CHOICES: Preventing Alcohol Exposed Pregnancies

A woman talking to her doctor

CHOICES is a program for women who are not pregnant (but could become pregnant) and who are drinking alcohol at excessive levels. It is an evidence-based intervention (i.e., based on activities that research has shown to be valid and effective) that helps women to reduce or stop drinking, use contraception (birth control) effectively, or both. CHOICES uses motivational interviewing to increase a woman’s motivation and commitment to change. Participants in CHOICES decide which behavior to focus on to reduce their risk of an alcohol-exposed pregnancy. It includes two to four counseling sessions plus a contraceptive counseling session.

CDC funded a randomized controlled trial in three cities in a variety of community settings. The CHOICES intervention was compared to usual medical care among 830 women, aged 18-44 years, who were at risk for an alcohol-exposed pregnancy. At the 9-month follow-up evaluation, over two-thirds (69%) of women in the CHOICES intervention reported reducing their risk of an alcohol-exposed pregnancy compared to about half (54%) of women in usual care.

Many women become pregnant and do not know it until 4 to 6 weeks into the pregnancy. This means they might be unaware that they are exposing their baby to alcohol.

An evidence-based program that works to prevent alcohol-exposed pregnancies is CHOICES. CHOICES is based on activities that research has shown to be effective.