Updated: January 2024

Author: Division of Substance Use Programs, Vermont Department of Health

This indicator, or population measure, is part of our Healthy Vermonters 2030 data set. Read more about how this data helps us understand and improve the well-being of people in Vermont on the Healthy Vermonters 2030 webpage.

Because this data is meant to show how the health of our state changes during the decade from 2020-2030, some indicators may have very few data points for now. Keep checking back to see the progress our public health system and partners are making.

We want to see the percentage of pregnant people who don’t use alcohol during the late stages of pregnancy increase to 91% or higher by 2030.

2020 is the baseline year for Healthy Vermonters 2030 and as we report more data a trend will emerge that can help us monitor progress toward this objective.

Most people do not use alcohol during their pregnancy, but some do. Use of alcohol during pregnancy, especially heavy use, may negatively impact the baby.

Looking for more data?

• Look at previous similar data on percent of pregnant women abstaining from alcohol from our 2020 Scorecards.
• See the corresponding national Healthy People 2030 objective for increasing the percent of people abstaining from alcohol during pregnancy.

Alcohol in a pregnant person’s blood passes to the baby through the umbilical cord. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities.

There is no safe time for alcohol use during pregnancy, and no known safe amount of alcohol use during pregnancy or while trying to get pregnant. Alcohol consumption by a pregnant person can cause problems for the baby throughout pregnancy, including before a person knows they are pregnant.

Any alcohol consumption during pregnancy increases the chance of premature birth, brain damage, problems with growth and development, birth defects, Fetal Alcohol Spectrum Disorders (FASD), low birthweight, miscarriage, or stillbirth. Alcohol consumption or untreated Alcohol Use Disorder (AUD) during pregnancy increases health risks for the pregnant parent as well, impacting major systems like the cardiovascular and nervous systems.

It is never too late to stop alcohol use during pregnancy. Stopping alcohol use will improve both the baby’s and the pregnant person’s health and well-being. Parental substance use is considered an adverse childhood event as well, which can contribute to childhood adversity and trauma even beyond the early years of life.

Learn more about alcohol use and misuse and how to prevent health risks from alcohol use: Alcohol | HealthVermont.Gov

Substance use is still highly stigmatized in our society, particularly for pregnant people. Parents with a substance use disorder report greater odds of incurring stigma when compared to non-parenting individuals with a substance use disorder. SAMHSA reports that children of parents with an alcohol use disorder (AUD) are at greater risk for depression, anxiety disorders, problems with cognitive and verbal skills, and parental abuse or neglect. They are 4 times more likely than children without a parental AUD to develop symptoms of an AUD themselves.

Substance misuse, mental health and intimate partner violence are strongly intertwined with all three subpopulations recognized as experiencing health disparities. This means that people who experience one or more of these are more likely to have worse outcomes related to their health and well-being and that of their children and families.

Poverty and substance misuse also intersect to create health inequities related specifically to perinatal death (perinatal is the time during and just after pregnancy). Poverty is disproportionally correlated with people in Vermont dying in the perinatal period. Of people who died during the perinatal period, 87% had Medicaid as primary insurance at time of their child’s birth and 69% were utilizing WIC. These are programs specifically serving people in Vermont with low incomes.

Vermont’s education level at time of perinatal death is very different from that of the national average. In Vermont, 85% of people dying in the perinatal period have a high school education or less compared with 53.4% nationally.

Parental substance misuse is also recognized as an adverse childhood event and contributes to childhood trauma, contributing to multigenerational adversity.

Racial disparities exist across all these intersecting systems. Across the board, People of Color have higher rates of untreated substance use disorder and child protective services involvement, not to mention perinatal health. Black and LatinX pregnant people are less likely to receive treatment for substance use compared to white women. Nationally, over half of Black children (53%) will experience a child protective services investigation by the time they turn 18.

One way we are trying to be more inclusive in Vermont is to change our language from referring to “pregnant women” and instead use “pregnant people”. This is an important way to ensure that all birthing individuals are included and see themselves in the data.

Understanding whether pregnant people are using alcohol, and which populations may be using it at different rates gives us the information we need to understand and reduce inequity in our public health systems.

The division of Family and Child Health (FCH) has implemented the One More Conversation campaign. This is an effort that focuses on substance misuse in pregnancy and provides materials for providers and pregnant people. Additionally, FCH works in close partnership with the Perinatal Quality Collaborative and the Department for Children and Families to support training for health care providers, improvements in health care delivery, and education and information for families.

The target of 91% for this indicator is based on historical data and is an ambitious, yet achievable goal through collective action in Vermont.

This indicator reports on alcohol use specifically during the last 3 months of pregnancy because that is the question asked in the Pregnancy Risk Assessment Monitoring System survey (PRAMS).

The Pregnancy Risk Assessment Monitoring System (PRAMS) is a survey of people who recently gave birth that asks about their experiences, behaviors, and healthcare utilization before, during and shortly after their pregnancy. People receive the survey two to six months after giving birth. Vermont has participated in PRAMS since 2001.

PRAMS provides data not available from other sources. PRAMS data are used by researchers to investigate emerging issues in the field of reproductive health and by state, territory, and local governments to plan and review programs and policies aimed at reducing health problems among mothers and infants.

There is ongoing data collection for this indicator. PRAMS randomly samples 1 in 4 women that has recently had a live birth every month. Women that delivered low-weight infants are over sampled. Women are surveyed approximately 3 months after delivery, and data collection of an annual cohorts expands from April to March of the following year, (i.e., the last batch of women that delivered in December are sampled in March). Data is completed, weighted, and ready for publication about 6 months after the last cohort is sampled.

View the 2023 PRAMS questionnaire