Over the last three decades, non-profit groups and public health agencies have waged a relentless campaign to spread the word about the risks of drunk driving. In response to these efforts, a number of laws have been passed at the state and federal levels that have reduced allowable blood-alcohol content percentages for drivers, strengthened DUI-related legal penalties, and mandated significant prison time for people who injure or kill others while driving drunk. Public awareness of the risks of drunk driving is at an all-time high, and as a result this behavior is no longer tolerated or ignored the way it so often was in the past. This vigorous effort to stigmatize a deadly and irresponsible activity has paid huge dividends. Since 1982, the number of alcohol-impaired driving fatalities in the United States has declined by a 53 percent, and, in 2011, (the most recent year for which we have official statistics) the U.S. death toll from drunk driving fell below the 10,000 mark for the first time in the 30-plus years that such records have been kept. Despite this success, there is much more work to be done, however, and as long as people are dying on America\u2019s highways at the hands of drunk drivers, the urgency of the campaign to combat this scourge should not be allowed to lose steam. But while the truth about the horrific consequences of drunk driving has been well publicized, here is an alcohol-related statistic that might surprise you. Did you know that over 40,000 children are born in the United States each year suffering from a medical condition known as Fetal Alcohol Spectrum Disorder (FASD)? This disabling disorder develops only in children born to mothers who consumed alcohol during their pregnancy, and it frequently causes significant brain damage and a host of physical, behavioral and emotional troubles that can plague its victims for life. Of course all physicians these days routinely warn expectant mothers about the dangers of mixing alcohol and pregnancy, which only makes these statistics all the more surprising. By this point we might expect that drinking during pregnancy would carry the same type of social and cultural stigma that drunk driving does, but given the fact that in any particular year the number of newborns suffering from FASD will be four times greater than the annual death toll from drunk driving, it would seem that this is not actually the case. The Numbers Behind the Numbers According to data collected in 2011-2012 by the National Survey on Drug Use and Health, almost 18 percent of all pregnant women confessed to consuming alcohol during their first trimester, and that included 6.6 percent who admitted to binge drinking. Thankfully these numbers dropped to just 4.2 percent in the second trimester and 3.7 percent in the final trimester, with minimal instances of binging behavior. It is easy to speculate that women who continue to drink throughout their pregnancy are probably suffering from alcoholism and are simply not able to overcome their addiction despite the harm it might do to their children. The steep decline in drinking that takes place after the first trimester would seem to confirm that most women who consume alcohol while pregnant do so only because they do not realize they are expecting a child (half of all pregnancies in the U.S. are unplanned). Even women who drink only sporadically in their first trimester and stop immediately when they realize they were going to have a baby can be at risk of giving birth to a child with FASD. Intentional or not, the consumption of alcohol during pregnancy can produce grim and frightening consequences. Fetal Alcohol Syndrome (FAS) is the most severe form of FASD, and children who are unfortunate enough to be born with this condition could be condemned to a lifetime of ill health and misery. FAS stunts growth, disrupts the function of the central nervous system, can cause abnormal development of facial features, is often associated with serious learning disabilities, and can interfere with vision, speech and hearing. FAS is a true nightmare for its victims and their family members, and because of the immense medical difficulties it creates, the lifetime cost of caring for a child born with this condition can often surpass $2 million. An Absence of Malice and the Virtue of Absence If we accept that most women who drink while pregnant were not aware of their condition and therefore did so unintentionally and without malice, it adds strength to the argument that sexually active couples should stay as far away from alcohol as possible, even if they are not planning on having a baby any time soon. This suggestion should not be interpreted as a subtle criticism of women who have inadvertently consumed alcohol while expecting a child. But the high rate of FASD must be seen for the health crisis that it truly is, and if being more cautious and proactive with alcohol is the best way to reduce the incidence of this disorder, then preemptive abstinence could have much to recommend it. At the very least, every sexually active couple should be fully aware of how risky it could be if they should happen to become pregnant during a time when alcohol is still a part of their lives\u2014and if this awareness is enough to motivate them to make positive changes in their drinking habits, so much the better.