When I was pregnant, I wondered: Can I have a drink? It is known that drinking to excess during pregnancy is dangerous, but what about an occasional glass of wine with dinner?
America's "pregnancy bible,'' What to Expect When You're Expecting, says no alcohol. The Panic-Free Pregnancy says an occasional drink is fine.
My obstetrician said a few drinks a week was fine. I needed to go to the data myself.
I focused on studies that compare women who drank lightly or occasionally during pregnancy to those who abstained. The best of these studies are ones that separate women into several groups and limit the focus to women who say they never had a binge drinking episode.
With these parameters, we can really hone in on the question of interest: What is the impact of having an occasional drink, assuming that you never overdo it?
I summarize two studies in my book, Expecting Better: one looking at alcohol consumption by pregnant women and behavior problems for the resulting children up to age 14, and one looking at alcohol in pregnancy and test performance at age 14. Both show no difference between the children of women who abstain and those who have up to a drink a day. I argue that based on this data, many women may feel comfortable with an occasional glass of wine — even up to one a day — in later trimesters. (More caution in the first trimester — no more than two drinks a week — because of some evidence of miscarriage risk.)
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Although this discussion takes up only a small part of the book, it has garnered the loudest reaction, much of it outrage. NOFAS, a fetal alcohol syndrome advocacy group, issued a press release even before the book came out, saying I was harmful and irresponsible. Amazon reviews of the book attacked me and anyone who had a drink during pregnancy as an alcoholic.
Some of the arguments are philosophical. People ask, "Why take the risk?" since there is no benefit to the baby. But this ignores the fact that we are always making choices. Driving in a car carries some risk to your baby, and your fetus does not benefit from that vacation you took. Or they ask, "Is it so hard to give up drinking for nine months?" The answer is, of course, no, but because you might enjoy the occasional beer, it seems worth at least understanding the risks.
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Like alcohol, Tylenol, caffeine, and antinausea drugs like Zofran are substances that — in moderation — are thought to be safe during pregnancy. But they are also substances that in excessive doses could be dangerous. Some women decide that they will therefore avoid them altogether because they cannot be sure. And many women, seeing the evidence on alcohol, will still choose to avoid it.
But others will see the data, like the data on caffeine or Tylenol, and choose to have an occasional drink, as I did. The value of the data is not that it leads us all to the same choice, just that it introduces a concrete way to make that choice.
Emily Oster is an associate professor of economics at the University of Chicago Booth School of Business. © 2013 Slate