Drinking Alcohol During Pregnancy: What to Believe?

I.  Background

Drinking alcohol during pregnancy is a subject that elicits very strong emotion. Some pregnant women have actually become frantic upon realizing they had eaten salad with wine vinegar dressing. They feared their children would be born suffering from Fetal Alcohol Syndrome (FAS). Servers have told pregnant women ordering wine with dinner in restaurants that they may not have it. Strangers have publicly chastised expectant women for sipping a drink.

Overview

I.    Background

II.   Confusion

III.  Research Findings

IV.   Trends

V.    Promising Research

VI.   Resources for Pregnancy

In England, physicians have faced damage suits for not advising patientsw that alcohol could affect the foetus.1  Mothers who drink during pregnancy face increasing legal controls, compulsory treatment and even imprisonment. If their baby shows damage they may also face charges of child abuse.2

In the U.S., a woman four months pregnant called police after a beating by her husband. Officers found her BAC illegal. So they arrested her and charged her with felony child abuse.3

Conflicting Advice

drinking alcohol during pregnancyWomen who seek guidance from medical experts face confusion. The National Institute for Health and Clinical Excellence issues guidelines in the UK. It said it was safe for expectant mothers to have a small drink every day. But just two weeks later, the U.K. Department of Health changed its advice from having up to two small drinks daily to abstinence.4

Considerations

With conflicting advice, what’s a woman to do? That’s a very personal decision only she can make. But some things to consider might be this.

  • Those who oppose drinking in general will always insist that there is no safe limit. We never will know what it is. It’s impossible to prove a negative.
  • There is no evidence that moderate drinking during pregnancy has ever caused FAS in a single child. The burden of proof lies on those who contend that such drinking is harmful.
  • Women who choose to drink alcohol moderately during pregnancy can do knowing it is consistent with the medical evidence.
  • Light or moderate drinking during pregnancy might cause some as yet unknown harm to a fetus.
  • Because of that possibility, however remote, the very safest choice would be to abstain.
  • A women who is pregnant or plans to be should discuss the matter with her doctor. This includes the possible heart and stroke risk to herself from abstaining. The doctor will know her health history, medical problems, and other factors. This can help her make an informed decision.

Learn more about drinking alcohol during pregnancy. Find these links under 1) Confusion, 2) Research Findings, 3) Trends, and 4) Promising Research.

II. Confusion about Drinking Alcohol During Pregnancy

drinking alcohol during pregnancyPregnant Women and Advice on Drinking Alcohol

Unfortunately, pregnant women often receive conflicting advice from reputable groups about drinking during pregnancy.

Drinking Alcohol During Pregnancy

The Australian Alcohol Guidelines identify a safe level for drinking during pregnancy. It’s having fewer than seven drinks weekly, with no more than two drinks on any one day .

Harvard Advice on Drinking While Pregnant

The Harvard Women’s Health Watch advises pregnant women. It says that having more than one drink daily increases the risks of defects and disabilities.

Abortions and Drinking Alcohol During Pregnancy

The Province of Quebec abandoned its use of scare tactics to discourage drinking during pregnancy. Some wome had as little as a single drink before discovering  their pregnancy. But the scare tactics caused them to obtain abortions.

Pregnant Drinking OK, Meds Say

Medical schol textbooks present science rather than speculation or ideology. Most medical school textbooks on obstetrics condoned drinking at some level by pregnant women.

Drinking Alcohol During Pregnancy

FAS is a very serious medical problem. However, there is no scientific support for the widespread hysteria surrounding the subject of drinking during pregnancy.

Safe Use of Alcohol During Pregnancy?

Moderate drinking during pregnancy does not appear to cause FAS. But there is still good reason to abstain from alcohol during pregnancy. Learn why.

III. Research Findings about Drinking Alcohol During Pregnancy

Myth

If a pregnant woman has single sip of alcohol it could cause her child to have FAS.

Fact

Drinking alcohol during pregnancy has been studied. It has involved hundreds of thousands of women around the world. It has failed to find evidence that light drinking by an expectant woman can cause FAS. The risk of any type from a sip of alcohol is highly remote.

There is a stigma against drinking while pregnant. Therefore, it is reasonable to assume that actual drinking rates are somewhat higher than reported. To the extent that this is true, the actual safe drinking levels are higher than reports suggest.

Is Occasional Light Drinking During Pregnancy Harmful?

Analysts carefully reviewed the existing research. They report no clinically important risks to the fetus from an occasional drink during pregnancy.’

How Safe is Drinking Alcohol During Pregnancy?

Reports the results of large study. It investigated affects in five-year-old children whose mothers drank low to moderate amounts of alcohol during pregnancy.

Beneficial?

Light Drinking During Pregnancy May be Beneficial for Children

Doctors made a large study of three-year-old children. Those born to mothers who were light drinkers during pregnancy had fewer conduct, emotional and peer problems. Those born to abstaining mothers or those who drank heavily while pregnant had more problems.

Drinking Alcohol During Pregnancy and Birth Defects (Including FAS)

Doctors studied heavy drinking during the first trimester of pregnancy. It increased the risk of giving birth to a child with an alcohol-related birth defect. However, low, moderate or heavy drinking during the second or third trimester did not.

Little Evidence that Occasional Binge Drinking by Pregnant Women …

Investigators studied drinking during pregnancy. There was little evidence that binge drinking caused miscarriage, stillbirths, abnormal birth weight, or birth defects. However, there was some suggestion that it might impair normal neurodevelopment. Yet the effects were generally quite small.

Effects of Moderate Alcohol Drinking During Pregnancy

Researchers studied drinking during pregnancy.  They found low-to-moderate drinking during pregnancy not linked with increased risk of low birth weight or premature birth.

Premature Birth

Premature Birth and Low Birth Weight: Drinking Alcohol During …

Doctors did a large study.  Mothers’ drinking levels during pregnancy did not effect either premature births or low birth weights.

Effects of Moderate Alcohol Drinking During Pregnancy

Epidemiologists studied almost 5,000 women. They looked at low-to-moderate drinking during early and late pregnancy. It did not lead to low birth weight, intrauterine growth restriction, or premature birth.

Light Drinking During Pregnancy and Children’s Learning and Mental Health

Researchers found an overall lack of any adverse effects of light drinking in their cohort study.  They examined mental health and academic outcomes at the age of 11 years.

Drinking During Pregnancy

Women who consumed one or two drinks per day during their pregnancies had no increase in premature births

Drinking during Pregnancy

Researchers studied over 130,000 pregnancies. Women who had 2-14 to 14 drinks weekly had no increased risk of a child with either malformations or FAS.

IV. Trends in Drinking Alcohol During Pregnancy

Heavy Drinking by Pregnant Women Rare

According to the U.S. Department of Health and Human Services, an estimated eight-tenths of one percent (0.8) of pregnant women were heavy drinkers. Unfortunately, that’s too many.

Drinking Down among Pregnant Women

The U.S. Centers for Disease Control and Prevention (CDC) reported that alcohol consumption by pregnant women had declined by the late 1990’s.

V. Promising Research on Drinking Alcohol During Pregnancy

Fetal Alcohol Syndrome and Vitamins

Pregnant women taking vitamins C and E, folic acid, beta-carotene and flavonoids might protect their fetus against damage. However, these findings cannot serve as a basis for action.

Antioxidants May Protect against Birth Defects from Alcohol Abuse

Antioxidants during pregnancy might reduce the risk or even prevent birth defects in babies born to women who abuse alcohol. Animal tests have found this. However, this needs confirmation among humans and does not provide a guide to action

VI. Resources for Pregnancy

Champion, P. and McCormick. Eating and Drinking in Labour. Boston: Butterworth-Heinemann, 2002.

Dolan, S. and Kelly, A. Healthy Mom, Healthy Baby. The Ultimate Pregnancy Guide. NY: HarperOne, 2013.

Duigan, J., et al. Clean & Lean Pregnancy Guide. London: Kyle, 2014.

Geddes, L. Bumpology: The Myth-busting Pregnancy Book for Curious Parents-to-be. NY: Simon & Schuster, 2014.

Glicksman, M. and DiGeronimo, T. The Complete Idiot’s Guide to Pregnancy and Childbirth. NY: Alpha,2010.

Ricciotti, H. and Connelly, V. The Pregnancy Cookbook. NY: Norton, 1996.

 References for  drinking alcohol during pregnancy.

  • 1. This is the correct British spelling.
  • 2. Waterson, J. Women and Alcohol in Social Context: Mother’s Ruin Revisited. Hampshire, UK: Palgrave, 2000, pp. 167-168. Internal references deleted from original text.
  • 3. New York Times, January 22, Feb 3 and 5, and June 4, 1990.
  • 4. Rose, D. Pregnant women told glass of wine a day is fine – and too dangerous. The Times (UK), Oct 11, 2007. Cockcroft, L. Pregnant women told to keep off alcohol. Tele Media, Oct 26, 2007. Yee, L. New Study Says Some Alcohol OK for Pregnant Women. HealthWatch website, Nov 15, 2007. O’Brien, P. Is it all right for women to drink small amounts of alcohol in pregnancy? Yes. British Medical Journal, 2007, 335, 856. Nathanson, V. Is it all right for women to drink small amounts of alcohol in pregnancy? No. Brit Med J, 2007, 335, 857.

Readings for  drinking alcohol during pregnancy.

  • Abel, E., and Kruger, M. Reply: Physician attitudes concerning legal coercion of pregnant alcohol and drug users. Am J Obstet Gyne., 2010, 188(1), 299.
  • Bakker, R., et al. Associations of light and moderate maternal alcohol consumption with fetal growth characteristics in different periods of pregnancy. Int J Epid., 2010, 39(3), 777-789.
  • Chavkin, W., and Paltrow, L. Physician attitudes concerning legal coercion of pregnant alcohol and drug users. Am J Obst Gyne., 188(1), 298.
  • Goh, Y., et al. Alcohol content in declared non-to low alcoholic beverages. Implications for pregnancy. Can J Clin Pharm., 2010, 17(1), e47-50.
  • Henderson, J., et al. Systematic review of the fetal effects of prenatal binge-drinking. J Epid Comm Hlth., 2007, 61, 1069-1073.
  • Kelly, Y., et al. Light drinking in pregnancy. Int J Epid., 2008. doi:10.1093/ije/dyn230
  • Loop, K., and Nettleman, M. Obstetrical textbooks.. Am J Preven. Med., 2002, 23(2), 136-138.
  • Lowe, P., and Lee, E. Advocating alcohol abstinence to pregnant women. Hlth Risk Soc., 2010, 12(4), 301-311.
  • Lundsberg, L., et al. Low-to-moderate prenatal alcohol consumption and the risk of selected birth outcomes. Ann Epid., 2015, 25(1), 46-54.
  • Ornoy, A.. and Ergaz, Z. Alcohol abuse in pregnant women. Int J Envir Res Pub Pol., 2010, 7(2), 364-379.
  • Pfinder, M., et al. Preterm birth and small for gestational age in relation to alcohol consumption during pregnancy. BMC Preg. Child., 2013, 13, article number 49.
  • Polygenis, D. et al. Moderate alcohol consumption during pregnancy and the incidence of fetal malformations. Nero Teralol. 1998, 20, 61-67.
  • Sayal, K., et al. Light drinking in pregnancy and mid-childhood mental health and learning outcomes. Arch Dis Child., 2013, 98, 107-111.
  • Stockley, C. The safe use of alcohol during pregnancy. AIM Digest, April, 2005.
  • Toutain, S. What women in France say about alcohol abstinence during pregnancy. Drug Alco Rev, 2010, 29(2), 184-188