Can You Drink Coffee While Pregnant?
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 women," 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 women can safely consume 200 mg or less of caffeine per day; this correlates to about one cup of joe.
Decaf may be a safer option, but pregnant women may want to do their research before brewing. A recent independent study found that several leading decaffeinated coffee brands contain methylene chloride—a solvent that has been linked to cancer, asphyxiation, and cognitive impairment.
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.
Some pregnant women drink much more than 200 mg of caffeine with no consequences, but it's better to be safe than sorry. That's because 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 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 leukaemia." 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.
"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: 23 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. They published the results here: https://www.cleanlabelproject.org/decaf-coffee/.
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 women 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 women 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.
Should You Drink Coffee When Trying to Conceive?
If you are trying to conceive, both you and your partner should rethink that third cup of coffee. 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 a woman's miscarriage risk.
For the study, researchers looked at the lifestyle factors of 344 couples enrolled in the Longitudinal Investigation of Fertility and the Environment Study. They all had singleton pregnancies and were followed from before they conceived to the seventh week of gestation. According to the press release, researchers evaluated factors like caffeinated beverage consumption to determine their "hazard ratio," or the daily likelihood of pregnancy loss over a given time period.
The biggest factor in whether a woman miscarried was age, since a woman older than 35 had nearly twice the miscarriage risk of a younger woman. But drinking two or more cups of beverages containing caffeine also raised the risk of miscarriage—and that held true for both men and women. 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 percent reduction in risk for pregnancy loss in women who popped dailies before conception; a risk reduction of 79 percent was found for women who continued 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.
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!