British women can enjoy a glass of wine from time to time during pregnancy, but in the US, drinking during pregnancy is difficult. Forty-three U.S. states have regulations around this practice, ranging from prohibiting criminal prosecution of pregnant women who drink alcohol to rehabilitation for pregnant women who drink alcohol. The Centers for Disease Control and Prevention (CDC) estimates that more than 3 million American women are at risk of pregnancy exposed to alcohol, a controversial figure that includes all women who consume alcohol without being under birth control. Of course, it is harmful to expose a fetus to a high alcohol content and can cause all kinds of disabilities. But a study published this week in the journal Alcohol and Alcoholism found an interesting correlation: states with more criminal laws on alcohol consumption during pregnancy also had restrictive abortion laws. Roberts told Vox that she started thinking about studying these guidelines after working with pregnant women in Northern California who used alcohol and drugs. In examining the barriers that prevent some of these women from receiving antenatal care, she found that «they were really afraid of being reported to child protection services and having their children removed.» Some of the women she worked with were also «really concerned that they had already done irreversible harm to their babies and that if they received antenatal care, they would get confirmation of it» – and perhaps they would be evaluated by a doctor or their use would be published in some way. In a study published Wednesday in the journal PLOS One and made available exclusively to Vox before publication, Meenakshi S.
Subbaraman, a biostatistician at the Institute of Public Health, and Sarah C.M. Roberts, associate professor of obstetrics and gynecology in UCSF`s Advancing New Standards in Reproductive Health (ANSIRH) research group, examined government guidelines designed to discourage pregnant women from drinking. They found that many of these guidelines, including putting up warning signs in bars and restaurants and defining alcohol use during pregnancy as child abuse or neglect, are actually associated with poorer health outcomes for babies. especially low birth weight and premature birth. One reason, according to the researchers, is that policies can actually discourage women from taking antenatal care. There is no safe time for alcohol consumption during pregnancy. Alcohol can cause problems for the baby during pregnancy, before a woman even knows she is pregnant. Drinking alcohol during the first three months of pregnancy can cause the baby to develop abnormal facial features. Growth and central nervous system problems (e.g. low birth weight, behavioral problems) can occur as a result of alcohol consumption at any time during pregnancy. The baby`s brain develops during pregnancy and can be affected at any time by alcohol exposure.
There is evidence of a link between FASD and binge drinking (defined by the CDC as occasional $4 drinks, usually within two hours) or heavy drinking (≥8 drinks per week) during pregnancy.7 Public health guidelines, published in 1977 by the National Institutes of Health, suggested a limit of two drinks per day for pregnant women. provided that ≥6 drinks a day posed a clear risk of harm to the fetus.5 In 1981, U.S. Surgeon General Edward Brandt advised women who were pregnant «or contemplating pregnancy» not to drink alcohol at all,8 a recommendation repeated by Surgeon General Richard Carmona in 2005.9 Similar recommendations have been made by professional societies.10–12 World Organization Health Evidence Network Health: «Is exposure to low doses of alcohol during pregnancy harmful?» «We know that alcohol affects brain cells and that the baby`s brain is constantly evolving throughout pregnancy,» she says. «So I would tell a pregnant mom that it`s probably best to abstain from all alcohol.» More questions about alcohol use during pregnancy? «The problem with drinking alcohol during pregnancy is that there is no amount that has been shown to be safe,» says Jacques Moritz, MD, director of gynecology at St. Luke`s-Roosevelt Hospital in New York City. Despite previous recommendations, the CDC`s announcement has sparked controversy. Critics have argued that the guidelines focus entirely on the well-being of the developing fetus while ignoring women`s rights as autonomous beings, downplaying the role of men in unwanted pregnancies, and ignoring the structural factors that contribute to fetal exposure to alcohol (p. e.g., which contribute to socio-economic factors influencing access to reproductive services, including contraception).15–17 Some experts applauded recommendation 15 After an influential paper was published on the effects of maternal alcohol consumption in 1973, policymakers began discouraging pregnant women from drinking, Dr. Jen Gunter wrote in The New York Times earlier this year. The number of states with policies regarding alcohol and pregnancy — such as warning labels about the effects of maternal drinking in places where alcohol is sold — rose from one in 1974 to 43 in 2013. Carol Archie, MD, clinical associate professor of obstetrics and gynecology at UCLA`s David Geffen School of Medicine, worries that even small amounts of alcohol can affect a developing baby`s brain. «I`ve always told my patients that I think it`s a personal choice and there`s no evidence that light drinking is dangerous,» says Marjorie Greenfield, MD, professor of obstetrics and gynecology at Case Western Reserve University School of Medicine in Cleveland and author of The Working Woman`s Pregnancy Book.
«About one to two drinks a week is probably fine. But never consume more than two at a time or drink to the point of being drunk,» she says. Moritz also says she thinks a celebratory glass of alcohol is more than likely acceptable — for example, if someone toasts on a holiday or at a birthday party. Roberts points out that while there is little or no research on the effects of punitive measures related to pregnancy and alcohol, there are studies on attempts to curb other alcohol-related behaviors, including drunk driving.