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Reproductive Health

What You Should Know About Alcohol and Pregnancy

by DR. LORIANA SOMA, EXPERT OB/GYN

Wine with dinner, a beer at a BBQ, cocktails with friends: alcohol is often a part of women’s social lives. So when those two blue lines appear, avoiding alcohol is one of the most immediate, and biggest lifestyle changes, women have to make. Women often worry about drinks they have before they knew they were pregnant, or just how unsafe it is. Here are some answers to common questions women have about alcohol in pregnancy.

Spoiler alert: The safest choice is no alcohol.However, the data on the safety of alcohol use in pregnancy, especially light drinking, is uncertain.  

What are the risks of alcohol during pregnancy?

Consumption of alcohol during pregnancy has been linked to birth defects, preterm delivery, restricted fetal growth, developmental abnormalities, miscarriage or stillbirth, and behavioral and cognitive issues after birth. There is no conclusive research that points to a safe level of alcohol intake during pregnancy. Studies on the effects of alcohol and pregnancy are complicated. There are too many unknown variables, like drug and tobacco use, different drinking patterns, and the mother’s individual ability to process alcohol. A glass of wine in one woman could feel very different for another.

Many doctors recommend complete abstinence from alcohol during pregnancy. Other doctors and scientists say an occasional drink is unlikely to have long term effects. This advice can be confusing and is often compounded by the stories and opinions of pregnant friends and acquaintances around you. 

What about Fetal Alcohol Syndrome?

Most people have heard of Fetal Alcohol Syndrome. And while it can cause profound complications, including facial dysmorphism, central nervous system disorders, and growth retardation, the prevalence of FAS in the U.S. is estimated to be only 0.2%. Evidence shows that heavy and binge drinking can cause FAS and other fetal alcohol spectrum disorders (FASD). It’s important to note that all pregnant women who consume alcohol are at risk of having a child with FASD, but other risk factors increase those odds. Poor nutrition, drug use, smoking, mental health disorders and poverty all are associated with a higher risk of FASD.

Will my pregnancy be affected by light or occasional drinking?

Again, there are mixed thoughts on this question, depending on who you ask.

Emily Oster, economist, and author of “Expecting Better: Why The Conventional Pregnancy Wisdom is Wrong”, reviewed studies comparing pregnant women who drank lightly or occasionally to those who did not. She concluded that light drinking does not affect children’s outcomes. She believes women should make their own educated decisions and may be ok with the occasional drink after the first trimester when the risk of miscarriage drops.

The Royal College of Obstetricians and Gynecologists, in the UK, state that although no alcohol is the safest option, light drinking has not been shown to be harmful. However, in the United States, the American College of Obstetricians and Gynecologists, the Center for Disease Control and the American Academy of Pediatrics suggest that women completely avoid alcohol during pregnancy.

Is it ok to drink alcohol when trying to get pregnant?

Another tricky question! If you want to be conservative, it would be prudent not to drink when trying to conceive. Why? First, if you do conceive, there are two weeks between conception date and when a positive test would show up. Also, heavy drinking can impact fertility and menstrual cycles.

However, if you are struggling with infertility, or it’s taking longer than you thought to get pregnant, never having a drink can feel restrictive. A nice middle ground could be drinking during your period and before ovulation (which occurs about two weeks into your cycle) and abstaining for the last two weeks. Or, simply keeping your drinking light, no more than 1-2 drinks at a time.

I found out I’m pregnant, but I went out drinking last weekend!

This is a common concern. Many women might have had a few drinks before they found out they were pregnant. More than likely, everything will be fine. It’s not helpful to feel stressed or guilty. Once you have a positive test, you can continue making safe choices. I do not think any intervention outside of standard prenatal care is necessary.

Can I eat rum cake?

Yes! If alcohol is cooked, it’s fine, and you wouldn’t get the same effect as you would from a shot of rum. However, you would want to avoid uncooked alcohol, like a boozy milkshake.

Whether or not to abstain from drinking is the personal choice of the pregnant woman. While there is no conclusive evidence that light drinking can cause complications, it is not advised by most obstetric bodies. Forty weeks may feel like a long time, but in the grand scheme, it is a short time to make a lifestyle change for the health of your baby. 


REFERENCES

1. Oster, Emily. “I wrote that it’s ok to drink while pregnant. Everyone freaked out. Here’s why I’m right.” Slate. Sept, 2013. Slate.com Web. 1 Nov. 2017.

2. Center for Disease Control and Prevention. Alcohol use among pregnant and nonpregnant women of childbearing age – United States, 1991-2005. MMWR Morb Mortal Wkly Rep. 2009 May, 58 (19): 529-32.