This survey, an update of the 2015 survey, serves the purpose of monitoring the prevalence of the use of alcohol, tobacco, marijuana and now also vaping amongst pregnant women. The rationale for the survey is that alcohol, tobacco, and marijuana use in pregnancy increases the risk of negative pregnancy outcomes.

Mr. Speaker, in gathering data which is vital to all programmes and services, the survey utilized a standardized questionnaire, called the AUDIT. This tool comprises a set of ten simple questions designed to identify persons whose alcohol consumption has become hazardous or harmful to their health. An additional twelve questions on tobacco sought to identify the respondents’ consumption patterns and their perception of harm along with their intentions to use tobacco (cigarettes) in the future. Five questions related to marijuana use were also included. The Survey was administered to two hundred and twenty four pregnant women presenting for prenatal care at their obstetrician and gynecologist offices, over a three-week period, from Monday, August 17th to Friday, September 4th, 2020.

Mr. Speaker, in this day of advanced technology, the results of the survey of pregnant women revealed the following data:

29.0% of women surveyed indicated having a drink containing alcohol monthly or less.

Nearly four in ten or 36.6% of the respondents reported drinking 1 or 2 alcoholic beverages on a typical day.

A small proportion of women (0.9%) stated that they needed a drink in the morning to get them going.

Almost one in six (14.7%) women had an alcoholic beverage since they became pregnant, while a small number, seventeen, reported that they did not stop drinking when they became pregnant.

There was a strong likelihood of hazardous or harmful alcohol consumption related to binge-drinking; with 19.6% of women noting that they have six or more alcoholic drinks on one occasion.

There were a small proportion of current smokers of both cigarettes (0.9%) and marijuana (3.6%).

Of the current smokers, cigarettes and marijuana, a few women (10) did continue smoking even while in their second and third trimester of pregnancy.

Nearly one in five (19.6%) respondents indicated that they quit cigarette smoking because they became pregnant.

From a public health point of view, more than half (53.6%) of the women reported that their doctor or other health professional had discussed the harmful effects of smoking with them since becoming pregnant.

In the last year, 5.8% of women smoked between one to ten cigarettes on the days that they did smoke.

A considerably high proportion (92.0%) of women reported that they were aware of the harmful effects of smoking during pregnancy.

There was a small proportion (1.8%) of women who indicated that they sometimes feel like having a cigarette first thing in the morning.

Some women (1.3%) thought that smoking cigarettes was definitely not harmful to one’s health.

No one who had stopped smoking cigarettes indicated an intent to continue doing so in the short-term; whereas a small proportion five (5) stated their intent to probably do so in the long-term.

In terms of smoking cessation, most women (77.2%) expressed that it would be difficult to quit smoking once started.

There were 16 or 7.1% of women who reported that they had used an electronic vaping device (i.e. e-cigarette, electronic nicotine products or hookah) in their lifetime.

During the three months before becoming pregnant, on average, 1.7% of women noted that they used an e-cigarette or other electronic nicotine product one day a week or less and a small number (0.4%) noting their use to be more than once a day; whereas 3.6% had used a hookah for one day a week or less.

This, Mr. Speaker, the fourth survey conducted under the Department for National Drug Control, demonstrates that substance use remains a complex phenomenon that presents unique and costly consequences to the unborn child. Drinking alcohol during pregnancy can cause physical and mental birth defects. Although many women are aware that heavy drinking during pregnancy can cause birth defects, many do not realize that moderate—or even light—drinking also may harm the fetus. In fact, no level of alcohol use during pregnancy has been proven to be safe, and should be avoided. Counselling of women who drink small amounts of alcohol before realizing they had conceived is a complex but important task, especially given that 14.7% of the respondents (or 26.4% of the alcohol users) said that they still drank alcohol after finding out they were pregnant.

Mr. Speaker, additionally, the smoking of tobacco and marijuana have both been linked to adverse consequences for newborns. From low birth weight, sudden infant death syndrome (SIDS), to problems with neurological development. The American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists warn and advise women against using marijuana while trying to get pregnant, during pregnancy, and whilst they are breastfeeding.

The Department of National Drug Control’s Report of the 2020 Survey of Pregnant Women, Mr. Speaker, represents an important step forward in addressing the challenges presented to us regarding prenatal substance use and its implications. This report, along with other publications of the Department for National Drug Control, which can be found on the

Government portal at www.gov.bm, provides a clear body of evidence that speaks to the drug situation in Bermuda and is used to inform policy development with regard to drug use in Bermuda. I invite Honourable Members and the general public to review the information in this report, ask questions and, most of all, support us as we continue to enhance the health and safety of Bermuda’s residents.

Mr. Speaker, children are one of our most precious resources – they are our future and we must remain the pillars of support upon which they must grow and develop into healthy and productive adults. Even the unborn child must remain a priority for us in this community. This report on the 2020 Survey of Pregnant Women supports the Government’s on-going efforts to inform the community about the harmful effects of substance misuse for pregnant women.

Thank you Mr. Speaker.