Tuesday, November 21, 2017
Opinion

CDC tells women to stop drinking if not on birth control, and they're not kidding

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A new Centers for Disease Control report recommends that women of childbearing age who are sexually active and not using birth control stop drinking alcohol altogether. "The risk is real. Why take the chance?" the CDC's principal deputy director says in the press release accompanying the report.

The agency's logic is that about half of all American pregnancies are unplanned, and many women don't know they're pregnant for the first month or so. But it's the kind of swath-yourself-in-bubble-wrap thinking that has turned modern pregnancy into a nine-month slog of joyless paranoia.

The CDC has been a leader in the better-safe-than-sorry school of pregnancy care for at least a decade now. A 2006 report recommended that all women between menses and menopause should take folic acid, avoid smoking, and maintain a healthy weight to prepare for healthy pregnancies, just in case. Critics at the time accused the government of viewing millions of women as "pre-pregnant," regardless of whether they were planning on having babies soon, or ever.

The latest recommendation to avoid alcohol completely is obviously out of step with the way many "pre-pregnant" people live their lives. (Imagine how the birth rate would drop if women never took a sip.) But unlike the well-tested advice to take folic acid, is also unnecessarily restrictive of women who are pregnant or trying to be.

The CDC's recommendation is also out of step with the way many women already conduct their pregnancies. A 2012 report from the agency itself found that older and more educated women were significantly likelier to drink during pregnancy than younger, less-educated women are. And many doctors seem perfectly comfortable with moderate alcohol consumption in the late stages of pregnancy. When I told my doctor that I was enjoying a glass of wine per week in my third trimester, she didn't bat an eye.

With the obligatory caveat that heavy drinking in pregnancy can be extremely damaging, the commonly repeated notion that there is "no known safe amount of alcohol" for pregnant women is seriously misleading. As the economist Emily Oster pointed out in her 2013 book Expecting Better, there is also no "proven safe" level of Tylenol or caffeine, and yet both are fine in moderation during pregnancy. Oster pored through reams of research on alcohol and pregnancy for her book, and concluded that there is simply no scientific evidence that light drinking during pregnancy impacts a baby's health. (In one frequently cited 2001 study that suggested light drinking in pregnancy increases the chances of a child displaying aggressive behaviors, the drinkers were also significantly likelier to have taken cocaine during pregnancy.)

The backlash to this dose of sanity was swift and severe, as Oster detailed in Slate, but I recommend her sanity-preserving book to any pregnant woman overwhelmed by advice like the CDC's. What the heck, I'll go CDC-style and recommend it to anyone who could possibly ever become pregnant, at any point in the future, no matter how small the odds. Why take the chance? — slate.com

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