Should Women Drink Alcohol While Pregnant?

Quinn says her drinking was ob-gyn-sanctioned in what she calls a “wink-wink” sort of way. “There are so many things you can’t do when you’re pregnant,” she says. “You 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.”

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 didn’t 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. “I don’t feel like having a glass of wine made me a bad person, or a bad soon-to-be mom,” she says. “It helps me relax, and we all know pregnancy can be stressful.”

That’s 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 “I’m not too sure relying on alcohol to relax you is a reasonable way to live. The question is, Why don’t you have different coping skills? Because you’re going to need them once you have a baby.”

Riley is unwavering in her position of zero tolerance. “While 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 time” to give up drinking, she says. “It’s 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 you’re not buzzed doesn’t mean that your baby’s not getting the end result.” To the women she sees who point to themselves or their friends as products of mothers who drank their way through their 1970s pregnancies, Riley’s response is, “I say you were lucky.”

It’s true that there are no studies that prove a glass of wine “here and there” is harmful, but it’s also true that there’s no real way to define “moderate” 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. “What level is safe for Mrs. Jones and what level is safe for you may be entirely different,” 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 women—pregnant or not—traditionally 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 it’s okay to drink in moderation if that patient has no real conception of what moderation looks like? Even “women who are not diagnosed with any substance abuse disorder may not recognize how much is too much,” says Kelley Saia, assistant professor of Obstetrics and Gynecology at BU’s School of Medicine. “And because alcohol is so widely available, we have to be careful what we say.” Even one glass a few times a week, she says, counts as chronic exposure.

“Parents are constantly in an uproar about the fact that there’s more ADD, there’s more this, there’s more that,” Riley says. “I just don’t understand, if you’re 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 God’s sake. They’re worried about mercury poisoning when, really, what’s 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.”

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: “I didn’t 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?”