Can You Drink During Pregnancy? Sorry, the Jury Is Still Out

In movies and TV a secret pregnancy is always revealed after the woman declines a cocktail. The assumption being, of course, that responsible, educated moms-to-be would never partake in alcohol while they’re expecting for fear of hurting their unborn child. Trouble is, the research on drinking during pregnancy has never been clear-cut.

And now, two new studies, out of the U.K. and Denmark, could be confusing matters even more: After tracking children for five to seven years, the researchers found no developmental problems associated with women who drank up to six drinks in a week—no more than one drink a day, broken up over time.

Don’t get me wrong, the link between binge drinking—which is defined as five drinks in a single bout of drinking—during pregnancy and developmental delay in children is universally accepted as a bad idea. Fetal alcohol syndrome (FAS), in which a fetus is exposed to excessive alcohol, can cause stunted growth and is known to cause mental retardation. But while FAS is associated with heavy drinking during pregnancy, there’s less data about low- and moderate-alcohol use. That’s because this is information that’s hard to come by—you can’t exactly randomly assign pregnant women to drink different amounts and then see how their kids turn out.

But this new research is starting to fill the gap. Which is not to say that light drinking during pregnancy is conclusively “safe,” and it’s definitely not an endorsement of it as a habit. Authors from one of these most recent studies made clear the possibility that their results could be due to other factors, and in all research there is potential for confounding factors. For example, the authors suggest that it’s possible that the different socioeconomic status (SES) between groups of women could play a role. More women who binge-drink during pregnancy are low-SES; and low-SES women are more likely to have riskier pregnancies, less prenatal care, and less-healthy infants than their high-SES counterparts. This is just one potential reason it’s so difficult to offer conclusive data—and clear advice for women to follow.

The official position in the U.S., which comes from the National Institutes of Health, is strict and clear: “Women who are pregnant or who are trying to get pregnant should avoid drinking any amount of alcohol. The only way to prevent fetal alcohol syndrome is to not drink alcohol during pregnancy.” That’s true, just as abstinence is the only certain way to prevent STDs and pregnancy. The position offered by the National Health Service in the U.K. is a bit more lenient: “[To] minimise the risk to the baby, we recommend [that women] should not drink more than 1-2 units once or twice a week and should not get drunk.’”

This creates an interesting question: In the age of Big Data—with Millennials turning to Google for every question, no matter how small—what sort of messages should be sent about the relative safety of alcohol consumption during pregnancy? We could move toward more evidence-based advice, and tell women that not drinking is ideal but that a drink or two a week probably won’t hurt their child. There might be concern that this would change the prevailing attitude about alcohol during pregnancy; there is still evidence that daily consumption can be bad for fetal development. Would women use looser guidelines as an excuse to drink more than is safe? Moreover, there are individual characteristics that studies like this can’t account for; each person processes alcohol differently, so “safe” levels of consumption will vary.

The new research from abroad might be most reassuring to women who become pregnant accidentally and aren’t able to change their drinking habits until after they find out. After all, according to the CDC, some 37 percent of pregnancies are unintended. At least with this research, women don’t have to stress as much over having enjoyed happy hour a few times a week before they knew they were pregnant. The bottom line is that a majority of experts are still likely to tell you not to drink while pregnant, and it’s still definitely the safest course of action.

Do you think this new information should do anything to change the conversation about alcohol during pregnancy? Or should all women forgo all drinking during pregnancy to be safe?