I was pregnant with my second son, and we were on a late-night flight back home after visiting friends halfway across the country. I’ve never been the most confident flyer, and pregnancy only made it worse. What if something happened to me or the baby while we were in the air? A glass of wine would have been my normal source of solace on the plane, but as a (visibly) pregnant woman, I was out of options. Soon, I felt trapped, breathless, and hot as panic coursed through my body. I had two choices: Demand that the pilot land the plane, or take a few sips of wine and pray for the anxiety to subside. I opted for the latter, then melted into my seat calmly until we safely landed.
At my next OB appointment, I asked my doctor what she thought about drinking during pregnancy. I found her answer to be vague: Consistent panic attacks aren’t the best for moms or babies, and neither is heavy drinking. But limited alcohol in a moment of panic should be fine. And I guess it was — my son was born strong and healthy a couple months later, in spite of (or thanks to?) the smattering of half-glasses I consumed as a last-resort remedy for panic attacks.
Light drinking in pregnancy was my educated choice, a risk I was willing to take given the debilitating, daily anxiety I experienced. But it was tricky for me to find a straight answer about whether or not it was safe for me and my baby. Responses varied depending on who (and when) I asked.
Officially, most doctors and midwives I spoke with during my two pregnancies were clear that avoiding drinking altogether is the safest option. It’s better to be safe than sorry, they would imply. But unofficially — off the record — it seemed like if alcohol was the lesser of two evils, it likely wouldn’t hurt my developing child. In the end, I felt like it was up to me.
Given their obligation to my (and my baby’s) health and safety, the doctors and midwives I spoke with held to the official national guidelines on drinking during pregnancy. The traditional approach to pregnant mothers’ alcohol use is conservative, in large part because research in the last 30 to 40 years has connected alcohol to Fetal Alcohol Syndrome (FAS), preterm delivery, stillbirth, and even Sudden Infant Death Syndrome (SIDS).
The Surgeon General, the CDC, and the American Academy of Pediatrics recommend abstaining from alcohol altogether, as studies have not determined a precise safe amount of alcohol to consume during pregnancy. Still, “I drank while pregnant and my baby is fine” articles continue to surface, pushing back on traditional guidelines alongside recent studies demonstrating that light drinking is unlikely to negatively affect developing babies.
The complicated, on-again off-again relationship between alcohol and pregnancy is nothing new. Alcohol has long been revered for its medicinal properties, historically sought as a solution for ailments like colds and cholera. In the 19th century, physicians recommended that women with severe morning sickness drink Champagne and often prescribed brandy with soda to stimulate appetite in nauseated women. Drinking in general obviously declined during the prohibition, but when alcohol re-emerged as publicly acceptable, attitudes toward drinking in pregnancy remained generally lax. Public stigma around alcohol and pregnancy more broadly surfaced in the 1970s, when FAS was officially defined and more widely recognized.
Thanks to its nuanced history — not to mention the individual stigmas that surround it — arguments continue over how much, if any, alcohol pregnant women can drink. But even beyond the US, cultural attitudes on alcohol play a significant role in defining each specific population’s attitude on drinking in pregnancy. For example, like the US, most European countries officially recommend abstaining from alcohol. However, drinking patterns among pregnant women vary country by country.
In 2012, a long-term Danish study concluded that low to moderate weekly alcohol consumption during pregnancy had no significant effect on a child’s neurodevelopment. A separate Danish study from the same year found that while low to moderate alcohol consumption raised the risk of miscarriage in early pregnancy, that risk was basically gone after 16 weeks.
Danish OB-GYN Dr. Ulrik Schiøler Kesmodel, who researched the effects of drinking during pregnancy, says he thinks women in European countries are probably more informed about the actual evidence on alcohol in pregnancy and not so much swayed by non-evidence-based peer pressure. In spite of diverse attitudes, though, he feels health practitioners should continue to make patients aware of official recommendations — which may be one reason why patients like me find physicians’ answers to be vague and unhelpful. Doctors have a responsibility to err on the side of caution, even in the face of more relaxed cultural opinions.
“Generally, health personnel should be loyal toward official recommendations and tell pregnant women about them,” Kesmodel said. “However, when a pregnant woman tells her doctor she drinks one to two drinks a week, it may be reasonable to tell her that there is no evidence that these amounts of alcohol can damage her child’s development.”
Ultimately, whether or not to drink during pregnancy, and how much, is a personal decision. Like it was in my case, a few sips of wine here and there may be a more comfortable — and safer — alternative than benzodiazepines, for example, which have been linked to cleft lip and palate when used in the first trimester.
But even as research evolves, issues like drinking in pregnancy may never be black and white. The safest bet for pregnant women craving a cold one (or two)? Stay in conversation with your healthcare provider, consider evidence-based clinical studies, and be pleasantly surprised if and when the evidence (and your conscience) point you toward a (small) glass of wine.
What do you think about attitudes over drinking during pregnancy? Tell us @BritandCo.
(Photos via Getty)