To provide women with the information they need to know about alcohol consumption during pregnancy it is important to know how much a woman is drinking and how this has changed since she found out that she is pregnant. This assessment of alcohol consumption, combined with education and support, can assist women to stop or reduce alcohol use in pregnancy and prevent adverse consequences from alcohol consumption such as Fetal Alcohol Spectrum Disorder.1
One way to assess a woman’s alcohol consumption is by using the AUDIT-C (Alcohol Use Disorders Identification Test – Consumption). This tool has three short questions that estimate alcohol consumption in a standard, meaningful and in non-judgemental manner. The total score from these questions provides an indication of the risks to the woman’s health and can be used to guide conversations about alcohol and pregnancy. However it is safest for pregnant women not to consume any alcohol during pregnancy.
The AUDIT-C is a shortened version of the 10-item AUDIT tool, first developed by the World Health Organization in 1989. AUDIT-C has been validated for used with pregnant women2 and is recommended for use by an Australian study that examined what questions should be asked about alcohol consumption and pregnancy.3
The three AUDIT-C questions that measure the amount and frequency of a person’s drinking are included below. Add the scores for each question to get a total score and match the score to the risk of harm overleaf.
|How often do you have a drink containing alcohol?|
Monthly or less
2 – 4 times per month
2 – 3 times per week
4+ times per week
|How many standard drinks of alcohol do you drink on a typical day when you are drinking?|
1 – 2
3 – 4
5 – 6
7 – 9
|How often do you have 5 or more drinks on one occasion?|
Less than monthly
Daily or almost daily
Australian standard drinks
Standard drinks are a measure of alcohol consumption and are used in the AUDIT-C questions. It is more reliable to count standard drinks than counting glasses or bottles or cans as alcohol is served in many different containers. The Australian standard drink measure contains 10grams of alcohol (equivalent to 12.5mls of pure alcohol).4 For example:
- 100ml glass of red wine at 13% alc vol = 1 standard drink.
- 100ml glass of white wine at 11.5% alc vol = 0.9 of a standard drink.
- 375ml bottle or can of full strength beer at 4.8% alc vol = 1.4 standard drinks.
- 30ml nip of high strength spirit at 40% alc vol = 1 standard drink.
- 330ml bottle of full strength ready-to-drink 5% acl vol = 1.2 standard drinks.5
Many Australia women aren’t aware of what a standard drink is so it is a good idea to have a chart that demonstrates this. Download these from the NHMRC website
Information and guidance for pregnant women following the AUDIT-C
The best advice for all women, regardless of whether or not they drink alcohol is that:
- No alcohol is the safest choice when pregnant or trying to get pregnant.
- No safe level of alcohol consumption during pregnancy has been determined.4
This advice is consistent with the National Health and Medical Research Council’s Australian Guidelines to Reduce Health Risks from Drinking Alcohol.
Feedback should be provided to the woman based on the total AUDIT-C score (out of 12).
|Advice to be given*|
no risk of
| 5+ =|
About the Women Want to Know project
The Women Want to Know project was developed by the Foundation for Alcohol Research and Education (FARE) in collaboration with leading health professional bodies across Australia.
The Women Want to Know project is funded by the Australian Government Department of Health.
For more information on the Women Want to Know project visit the Alcohol webiste.
Information on referral points to specialist services for each state and territory are available on the Alcohol website.
1. Change, G. (2004). Screening and brief intervention in prenatal care settings. Alcohol Research and Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism. 28 Vol 2. 80-84.
2. Dawson, D. Grant, B., Stinson, F. and Zhou, Y. (2005). Effectiveness of the derived Alcohol Use Disorder Identification Test (AUDIT-C) in screening for alcohol use disorders and risky drinking the US general population. Alcohol Clinical and Experimental Research Vol 29, No 5. Pp: 844-854.
3. Murdoch Children’s Research Institute (2010). Alcohol in Pregnancy: What questions should we be asking? Report to the Commonwealth Department of Health and Ageing. AQUA Project (Asking Questions about Alcohol in pregnancy), Victoria.
4. National Health and Medical Research Council (2009). Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth of Australia. Canberra.
5. Australian Government webpage: Standard drinks guide
6. Commonwealth Government Department of Health and Australian General Practice Network (2009) Lifescripts resources: Alcohol methodology card to help patient’s reduce health risks from alcohol
7. Drug and Alcohol Office (2013). Strong Spirit Strong Future: promoting healthy women and pregnancies resource for professionals. Drug and Alcohol Office, Perth. Western Australia
8. Alcohol and Pregnancy Project (2009). Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: a Resource for Health Professionals. Telethon Institute for Child Health Research