Can You Drink Coffee While Pregnant?
Is coffee really bad for you during pregnancy? What about when you’re trying to conceive? Find out why regular and decaffeinated coffee may still be fine to drink in moderation.
Your days of tequila shots and tuna sashimi are over—at least for the next nine months. But is it safe to drink your go-to vanilla latte while expecting? The short answer: No one is completely sure.
"It's difficult to get good and accurate studies on pregnant [people]," says David Elmer, M.D., an OB-GYN at Nantucket Cottage Hospital in Nantucket, Massachusetts. "It isn't ethical to give 1,000 pregnant women an unknown substance and see how many have complications."
That said, the limited research we have suggests that caffeinated coffee isn't harmful in moderation. "The overwhelming evidence is that it really isn't as bad as we think," Dr. Elmer says. Indeed, most experts believe pregnant people can safely consume 200 mg or less of caffeine per day; this correlates to about one cup of joe.
Related:How Much Caffeine Can You Safely Drink During Pregnancy?
Decaf may be a safer option, but pregnant people may want to do their research before brewing. An independent study by Clean Label Project found that several leading decaffeinated coffee brands contain methylene chloride—a solvent used in paint thinners that's also used in the chemical process to remove caffeine from coffee.
Here's what you need to know about drinking coffee while pregnant and trying to conceive.
Can You Drink Caffeinated Coffee While Pregnant?
When it comes to caffeine during pregnancy, most of the evidence comes from retrospective studies, according to Dr. Elmer. "These look at people who happen to encounter a particular drug or substance to see if they're having more problems than those who don't," he says.
While the results of these retrospective studies are conflicting, most come to a similar conclusion: moderate caffeine consumption (less than 200 mg per day) hasn't been linked to adverse effects like miscarriage or preterm labor. Indeed, the American College of Obstetricians and Gynecologists (ACOG) also recommends the 200 mg per day caffeine limit.
To put it in perspective, 200 mg of caffeine is about one 12-ounce cup of coffee. But keep in mind that the super-caffeinated coffee at Starbucks is over the 200-milligram limit, even at the smallest "tall" size.
Related:A Food Safety Guide for Pregnancy
So what happens over that 200 mg limit? The truth is, we don't really know. Some pregnant people may drink much more than 200 mg of caffeine with no consequences, but there's no conclusive research on what might happen during pregnancy with that level of caffeine. Additionally, animal studies have shown harmful effects of excessive caffeine while pregnant. Although "there are no conclusive studies in humans, studies in animals do show decreased fertility, increases in birth defects and miscarriage rates, and low-birthweight babies," says Michele Hakakha, M.D., a board-certified OB-GYM in Beverly Hills, California and author of Expecting 411.
It's also important to note that some studies, including an August 2020 review published in the journal BMJ, report that no known amount of caffeine is safe during pregnancy. That particular review linked maternal caffeine consumption to "miscarriage, stillbirth, low birth weight and/or small for gestational age, and childhood acute leukemia." Despite these results, however, organizations like the ACOG and the United Kingdom's Royal College of Obstetricians and Gynaecologists stick by their 200 mg recommendation. Additionally, the studies did not specify exactly how much caffeine was consumed to be linked to the negative outcomes.
"My advice to patients is: no more than one, and on occasion, two caffeinated drinks a day during pregnancy," Dr. Hakahka says. "Always avoid something that might be potentially dangerous to your developing fetus."
Is Decaf Coffee Safe During Pregnancy?
Decaf coffee may seem like a great alternative, but it still contains trace amounts of caffeine. According to the Mayo Clinic, a single cup of decaf has between 2 and 12 milligrams of caffeine. So if you like the taste and can do without that caffeine buzz, you can have lots more decaf coffee before you hit the 200-milligram limit.
"It's OK to drink decaf coffee and tea during pregnancy, but to not overdo it," says Elisa Zied, M.S., R.D., C.D.N., a dietitian in New York City and author of Feed Your Family Right. Even small amounts of caffeine in so-called decaf products can add up if you're having multiple servings.
Related:22 Tips for a Healthy Pregnancy
But is decaf coffee bad for you? Certain products might be. An independent study by the national nonprofit organization Clean Label Project, published in January 2020, found that some brands of decaf coffee contain methylene chloride (also known as dichloromethane or DCM). This solvent is in products like paint strippers, adhesives, and automotive cleaning products. It's used during the decaffeination process for coffee.
Methylene chloride has been linked to "cancer, cognitive impairment, and asphyxiation," according to the organization's press release. It's also associated with liver, kidney, and reproductive toxicity.
So how do you know if your preferred brand of decaf coffee is toxic? The Clean Label Project tested 23 top-selling products for contaminants.
Fifteen tested products had undetectable levels of methylene chloride (less than 50 parts per billion). These products are safest for pregnant women, and they include:
Allegro Coffee Decaffeinated Organic French Roast
Archer Farms Decaffeinated House Blend
Caribou Coffee Decaffeinated Caribou Blend
Community Coffee Decaffeinated Café Special
DAZBOG Coffee Decaffeinated French Roast (12 oz)
Dunkin' Donuts Decaffeinated Medium Roast
Folgers Decaffeinated Classic
Illy Decaffeinated Illy Blend
Kicking Horse Coffee Decaffeinated Dark
Nescafe Decaffeinated House Blend
Peet's Coffee Decaffeinated
Major Dickason's Blend
Starbucks Decaffeinated House Blend
Starbucks Decaffeinated Cafe Verona
The Organic Coffee Co. Decaffeinated Organic Gorilla
Tim Hortons Decaffeinated Medium Roast
Four products have detectable levels of methylene chloride at a rate of 50-89 parts per billion. Pregnant people may want to avoid these products so they don't introduce toxic chemicals to their babies.
Kirkland Signature Decaffeinated Dark Roast
Maxwell House Decaffeinated The Original Roast
Peet's Coffee Decaffeinated House Blend
Seattle's Best Decaffeinated Portside Blend
Finally, six decaffeinated coffee products had detectable levels of methylene chloride above 90 parts per billion. Pregnant people should avoid these products at all costs.
AmazonFresh Decaffeinated Colombia
Café Bustelo Decaffeinated Café Molido
Gevalia Kaffe Decaffeinated House Blend
Great Value Decaffeinated Classic Roast
Green Mountain Coffee Roasters Decaffeinated Breakfast Blend
Kroger Decaffeinated Classic
What if your favorite brand isn't on the list? You might want to look into their decaffeination process. The Clean Label Project also suggests looking for "certified organic or water processed" products to lower your risk of exposure.
Related:Nutrition During Pregnancy: 10 Do's and Don'ts
Should You Drink Coffee When Trying to Conceive?
Studies are still mixed on whether or not caffeine is linked to problems with pregnancy. For instance, a 2016 study from the National Institutes of Health and Ohio State University in Columbus, published in Fertility and Sterility, found that two or more caffeine drinks a day in the weeks prior to conception increases miscarriage risk. However, a newer 2022 study from the the University of Queensland found no increased risk to pregnancy from one or two cups of caffeinated drinks per day.
But if you are trying to conceive, both you and your partner may want to consider cutting back on caffeinated drinks in general. The biggest factor in whether someone miscarries is age since a person older than 35 had nearly twice the miscarriage risk of a younger individual. But drinking two or more cups of beverages containing caffeine also raised the risk of miscarriage—and that held true for both biological males and females. As lead researcher, Dr. Buck Louis explained, "Our findings also indicate that the male partner matters, too. Male preconception consumption of caffeinated beverages was just as strongly associated with pregnancy loss as females'."
There is something coffee addicts can do. Researchers say taking a multivitamin both before conception and during early pregnancy lowers the risk of miscarrying. Indeed, researchers noted a 55% reduction in risk for pregnancy loss in those who popped dailies before conception; a risk reduction of 79% was found when taking vitamins during early pregnancy. Findings confirmed that specifically taking a multi-containing vitamin B6 and folic acid helped reduce the risk.
The Bottom Line
Should stop your Starbucks habit when trying to conceive? How about after your pregnancy test turns blue? Experts say there's merit in limiting caffeine in both situations, but you should cut back slowly.
"People get rebound headaches when they cut back on caffeine, so cutting back slowly is better than going cold turkey, especially when there's no good evidence of it being a big problem," says Dr. Elmer. "Somebody who's a six- or eight-cup of coffee person could cut down to five or fewer, and aim for just two to three cups a day"
You can also try "having a smaller cup, switching to decaf (as long as it's free of methylene chloride), diluting your coffee with milk or cream, or start drinking tea, which has some caffeine but much less than coffee," Dr. Hakakha suggests.
Related:What's Safe During Pregnancy? A Guide by Trimester
And remember: Although your OB-GYN probably won't deny you that daily cup of joe while pregnant, the American College of Obstetricians and Gynecologists recommends calling it quits at 200 milligrams per day, which is about the amount in a cup of regular coffee.
Even if you do have to cut back on the coffee now, don't worry—you'll be drinking plenty of it in a few months when your baby keeps you up all night!
