Is drinking alcohol during pregnancy a definite no-no or is there wiggle room for the occasional glass of wine? Pregnant women get conflicting advice when it comes to alcohol consumption during pregnancy. So much so that the British Medical Journal recently asked experts on both sides of the issue to weigh in. The conclusion? It's clear as mud.
Pediatrician Mary Mather and Kate Wiles, a doctoral research fellow at Guy’s and St Thomas’ NHS Foundation Trust, argued that pregnant women should not consume even a single drop of alcohol during pregnancy. Not a drop. Their reasoning is that there is no evidence of a "safe" threshold amount of alcohol that a pregnant women could consume during pregnancy without harming her unborn baby.
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Mather and Wiles note that the current advice given to pregnant women is conflicting and ambiguous. While some obstetricians advise pregnant women to abstain from alcohol during the entire pregnancy, others recommend abstaining only during the first trimester or limiting alcohol consumption to one to two "units" once or twice per week. But what defines a unit? According to Mather and Wiles, this is exactly why pregnant women should just be given a clear "no," when it comes to alcohol.
"The only ethical advice that can be given is complete abstinence from alcohol in pregnancy," said Mather and Wiles.
On the flip side, Dr. Patrick O'Brien, a consultant in obstetrics and gynecology at University College London Hospital, argued that women were intelligent enough to understand the complexities of alcohol consumption during pregnancy and make their own decisions accordingly.
"On a daily basis, for example, obstetricians and midwives explain to women the complexities of screening and diagnostic tests for Down’s syndrome," O'Brien noted. "We do not shy away from the discussion just because it is complex. We do not say 'This is difficult for you to understand; just have an amniocentesis.' We respect our patients’ autonomy and recognize that it is our responsibility to find a way of imparting the information in a way that is understandable to them, then support them in coming to a decision."
According to O'Brien, drinking alcohol during pregnancy is a judgment call. Some women are more affected by alcohol than others and some are more accustomed to a daily glass of wine or an evening beer than others. When doctors and health experts blindly make that judgment call for their patients, they risk losing the faith of their patients in other aspects of their care.
"One thing is clear," said O'Brien, "If we try to appeal to the lowest common denominator, most women will seek the evidence online and judge it for themselves. And if they perceive that we have been making value judgments on their behalf, or professing certainty where none exists, we are certain to lose their trust."
So what do real moms think of all of this conflicting advice? In an informal survey of my Facebook friends, I found that most women used their own judgment when it came to drinking during pregnancy. Some were advised not to and didn't. Some were told by their doctors that they could but still decided not to. While others were advised to abstain but decided that the occasional glass would be fine.
According to the American College of Obstetricians and Gynecologists, "Even moderate alcohol use during pregnancy can cause lifelong problems with a child’s learning and behavior. Any amount is risky for women who are pregnant or trying to become pregnant. All types of alcohol are harmful, including beer and wine."
But in the end, the only thing that is really clear is that each woman has to make her own decision regarding alcohol consumption during pregnancy.