Treatment experience with pregnant problem drinkers.

Therapy for heavy drinking was integrated with routine prenatal care at Boston City Hospital's women's clinic. Of 49 pregnant problem drinkers who participated in at least three counseling sessions, 33 (67%) reduced alcohol consumption before the third trimester. Therapeutic success was achieved with some of the heaviest drinkers. The desire to have a healthy baby was a powerful motivating force. Supportive counseling focused on reduction of alcohol consumption and potential benefits to the fetus. Guilt-provoking criticism was avoided. Referrals were made when women did not respond within two weeks. Planning of treatment strategies was facilitated by classification into social, symptom, and alcohol-dependence phases. Primary providers who are knowledgeable, interested, and accepting can successfully treat pregnant patients at risk from alcohol. Examinations of two cohorts of newborns have previously demonstrated benefits to offspring when heavy drinking ceased before the third trimester.