

Here's a gem from qwerty earlier.

"anyone who knows anything at all knows I am correct"

@NotMyselfWithoutCoffee. I said in a post upthread that I was done with this discussion. Re-read some of the posts earlier this morning and came to the same conclusion as you. I decided to post again to try to clarify my experience because when I re-read the thread it’s clear that some people are hell bent on misreading or misinterpreting sound information and end up posting crap in reply. The tone of the whole thread is bad tempered and accusatory, when in fact it could have been a useful discussion about something that’s a growing problem in the UK, and in no small part due to the pandemic.

Cripes, a lot of drama on this thread. You just will have exceeded the arbitury threshold they have, but you can say no the referral without consequence- just say no and move on. Its a service they offer as some will benefit from it.

Personally I think drinking every day is excessive because it suggests the person takes some sort of comfort from it or has formed a habit; but that doesn't mean being an alcoholic or whatever. But you've stopped anyway so why does it matter.

"An alcoholic is someone who has an addiction, addiction is not knowing when to stop!" You have!

You don't like to be challenged, you just want to be right. I'm being directive because I don't agree with your statement. You're very clear with what you say. The fact the MW has seen an unusual pattern means an intervention can happen! If it's not a problem fine but what if it is, now she can get the right support.

@Beline4u

"An alcoholic is someone who has an addiction, addiction is not knowing when to stop!" You have!

You don't like to be challenged, you just want to be right. I'm being directive because I don't agree with your statement. You're very clear with what you say. The fact the MW has seen an unusual pattern means an intervention can happen! If it's not a problem fine but what if it is, now she can get the right support.

You’ve not even referenced it right! And now I understand your username!

I have identified alcoholism as an addiction...I have never once said that addicts know when to stop which is what you continually imply I do! I suggest you go back through my posts and read them correctly!

Be as directive as you like, again, if you go back through my posts I am quite willing to debate it, just because people have different opinions on the subject though does not mean one or the other is right...or wrong!

I don’t think the OP or any discussion around it has warranted a discussion on alcoholism...at all! I eat crisps whilst I watch tv...am I a crispoholic?? No, I am not!

I think it’s quite clear we aren’t going to agree Beline...so stop making one for me and let’s leave it the hey?

@Supergirl. I agree with you here, but I do think the discussion around alcoholism was warranted given that the OP said she felt as thought she was being treated as one - in fact she was not. She was being treated as someone who was engaging in alcohol abuse which may have formed a habit leading to alcohol dependence. I think this was the whole reason for the referral - not just the amount of alcohol, but the fact that it was on a regular basis. Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you, but this is a grey area because even mild abuse of alcohol can be harmful without being an addiction.

They automatically have to refer someone who admits to drinking every day particularly as home measures are well known to be more than pub measures. Some people can be quite generous with the measures at times!

It's an automatic thing which the system will have picked up right away. Similar would have happened if it had been someone who smoked or someone who had smoked a lot and the midwife felt they might struggle with not smoking during pregnancy.

An awful lot of people tend to minimise how much they drink as well. I don't drink at all and I get numerous suspicious looks when I answer that question!

It will be box ticking and obviously it has to be done as she can't be seen to not be offering support in case you happen to go back to drinking every night at home once baby is here.

I do agree that a lot are thinking of their own drinking habits throughout this thread which is natural to do.

It's looking out for baby and mum as well but obviously more so for baby. They have to do it to protect themselves also.

[quote pam290358]@Supergirl. I agree with you here, but I do think the discussion around alcoholism was warranted given that the OP said she felt as thought she was being treated as one - in fact she was not. She was being treated as someone who was engaging in alcohol abuse which may have formed a habit leading to alcohol dependence. I think this was the whole reason for the referral - not just the amount of alcohol, but the fact that it was on a regular basis. Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you, but this is a grey area because even mild abuse of alcohol can be harmful without being an addiction.[/quote]
Absolutely.
If someone is using alcohol as a crutch, for example they need it after a tough day/ they need it to relax and they would struggle to find other ways to cope with those stresses, or they simply need the thought of a drink to at the end of the day to get them through, this is an indication that they have developed a dependency on it. This is not alcoholism in itself but it’s certainly on the same track.

I’m not sure what good shying away from this does.

@AllTheUsernamesAreAlreadyTaken. Don’t think it does any good at all in the long run. There are so many levels of ignorance surrounding alcohol use and abuse on this thread I don’t know where to start, and so many people who come across as angry and aggressive - it’s hard not to come to the conclusion that it’s because their own drinking habits are being called into question. The fact that a relatively small amount of alcohol consumed on a regular basis can form a habit and end up damaging your health seems to be a concept that some people either can’t or don’t want to accept. I find interesting that breast cancer hasn’t been mentioned. There is a proven link between even small amounts of alcohol and breast cancer - as little as 10 grams of alcohol is enough to raise estrogen levels and increase the risk, and yet the NHS is being castigated for being OTT and out to police womens’ bodies. Such hypocrisy.

I find it weird that people assume that daily drinking even small amounts means someone is dependent on alcohol . It's not necessarily any different from having a bar of chocolate and automatically referring someone just because the alcohol is drunk each day regardless of whether the weekly amount is relatively low is a waste of NHS resources. I don't drink that much myself but my parents would always have one drink when they got home from work everyday and still have a drink each evening. They are certainly not dependent (have no problem stopping if on a diet) but even if they were I don't see that it matters given the overall amount they drink is low and not harmful to them. They are both in their 80s now and in good health for their age.

[quote pam290358]@AllTheUsernamesAreAlreadyTaken. Don’t think it does any good at all in the long run. There are so many levels of ignorance surrounding alcohol use and abuse on this thread I don’t know where to start, and so many people who come across as angry and aggressive - it’s hard not to come to the conclusion that it’s because their own drinking habits are being called into question. The fact that a relatively small amount of alcohol consumed on a regular basis can form a habit and end up damaging your health seems to be a concept that some people either can’t or don’t want to accept. I find interesting that breast cancer hasn’t been mentioned. There is a proven link between even small amounts of alcohol and breast cancer - as little as 10 grams of alcohol is enough to raise estrogen levels and increase the risk, and yet the NHS is being castigated for being OTT and out to police womens’ bodies. Such hypocrisy.[/quote]
So you think that there is proof that only 10g increases the risk of cancer? Love the fact that you assume women in the studies of breast cancer are totally honest/accurate about their alcohol intake when you have been insisting others underestimate it.

You don’t have to be pissed to be alcohol dependent… sounds to me like you have an issue if you drink every day like that

@Belladonna12. I don’t think anyone has actually said that daily drinking of small amounts in itself means you’re dependant on alcohol. What IS being said is that even small amounts of alcohol can damage your liver if drunk on a regular basis, and that regular drinking of small amounts can be habit forming and can lead to problems later on. Why do you find that weird ? The assertion that you know people who drink ‘low’ amounts which are not harmful, has no scientific basis - everyone is different, no amount of alcohol is ‘safe’ and you can’t tell how much damage the consumption is doing to someone without testing because the damage can build up over time without symptoms - some people, are not aware of the damage until it shows up during testing for other things. Much of the discussion has been around the fact that home measures are frequently larger than pub measures, which means that it’s not just a small amount - it can actually take you over the recommended level without you even realising it. The NHS has been criticised for treating the OP as an alcoholic. That’s not what was happening - the OP admitted to a level of drinking that was technically abuse, which could possibly form a habit which could possibly then lead to dependence. And this is the point. One poster put forward the argument that it was a waste of NHS resources because an alcoholic couldn’t be helped unless they wanted to be. We’re not talking about alcoholics - we’re talking about people who are possibly not aware that they are drinking at an unsafe level, and who may actually want to do something about it before the problem gets out of control. How is that a waste of NHS resources when to allow such problems to progress unchecked will cost the NHS vastly more ?

Sorry, just seen your post about breast cancer. I haven’t been insisting that others underestimate the amount of alcohol deliberately - my point is that it’s easy to misjudge, I wasn’t accusing anyone of lying. As for your point about the amount of alcohol relevant to increased risk of breast cancer - I have an interest in the studies because my mum has had it twice and none of the studies I’ve seen on the link between the disease and alcohol consumption have relied solely on anecdotal evidence from women. The data from various sources are pooled and the conclusions are reached scientifically. I’m definitely done with this thread now - continually repeating myself because people either can’t be arsed or don’t have the mental capacity to read the posts properly and then post crap in response.

I don’t think anyone has actually said that daily drinking of small amounts in itself means you’re dependant on alcohol.

A few people on this thread and certainly on other threads have said that those who drink daily are dependent on alcohol.

What IS being said is that even small amounts of alcohol can damage your liver if drunk on a regular basis, and that regular drinking of small amounts can be habit forming and can lead to problems later on.

No, there is no strong evidence that small amounts of alcohol will damage the liver if drunk on regular basis. It is very hard to know how much alcohol people with liver damage have had as they are llikely to underreport and some people will be much more susceptible to damage than others.

The assertion that you know people who drink ‘low’ amounts which are not harmful, has no scientific basis

As I was talking about my parents who are in their 80s I am pretty sure that one small alcoholic drink each day has not been harmful to them and I doubt they are an exception.

Much of the discussion has been around the fact that home measures are frequently larger than pub measures, which means that it’s not just a small amount - it can actually take you over the recommended level without you even realising it.

You may have poured yourself large drinks but and not realised what you were doing but why do you keep on insisting that everyone else does the same thing. I am quite capable of measuring liquids and do so if making a drink for someone and I'm sure other people do the same thing.

The NHS has been criticised for treating the OP as an alcoholic. That’s not what was happening - the OP admitted to a level of drinking that was technically abuse, which could possibly form a habit which could possibly then lead to dependence. And this is the point.

OP didn't admit to drinking an amount that was technically abuse. She said that she had one or two drinks gins each evening and the midwife made the assumption that it was always two and always large as you have done.

We’re not talking about alcoholics - we’re talking about people who are possibly not aware that they are drinking at an unsafe level, and who may actually want to do something about it before the problem gets out of control. How is that a waste of NHS resources when to allow such problems to progress unchecked will cost the NHS vastly more ?

How is it a good use of NHS resources to make a referral for someone so that it can be pointed out that they may be drinking more the the recommended units? Firstly the midwife hasn't actually ascertained that OP is drinking too much (see above) and secondly if it was just to make the point, the midwife could have done it herself. Refering someone without their permission is not a good way to change peoples drinking habits.

Like I said, not engaging any more. Everything I’ve said about the effects and risks of low level drinking was as a result of information given to me by health professionals and from my own experience - the rest is easily verified by googling. Pick it to bits all you want - just because you don’t like it doesn’t make it any less true. Done now.

The assertion that you know people who drink ‘low’ amounts which are not harmful, has no scientific basis

There is LOADS of scientific basis for very healthy drinkers. Tonnes of research on the meditteranean centenerians who drink red wine every single day.
Teetotallars are statistically far less healthy and live shorter lives than moderate drinkers, this is proven.

@Qwerty789

The assertion that you know people who drink ‘low’ amounts which are not harmful, has no scientific basis

There is LOADS of scientific basis for very healthy drinkers. Tonnes of research on the meditteranean centenerians who drink red wine every single day.
Teetotallars are statistically far less healthy and live shorter lives than moderate drinkers, this is proven.

The Mediterranean way of drinking “healthily” is to drink wine or beer with a meal. It’s clearly stipulated that it is included as part of the meal so that your body absorbs it better. Mediterranean drinking doesn’t simply mean drinking small amounts every day and it’s definitely not about having a gin at the end of the day to relax.

They’re probably assuming home measures are heftier than pub, and also that people declare fewer drinks than they actually drink, in which case you could be well over 14 units. Obviously you may make weak drinks and be telling the absolute truth, in which you’d be okay!

@Qwerty789. Wrong again. Even low amounts of alcohol have been proven to be harmful if drunk regularly and without a break. And current medical evidence points to there being no ‘safe’ level of alcohol intake, which has been stated numerous times on this thread - the number of recommended units has steadily reduced over time in line with research.

I was simply stating that you can’t know what damage alcohol is doing simply by looking at someone, and that home measures are likely to be more generous than those in pubs unless you’re using a measure. There’s a perfect example of this upthread. A poster stated she had bought a measure and can now drink three 100ml glasses of wine instead of 2 pub glasses. Pubs use three sizes - 125ml, 175ml, and 250ml, so the maths is wrong - 300ml of 12% wine is 3.2 units and the average ABV for wine is anywhere between 11.5 and 13.5% and so can be slightly less or slightly more in units. If you’re drinking three glasses in one sitting and applying this as a general rule you can see how it would be very easy to exceed the recommendations even if you only drink 3-4 times a week.

I don’t know where you’re getting the statistics from for your posts, but they’re not consistent with anything I’ve found - and I’ve done a lot of research into this because what happened to me scared me, so I wanted to make sure it didn’t happen again.

Whether you like it or not, and whether you agree with it or not, the recommended units per week is 14. This doesn’t mean that you can safely drink this amount - it’s an indicator for keeping alcohol related damage to a minimum. These figures are not pulled out of the air, they’re based on scientific fact. Women absorb alcohol more easily than men because of their physiology and the onset of liver damage occurs more easily - and among other things it affects things like breast feeding and risk of various cancers. It’s not racist, it’s not sexist, it’s not ‘policing’ womens’ bodies, it’s biology. No one is saying that small amounts of alcohol will necessarily cause damage, and no one is saying don’t drink. It’s about balance and being mindful that the damage alcohol does is largely silent and takes time to get to a point where it causes symptoms - at which point it’s harder to deal with. So for that reason, rightly or wrongly, I’m in favour of the NHS approach because I now know from personal experience that prevention is better than cure, and for prevention you have to accept the facts and stay within the limits. That’s all. Personal choice.

@Qwerty789. Wrong again. Even low amounts of alcohol have been proven to be harmful if drunk regularly and without a break

Nope. Not true. It's propaganda. That's not what the science shows.

@Qwerty789. Would you like to back that up with sources ? I hardly drank before my husband died. My drinking increased to what my GP described as a low to moderate level, for just a few months. It did damage to my liver - thankfully reversible, but still damage. Again, not saying this would happen in all cases, because various factors are at play, but to describe the risks as ‘propaganda’ doesn’t make any sense. All of this stuff is easily googled. Do you think it’s all propaganda ? If so I think you’re deluding yourself. Or are you a troll ?