Drinking Alcohol While Pregnant: Safe or Risky?
It's one of the great questions of our time: Is a glass of wine OK during pregnancy? What about a few sips of beer? You can't fault a mimosa, right? Because...vitamin C?
We turned to experts to get to the bottom of your pregnancy qualms — and to find out if alcohol during pregnancy is ever a good idea.
The "official" stances on alcohol & pregnancy
Researchers publish studies on this topic on the regular — a recent one out of the U.K., for example, didn't find a lot of evidence that light drinking is harmful to a fetus or its mother — but for obvious reasons, it's tough to round up trial subjects (such as women willing to drink alcohol throughout pregnancy and, you know, just wait to find out what happens).
Despite those U.K. findings, most doctors routinely stand steadfast against the practice, especially when studies can't show a definite link between the two things — in the above case, that's drinking and the lack of serious outcomes. Study authors also emphasize that the lack of proven correlation doesn't mean pregnant women should feel free to drink whenever they feel like it. After all, studies that are limited and self-reporting may not be accurate, and the literature and data they're looking into here is relatively small.
According to the American Congress of Obstetricians and Gynecologists, alcohol is a teratogen, which means that it can harm a developing fetus. Prenatal alcohol exposure can sometimes result in growth deformities, facial abnormalities, central nervous system impairment, behavior disorders and impaired intellectual development. It can also result in a low birth weight and premature labor.
While those who drink heavily generally have the worst outcomes, the U.S. Surgeon General advises that pregnant women should completely abstain — yep, zero alcohol for 40-ish weeks. This advice is echoed by the Centers for Disease Control. Additionally, the U.S. government mandates labeling of alcoholic beverages to indicate that consumption can result in birth defects. But are all of these official statements just the government covering its butt?
What the doctors say:
We decided to speak directly with medical experts to get their stances on the topic — as individual practitioners rather than "official" government spokespeople for public health.
"Save it for the delivery room"
Dr. Janet Choi, director at the New York outpost of The Colorado Center for Reproductive Medicine, says that the answer to the question of "is it safe?" is "definitely not." She explains that no amount of alcohol is safe to use in pregnancy and notes that there have been studies that suggest that even alcohol consumption a month or two before conception might affect a baby's skull or facial bone development. However, she adds a caveat: "Is it OK to have a sip of wine at a party or dinner during pregnancy? Probably, but if you want to be truly safe, I'd advise against any alcohol during pregnancy. Save it for the delivery room once the kid is out!"
Joan McCraw, clinical specialist in psychiatry and addictions at Solutions Recovery, agrees that no alcohol should pass the lips of a pregnant people. "Anyone who is concerned about their baby developing properly is going to want them to be as healthy as possible and not introduce anything into their system that could cause damage," she says. "It’s unpredictable. When you have a chemical going through the body of a developing fetus, it could affect all kinds of organ systems: liver, pancreas, kidney, heart and brain."
"You do not share a blood supply" with the embryo early on
“There is no ‘safe' interval for continuing to drink once you have a positive pregnancy test,” explains Dr. Katherine Hicks, an OB-GYN in private practice in Massachusetts. Although, she adds, there's no need to stress if you were drinking before you found out you were pregnant — which, unsurprisingly, happens to pregnant women pretty often. Hicks explains that at two weeks pregnant, for example, "your blood — and the alcohol level in it — does not mix with the developing embryo. You do not share a blood supply with the pregnancy for a few more weeks. If you completely abstain from alcohol once you learn of the pregnancy, there should be no measurable risk of FAS [fetal alcohol syndrome]."
"Half a glass of wine... is probably fine"
Surgeon Sarah Ghanta is another doctor to toe the line and call for moderation. "Based on what I know, it's better to abstain," she explains. "Most studies seem to say abstention is best since it's a slippery slope. But half a glass of wine once in a while (less than daily) is probably fine after the first trimester. "
"American culture may be more geared towards binge drinking"
"The reality is that there is no one-size-fits-all," says Dr. Ian Tong, chief medical officer at Doctor On Demand. "That is why the ACOG guidelines take the extreme stance of total abstinence. American drinking culture may be more geared toward binge-drinking behavior for many reasons... Parents do not introduce their children to moderate use of alcohol... In this type of alcohol-drinking culture, abstinence may be the best policy. Americans are rarely taught to drink half a glass with a meal as some have suggested. That is why the guidance is typically customized to the individual, and the medical societies err on the side of caution with their guidelines. Abstinence reigns as the prevailing wisdom because it is safe for everyone, but if your cultural norms dictate some alcohol consumption you should consult a physician to receive individual guidance."
The bottom line
The consensus among experts is that it's best to err on the side of caution because nobody can predict how every baby's development and every mom-to-be will react to alcohol. And since nobody knows the exact threshold when "some" becomes "too much," most experts suggest abstaining completely.
And drinking doesn't seem to be a huge hit with many pregnant people anyway. "I didn't drink after finding out whatsoever," says Leia, who is expecting her second baby. "Growing up with alcoholics and also having close family members with fetal alcohol syndrome made it easy to not drink. It's put me off completely because of what I've seen happens in severe cases involving alcohol."
On the other hand, Amelia, who has a 2-year-old, did drink during pregnancy — for surprisingly similar reasons. "I also have alcoholic family members," she explains, "and it's really important for me to live a life of moderation rather than a zero-tolerance, all-or-nothing thing (besides, nobody I know outside of North America is at all concerned about drinking while pregnant). So while I was pregnant, I had a glass of Champagne on my birthday, ordered a 'tasting' size at the beer garden a few times, and drank a large glass of red wine while I was in labor."
So take into account your doctor's advice and the research that's out there, but remember that it's truly up to the mom-to-be whether she takes a risk — whether that's sushi, deli meat or a beer. And it's nobody's job to judge her.