New draft alcohol guidelines for Australia state that, for pregnant women and women planning pregnancy, ‘no drinking is the safest option’. One of the best known adverse effects of alcohol exposure on the fetus is the fetal alcohol syndrome. Others include alcohol-related birth defects, alcohol-related neurodevelopmental disorders and increased risks of miscarriage, stillbirth, intrauterine growth restriction, preterm birth and low birthweight. Over half of Australian women consume alcohol during pregnancy. Obstetricians have a pivotal role in advising women of the effects of alcohol on the fetus and reducing fetal exposure.