Should Women Drink Alcohol While Pregnant?
Striking numbers of expectant mothers are deciding that thereâs nothing wrong with the occasional drink of alcohol. New studies suggest that they may be right, but the medical establishment is hardly convinced.
Striking numbers of expectant mothersâprofessional, educated, and informedâare deciding that thereâs nothing wrong with the occasional drink of alcohol. New studies suggest that they may be right, but the medical establishment is hardly convinced. So are these moms-to-be valiantly pushing back against political correctness gone awry, or are they simply part of a new generation of entitled narcissists, unwilling to sacrifice even for the health of their babies?
For most of my life, I believed that my mother, who smoked until I was in my teens, had at least quit during the months she was pregnant with me, her only child. It wasnât until recently that I found out this wasnât the case. Sheâd never actually stopped, so maybe I couldâve been taller, after all. Back then, though, it was fairly standard to drink and smoke and eat cold cuts while carrying a baby: A good friend born the same year I was reports that her mom got stoned the night before giving birth. My aunt, meanwhile, remembers being pregnant with my cousin in the early â80s and having her Boston obstetrician advise that she cut back on cigarettesâto half a pack a day.
My mom had issued the lie in part, I assume, because by the time I was old enough to ask, smoking was no longer a recommended practice among the gestational, and because I was a kid who tended to like to assign blame. By 1984 the surgeon general had mandated labels on all cigarette packages warning women that smoking could cause fetal injury, low birth weight, and premature birth. This was not long after the surgeon generalâs official position for pregnant women became to abstain from drinking and smoking completely, following a study that identified a group of physical and mental birth defects now known as fetal alcohol syndrome. As it was, I had been crediting my poor showing on the Presidential Fitness one-mile run to a childhood spent in the confines of my momâs Nissan Maxima, hotboxing our way through afternoon errands. Armed with the information that sheâd also smoked throughout what were literally my most formative months, Iâm sure I would have been a sanctimonious nightmare. Eventually, I badgered her into quitting when I was 15. I told myself, and her, that if I was to become a mom one day, I would neither smoke nor drink.
Many people were soon taking an equally rigid position. After the surgeon general issued the new guidelines, the United States experienced a massive societal shift away from smoking and drinking by pregnant women. So complete was the transformation that by 2005, the surgeon general was advising women who were simply trying to get pregnant to also quit drinking entirely, just to be safe. But in more recent years, the mood, and the rhetoric, around drinking during pregnancy have begun to shift yet again. Lately, weâve seen the publication of study after study showing that, rather than dooming the unborn to a lifetime of birth defects and personality problems, the occasional drink or three may actually be free of negative consequences. One recent finding even suggested that as many as eight drinks in one week, and up to five in one sitting, may have no significant effects.
And so lots of educated, informed, and professional women are giving themselves license to drink. According to the Centers for Disease Control and Prevention, 7.6 percent of pregnant women drink at least occasionally. Among college-educated women, however, that number jumps to 10 percent, and of those between the ages of 35 and 44, 14 percent consume alcohol. These days, spotting your pregnant-with-twins lawyer neighbor having a glass of wine with dinner isnât quite as shocking as it once was.
The moms-to-be who are choosing to drink arenât thoughtless or careless women given to making blind decisions. Theyâre part of one of the most informed generations of mothers in history, middle- and upper-class professionals in their late twenties, thirties, and forties. They read all the books about having healthy babies. They eat organic food and work out in fancy gyms. They travel the world, always seeming to bump into pregnant women around Europe who smoke and drink and pop out beautiful, brilliant children.
And yet, their decision to drink while expecting puts them in the middle of what may be the greatest divide among the pregnant and those who come in contact with themâwhich, of course, is all of us. Thatâs because pregnant or not, woman or man, everyone, it seems, has an opinion about everyone elseâs drinking habits, especially if the everyone else in question is carrying a child. Iâve seen friends at both ends of the spectrumâfrom the one who sat at home for the first six months of her pregnancy for fear of doing anything that could possibly harm her baby to the one who took a far more âEuropeanâ approach. (If pregnant ladies in Europe are, in fact, doing JĂ¤ger shots.) Iâm also hearing them judge one another and the comparative health of their babiesâout of earshot, of course. And I have to wonder: Is there such a thing as âdrinking safelyâ while pregnant? And who has the right to say? Are we basing decisions about drinking while pregnant on science? Or something else?
From the end of Prohibition, in the 1930s, until the early 1970s, moderate drinking while pregnant was both common and unquestioned. In 1973, however, a University of Washington study attributed physical, mental, and developmental birth defectsâthings like heart murmurs, small heads, and narrow eyes at birth, as well as delayed speech and poor hand-eye coordination later onâto fetal alcohol syndrome, or FAS. It wasnât long before follow-up studies showed that FAS was actually a very rare outcome related to severe alcoholism, with an estimate of 0.5 to 2 cases per 1,000. But FAS as a notion was transformative, mostly because birth defects as a result of alcohol were viewed as completely preventable, which made continuing to drink not just thoughtless but also reckless and cruel. According to a 1999 report published in the journal Alcohol and Alcoholism, FAS was instrumental in turning excessive drinking in the publicâs mind from a moral (and largely private) concern to a public-health concern on par with child neglect and abuse. In our collective consciousness, drinking while pregnant became widely associated with poverty, crime, and mental illness.
Around the time of the surgeon generalâs 1981 call to abstinence, state and local governments began implementing point-of-purchase warnings about drinking during pregnancy, and in 1988, the United States became the first country to adopt legislation requiring similar warnings on the labels of beer and alcohol containers. A string of overwrought articles and moviesâsuch as The Broken Cord, based on Michael Dorrisâs bestselling 1989 book about the challenges and heartbreak of raising an adopted son whoâd been born with FASâhelped fuel the idea that drinking while pregnant wasnât just potentially dangerous but also immoral. In 1990 Wyoming became the first state to charge a drunk pregnant woman with felony child abuse.
So itâs not surprising that, according to the CDC, alcohol consumption among pregnant women declined throughout the â80s. After that, though, the numbers began to rise. Some of the shift is doubtless attributable to the fact that researchers to this day cannot definitively say just how much alcohol, at what stage of pregnancy, causes FAS. And some of it probably owes to the fact that studies keep coming out indicating that a drink from time to time while pregnant is safe. Like the one published in June in the International Journal of Obstetrics and Gynaecology that found that up to eight drinks in a weekâand as many as five at one time, which seems like an awful lotâdid not have significant negative cognitive effect on kids five years later. This study followed an earlier one published in the International Journal of Epidemiology that indicated that not only could pregnant women safely drink a glass of wine or two per week, but that their children would actually perform better three years after birth than those of women who chose not to drink at all. And in Europe (of course), where the perception, at least, is that pregnant women regularly drink and smokeâthough, in fact, the official position on drinking in France is abstinence throughout pregnancyâbirth-defect rates are lower than those in the U.S.
The truth is, thereâs no real proof that low levels of drinking are harmful to a fetus. âThe quality of information is not so definitive that it is absolutely clear that drinking in small quantities is going to significantly affect pregnancy outcome,â says Robert Barbieri, the chairman of Obstetrics and Gynecology and Reproductive Biology at Brigham and Womenâs Hospital. And, as we know, people like definites. Itâs this very absence of actual scientific evidence that drinking is absolutely and without question bad for a baby that has led a lot of very smart, very informed pregnant women to decide that thereâs nothing wrong with the occasional drink. Not that the rest of society necessarily agrees.
You donât have to be a parent yourself to know that modern parenting can seem like a series of unending judgments, from how we conceive to what we eat and do while pregnant, with stops along the way including, but not limited to, birthing, breastfeeding, vaccinating, what our kids eat, where they sleep, how they learn, how much TV they watch, if we marry, or stay married to, the people who helped us conceive them, and if we have them at all.
At 36, and many years after declaring my mother unfit to drive me around in her exaggeratedly smoky car, Iâm undecided about having children of my own. My uncertainty has nothing to do with other peopleâs decisions, and yet I sense that strangers and sometimes friends can feel a bit slighted when I canât explain what it is about parenthood that doesnât interest me. I do know my ambivalence is less about my opinion of children and more about knowing myself. Iâm not sure Iâm particularly well suited to sacrifice. Or to the pressures of parenting-by-comparison, which these days seems impossible to avoid. Having married a man with a child of his own, I believe I have a responsibility to be a thoughtful, caring parental figure and friend to my stepson, and supporter to my husband in his parenting choices. But I also know what itâs like to feel judged, and Iâm not sure I want to sign up for more.
âAs soon as youâre pregnant, or have a baby, itâs like all bets are off,â says Kara Baskin, a 33-year-old mother of a two-year-old boy. âPeople can say whatever they want, touch whatever they want, make whatever comments they want.â A few years back, she was at a Starbucks when the barista asked her, âAre you supposed to be having any caffeine when youâre pregnant?â She wasnât pregnantâit was just the shirtâbut of course that didnât matter. She ran out crying.
Baskin, an Arlington-based writer, eventually did become pregnant. She recalls the time she was eight months in and âenormous,â and was meeting a friend for dinner at Luckyâs Lounge, in Fort Point. While she waited, she ordered a bottle of OâDoulâs, the nonalcoholic beer. Barely two sips in, she noticed the table full of twentysomething women whispering and sending dirty looks her way. Finally, the women signaled for a waitress, who then marched over âas if she were going to arrest me or something,â Baskin says. At the table, however, the waitress got close enough to see that it was a nonalcoholic beverage. âOh, never mind,â she said to Baskin. âItâs okay. Itâs OâDoulâs!â But what if it hadnât been?
Womenâs bodiesâand not just the pregnant onesâare still somehow seen as public property. This summer, all 49 Massachusetts birth facilities banned free baby-formula gift bags in order to encourage new moms to breastfeed. Weâre the second state to do so (Rhode Island was the first). Okay, so we want to encourage breastfeeding, right? Then what to make of the uproar over the recent Time magazine cover featuring the breastfeeding mom who, in the court of public opinion, had âgone too farâ? No matter what she does, there will always be someone telling a mother sheâs doing it wrong.
âWe reason that itâs because the state has a vested interested in producing healthy babies, but itâs really about the sexist idea that women donât know whatâs best for them,â says Jessica Valenti, the founder of the blog Feministing, author of Why Have Kids?, and a Jamaica Plain mom. âMotherhood is a lifetime of judgment, unless youâre willing to do anything by someone elseâs standards. And thereâs always going to be someone else.â
Confident that what the data actually show is that thereâs nothing wrong with a drink from time to time, this new generation of mothers is determined to make its own choices about drinking while pregnant. âI had a sip of my partnerâs scotch here and there because I really like it,â says Jess Meyer, 35, a yoga instructor with two kids younger than three who drank a glass or two of wine four times a week while pregnant. âMy doctor was a mother of three herself and she was like, âHonestly, a little wine here or there is not bad.â Especially with the second one, when youâre dealing with a crazy toddler, too. The way I see it, if youâre sitting there with a bottle of vodka sucking it down: Thatâs a problem. But a few glasses of wineâthereâs nothing wrong with that.â She mentions the International Journal of Epidemiology study that found that prenatal drinking actually led to better-behaved kids, saying, âPeople are always complimenting me on my relaxed, chill children.â
Maybe so, but they werenât exactly kind about her drinking. Five or six months into her first pregnancy, Meyer was in Beacon Hill buying liquor for a party she was throwing when the clerk questioned whether he was legally allowed to sell to her. âI told him itâs illegal not to,â she says, but she still felt compelled to explain that she was shopping for a party, not herself. He needed to call his manager anyway. At various times throughout her two pregnancies, Meyer was also refused wine at restaurants. At least one waiter wouldnât even show her the wine list.
For every smart and informed woman whoâs chosen to have the occasional drink while carrying a baby, however, there are others whoâve made the opposite decision. One female friend of mine who regularly, and loudly, shares her point of view with pregnant women in restaurants around Boston, calls drinking while pregnant the âmost selfish act imaginable. I think those women should be put in jail!â And Baskin, whose drinking never progressed beyond that OâDoulâs, says, âIâd think of my baby swimming in a pool of chardonnay and being like, âMommy.ââ
Eliana Stern, a mother of two who lives in Exeter, New Hampshire, believes that âpart of being a good mother is loving your child more than you love yourself, and that means not drinking while youâre pregnant. Drinking can cause irreparable damage to the baby. Mothers who cause fetal alcohol syndrome in their babies have to live with that fact their entire lives. By not drinking during pregnancy, I gave my children the best chance to reach their full potential in life.â
Charlestown Yoga Studio owner Kristin Quinn, 33, used to feel that way, too. She recalls the time she was having a drink at the Liberty Hotel a few years back when she saw a very pregnant woman sipping a glass of red wine. âAnd I just couldnât stop staringââOh my God, that is the worst thing Iâve ever seen,ââ Quinn says. A year and a half later she was pregnant with her first child and very sorry sheâd been so judgmental. âI literally remember my first sip of wine,â says Quinn, who now writes a blog called Misadventures in Mommyhood. âIt was so delicious.â From then on, she enjoyed what she calls a ceremonial half glass every Friday. âIt was just something to look forward to and nothing dangerous,â she says. âSometimes, I didnât even finish it. Itâs actually better than to be stressed out.â But she wouldnât drink in public. âI knew people were out there judging,â she says, because, of course, she had been one of them. âYou just feel like you have a big target on your face.â
Quinn says her drinking was ob-gyn-sanctioned in what she calls a âwink-winkâ sort of way. âThere are so many things you canât do when youâre pregnant,â she says. âYou stress yourself out about everything. Did I get enough water? Did I eat enough vegetables? The wine was just a nice way to put your feet up and not have to worry about that.â
Leah Callahan, who is 27 and lives in Worcester, gave birth to her first child, a boy, in October. She started having an occasional glass of wine (never more than four ounces, she says) at about six months. Though she didnât discuss drinking with her doctor, she aimed to be healthy throughout. She ate right, exercised, and gained fewer than 20 pounds. Her blood work was normal. âI donât feel like having a glass of wine made me a bad person, or a bad soon-to-be mom,â she says. âIt helps me relax, and we all know pregnancy can be stressful.â
Thatâs something Laura Riley, the director of labor and delivery at Mass General, hears from a lot of patients. Being pregnant certainly is stressful, says Riley, the author of You & Your Baby: Pregnancy, but âIâm not too sure relying on alcohol to relax you is a reasonable way to live. The question is, Why donât you have different coping skills? Because youâre going to need them once you have a baby.â
Riley is unwavering in her position of zero tolerance. âWhile I recognize that there are random studies suggesting that small amounts of alcohol in some women are probably safe, I feel that nine months is a relatively short period of timeâ to give up drinking, she says. âItâs clear that alcohol in some levels can cause babies to have fetal alcohol syndrome, which is characterized by gross restriction and facial abnormalities and mental retardation. The fact that youâre not buzzed doesnât mean that your babyâs not getting the end result.â To the women she sees who point to themselves or their friends as products of mothers who drank their way through their 1970s pregnancies, Rileyâs response is, âI say you were lucky.â
Itâs true that there are no studies that prove a glass of wine âhere and thereâ is harmful, but itâs also true that thereâs no real way to define âmoderateâ drinking. Anyone who has that friend who gets embarrassing after a single glass of pinot noir, or who is that friend, knows that alcohol affects everyone differently. âWhat level is safe for Mrs. Jones and what level is safe for you may be entirely different,â Riley says.
Whatever the research may be telling us, not a single Boston-area doctor I spoke with would go on record saying that drinking any amount of alcohol during pregnancy is acceptable. And yet there is the sense that many of them are quietly telling their patients that an occasional beer or glass of wine is fine. Nearly all the women interviewed for this story said they got at least a tacit okay from their doctor before starting to drink. One factor that might give doctors pause about publicly endorsing drinking while pregnant is that womenâpregnant or notâtraditionally underreport how much they drink by four times the amount men do. That can make it far more difficult for doctors, or patients, to identify the kind of problem drinking that everyone seems to agree can lead to trouble for babies. Put another way, what good is it to tell a pregnant patient that itâs okay to drink in moderation if that patient has no real conception of what moderation looks like? Even âwomen who are not diagnosed with any substance abuse disorder may not recognize how much is too much,â says Kelley Saia, assistant professor of Obstetrics and Gynecology at BUâs School of Medicine. âAnd because alcohol is so widely available, we have to be careful what we say.â Even one glass a few times a week, she says, counts as chronic exposure.
âParents are constantly in an uproar about the fact that thereâs more ADD, thereâs more this, thereâs more that,â Riley says. âI just donât understand, if youâre concerned with all these different things that are all neurodevelopmental, why on earth would you take a chance with something that you know is a neurotoxin? People worry about eating fish, for Godâs sake. Theyâre worried about mercury poisoning when, really, whatâs the likelihood of that compared to all the beneficial things you can get from fish? I just find drinking a very odd thing for people to latch on to.â
Northborough mother Marile Borden, founder and editor of Momicillin Publishing, whose blogs include the wildly popular Moms Who Need Wine, sums it up this way: âI didnât want to have a reason to blame myself should, God forbid, anything have gone wrong with my pregnancy or baby. Not that I thought a drink here or there would harm the baby. But I never wanted to have to say, Was it something I did?â
Many women told me that they drank during pregnancy not to relax or be social, but simply to remember their carefree days prior to deciding to become a mother. For pregnant women, danger is everywhere: mercury in canned tuna, salmonella in peanut butter, listeria in soft cheese, disfigurement and mental retardation in a glass of wine. Nothing, theyâre told, is safe. Which apparently demands flawless behaviorâbeing perfect pregnant people. Itâs enough to drive a girl to drink.
In fact, some moms-to-be say the decision to drink was just one small step in pushing back against the overwhelming sense that they are very probably doing something wrong at any given moment of motherhood. âI feel like the ban on drinking promotes this idea that our job as mothers is to make sure that our babies are âpure,ââ says Arlington mom Jennifer Feller, âthat they never, ever have contact with a germ, a toxin, a speck of honey before the age of one. Itâs not that I ignored all of this, but itâs an approach to pregnancy that prepares parents for the overbearing, helicopter style of parenting weâre realizing is actually hurting our kids.â
Before her first glass of wine while pregnant, Sarah Pike, a Newburyport resident, decided on a level of drinking she and her husband both felt comfortable with: one to three glasses of wine over a one-week period, and not more than one in a single evening. âIf something happened and maybe was related to wine consumption, I had to go into that glass of wine knowing that I had made my decision based on the risks and non-risks,â Pike says. âMy midwife actually told me I could have a bologna sandwich every once in a while. Iâm pretty certain there are worse things in bologna than a glass of red wine.â Pike, now a mother of two boys, says that more than a desire to enjoy the alcohol itself, she found she simply missed the act of holding a glass of wine. âA little bit went so far for me in feeling I hadnât lost myself completely,â she says.
Still, many parents argue that parenting is about sacrifice, that you never really are quite the same againâindeed, thatâs one reason many people opt to have kids (and many, myself included, may opt not to). The current generation of moms may be the most educated and informed ever, but these women also embody the narcissism thatâs pervasive in this ambitious, driven era. According to a study published in the journal Social Psychology and Personality Science, clinical narcissism among college studentsâdefined by heightened feelings of entitlement, decreased morality, and a dog-eat-dog mentalityâincreased by 30 percent from 1982 to 2006, when two out of every three measured high for the disorder.
âHearing women say, âI want to (fill-in-the-blank) to be my true self againâ is not language we heard a generation ago,â says Jean Twenge, author of the recent The Impatient Womanâs Guide to Getting Pregnant and coauthor of The Narcissism Epidemic, which argues that we live in a culture that not only tolerates, but also encourages, me-first behavior. Twenge points to the highly competitive nature of pregnancy and parenting as a manifestation of narcissism. âWe have this new idea that we need to be true to ourselves and not waver from thatâwe use phrases like âNever compromiseâ and âBelieve in yourself,ââ she says. âEverything is personalized, customized. Thereâs the idea that âWeâre all unique,â that âThe rules donât apply to me.â And that is a problem for women when theyâre pregnant and transitioning to parenthood. You are the same person, but there are some things you have to do differently than you used to. And one of those things is not drink.â
Upon returning home from Luckyâs after the OâDoulâs incident a few years ago, Kara Baskin started to wonder if the women at the other table had actually been right. âI realized that sitting there with my bottle of OâDoulâs, I had felt like a badass, like I was being rebellious,â she says. âDid I really want to be a badass? I ended up going home and berating myself.â Because it wasnât just the taste of the beer that appealed to Baskin. At that point in her pregnancy, with only a few weeks to go, sheâd found the freedom of that sip intoxicating. âIt tasted like a memory, like a different part of my life that I might not ever get back to,â she says. She hadnât missed alcohol. She had missed being Kara. Because, of course, she wasnât anymore, and as far as she knew, might never be again.
Source URL: http://www.bostonmagazine.com/2012/11/drinking-alcohol-while-pregnant/