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The advice to abstain from alcohol during pregnancy is one of the oldest refrains in the book. Doctors have long known that alcohol consumption can lead to all sorts of problems in the fetus. It’s linked to a wide range of birth defects and pregnancy complications, as well as other behavioral abnormalities as children grow older.

Is any amount of drinking safe during pregnancy?
Despite the well-known risks, some scientists have begun to question this sacred truth in recent years, and there’s even been a push to try and de-stigmatize light to moderate alcohol consumption during pregnancy. Advocates for this cause point out that since women who drink during pregnancy differ fundamentally from those who don’t, there’s no way to tell what effects are caused by the alcohol and which come from other factors. They say that studies fail to prove a definitive link between alcohol use and pregnancy complications, and that when it comes to reasonable levels of drinking, the risks are nil. They cite as evidence the many women who have drank moderately throughout pregnancy and had seemingly healthy babies. So is it really necessary to shame and guilt-trip expectant mothers for the occasional glass of wine? Isn’t pregnancy hard enough as it is?

Not so fast, caution other experts. They are quick to point out that research has found positive correlations between drinking and fetal problems at even small levels of alcohol exposure. They say the risks are real and are well documented, and point out that no amount of alcohol is known to be safe during pregnancy. It’s best to play it safe, says biologist Kathleen K. Sulik, since “we will never, ever, ever know how much is safe for every individual.” (Wenner-Moyer, 2013)

Not surprisingly, the conflicting messages have left many moms-to-be confused. So which is it? Is alcohol always dangerous? Or is it safe for expectant mothers to have a drink here and there?

The effects of alcohol on a fetus

Let’s start off with what we do know. We know for a fact that alcohol crosses the placenta and is absorbed by the fetus. Furthermore, it’s known that alcohol enters the fetal bloodstream in about the same concentrations that are present in the mother’s blood, so whatever you drink, you’re sharing an equal part with your baby.

This is concerning enough as it is, but the situation gets worse. Because of different rates of metabolism and the baby’s immature liver, a fetus can’t handle the same amounts of alcohol as well as you can. As Murkoff and Mazel write, “Since it takes the fetus twice as long as its mother to eliminate the alcohol from its system, the baby can be at the point of passing out when the mother is just pleasantly buzzed.” (2008, p. 71) Another biological fact to contend with is that just like cigarette smoke and other toxins, alcohol tends to disrupt the placenta’s normal functioning, depriving a baby of oxygen and other nutrients that are critical for the development of every organ, most notably the brain.

What consequences these effects might bring is up for debate, and different studies have found different degrees of risk. But the aforementioned facts are not in dispute. We often have problems with published research, especially when scientists do correlation studies based on notions of popular culture without outlining the mechanisms of injury – that is, how precisely a particular action may lead to harm. But in this case the mechanisms of injury are clear. We know what alcohol does to the brain and body, and we know it gets to the fetus. We also know the effects of alcohol in general (on anyone), and that alcohol consumption isn’t good for the body.

The concerns about drinking during pregnancy

Here’s our position, and an explanation about why we think the “debate” over this topic is rather silly: It is indisputable that alcohol crosses the placenta and is absorbed by the fetus. So because your fetus shares every bit of alcohol you ingest, ask yourself this: Would you as a parent give your preschooler a few beers or a shot of vodka? Would you pour wine into a baby bottle and give it to your infant? If you would be reluctant to fill a sippy cup with alcohol and liquor up your toddler, why would you assume that it’s in any way acceptable to do the same to your fetus? Sure, you might get away with it without any permanent harm, just as a parent who pours wine into a baby bottle may get away with it. But getting away with something does not make that activity a sound and developmentally appropriate practice.

The fact that there is even a debate on this issue speaks volumes about the hypocritical double standard society routinely adopts when it comes to how we approach child welfare issues. If a parent were to give a young child alcohol, they would be arrested. I can show you news stories of parents who received substantial prison sentences for pouring wine into a sippy cup as a means of pacification. (Prison terms extend into the decades for those who have made the mistake of giving a child pot.) Yet there is really no difference between this and drinking or doing drugs during pregnancy; the only difference is that the child you’re sharing alcohol with is at a much, much younger stage in their development. In one case we arrest a parent, destroy their life, label them as bad and take their kids away. In the other, we have advocacy groups trying to make drinking during pregnancy less taboo.

It’s a rather hypocritical double standard. In the same way that parents will fret over hyped up and exaggerated threats that they perceive as existing “out there” (child molestation) while ignoring the many things they do to kids at home that are every bit as harmful (divorce, verbal abuse, substance abuse, family conflict, etc.), this debate shows how “child welfare” concerns revolve more around the prejudices of adults and what is considered normal versus abnormal than what is actually harmful to kids. To give a toddler alcohol seems strange and unnecessary and is therefore taboo, which is why we consider it horrible. Yet many people like their alcohol, and so we sympathize more with the pregnant woman who wants to drink, even though this behavior may be even more consequential and destructive than the parent giving wine to her preschooler as a sleep aid.

We realize that many expectant mothers enjoy alcohol, and we’re not trying to lay a noose around their neck or send them down a guilt trip to the land of Mommy Shame. As an organization, it’s always our goal to promote love rather than condemnation, and to advocate for solutions that allow everyone to accommodate their preferences in a reasonable manner. (For those who can’t fathom giving up that occasional beer or glass of wine, we’ll give some guidelines later on to help you drink as safely as possible.) Just understand that there is no reasonable debate about whether or not alcohol consumption during pregnancy is good or bad for the baby, just as there is no reasonable debate about whether it’s healthy to give liquor to preschoolers. It’s always going to be something you should avoid. It just might not lead to permanent damage, and the sky is unlikely to fall due to occasional or light drinking. Yet the lack of ubiquitous negative outcomes does not make the activity safe or healthy for your baby.

The slippery slope
The other thing that bothers me about this debate is the fact that there’s such a large pushback over what should be a rather minor restriction. Nine months without alcohol is not an exceptionally long time. Thinking back to my drinking days, even in my early 20s, I don’t think I ever drank more than once a year. While I may have been a big prude and landed on the lighter side of the spectrum in terms of alcohol consumption, I also know I’m not alone. At least half to two-thirds of the population are light or occasional drinkers, and so giving up alcohol for this brief period of time should be of little consequence. Therefore the fact that so many parents are pushing to make “light” drinking acceptable is a red flag in my mind. If such women really were such light drinkers, then going without alcohol for 9 months should be rather inconsequential. It only becomes a major sticking point for those who have developed an alcohol dependence. People who rely on a drink (or a few drinks) in order to get through the week. Not only is this unhealthy for the baby, but any type of chemical reliance is not good for the mother, either, and is a common precursor to full-blown alcoholism.

People with substance abuse problems also notoriously under-report their use. For example, when sewer epidemiology tests are conducted in neighborhoods to check for the level of drugs people are pissing out and flushing, actual drug usage is generally at least 2-3 times what is reported in ANONYMOUS surveys. “As dramatic as (alcohol use) findings are, they’re probably a good bit higher,” says researcher Robert Brewer. “We’ve done comparisons between what people report they drink and what is sold. We’re probably picking up less than a third of alcohol consumption.” (Lloyd, 1-11-2012) Hair and nail tests, which can reveal use going back several months and therefore document more occasional users, found usage for cocaine and other drugs as much as 10-times what had been suspected. (Jones, 11-20-2009) So when expectant mothers say they want the ability to enjoy the occasional drink without guilt, what many of them mean is that they want to have several guilt-free drinks. And by occasionally, they mean all the time. This is the slippery slope many experts worry about when it comes to giving the green light to any amount of alcohol consumption during pregnancy.

How many women drink during pregnancy?
Despite the risks, alcohol use during pregnancy remains a big issue. Though women do tend to curb their drinking as their pregnancy progresses, alcohol consumption is still widespread: 19% of women report drinking during their first trimester, 7.8% in the second, and 6.2% in the third. (Berman, 2009) While it’s good that they do seem to be cutting back, some of the most severe effects are suspected to occur in the early stages of pregnancy (some of which, unfortunately, may occur before women know they are pregnant). One percent of women report binge drinking. However, these numbers are likely to underestimate the actual problem, for reasons just discussed. The same study found that 10% of women were binge drinking shortly after delivery, and 31.9% were drinking alcohol within the first 3 months. So how many actually stopped drinking versus merely saying they did is unknown.

The bottom line
Most women who drink during pregnancy will avoid the most serious outcomes. Their baby will be born normal from all outward appearances. They’ll have 10 fingers and 10 toes, and no visible signs of damage. But make no mistake: alcohol is a poison. Your body treats it just like any other poison. It’s a poison for you and a poison for your baby. It’s up to you to decide how much of this poison you’re comfortable exposing your baby to.

Every drop of alcohol consumed is a toxin that raises the risk of negative outcomes both seen and unseen. For those who have a single alcoholic beverage once or twice a week, the risks may be rather small…no more harmful than some of the other environmental toxins pregnant women are exposed to. You might be willing to take that risk. Yet every additional drink you have raises the likelihood of problems, and many of the most lingering and permanent problems are not going to seem obvious at first: things like subtle behavioral changes (caused by the fact that your baby was intoxicated while their brain was growing and shaping itself) or the increased risk of alcoholism once your child grows into a teen and adult. So if you can’t eliminate drinking, at least do your best to limit it.

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