It's a no-brainer, right? Alcohol and pregnancy don't mix. So why are so many women still reaching for a glass of wine or indulging during a special occasion?

pregnant woman drinking red wine
Credit: Veer

It seems as though study after study reports on a woman's behavior during pregnancy. Did she exercise? Does she smoke? Did she gain enough or too much weight? It's no wonder the connection between a mom's alcohol intake and her pregnancy is scrutinized and debated as well.

Anecdotally, there are always going to be those women who drink during pregnancy and have healthy babies. Mona Prasad, D.O., M.P.H., an assistant professor in the department of obstetrics and gynecology in the Division of Maternal Fetal Medicine at Ohio State University, says, "The controversy [over alcohol use in pregnancy] may exist because previous generations were born to mothers whose physicians did not discourage alcohol intake during pregnancy and were are all presumably just fine."

True, most baby boomers didn't know there was anything wrong with a martini here or there during pregnancy. In addition, Dr. Prasad says, alcohol was even used in the past as a therapy to prevent preterm labor. "How could something previously thought to be therapeutic be so dangerous?"

Adding to the debate is all the literature suggesting that alcohol is not as harmful as we think. A recent study from Ireland showed that moms who drank moderately during the first trimester and beyond were no more likely to give birth to premature babies than were moms who didn't drink at all. Perhaps better known was the study from the University of Copenhagen that reported that women who drank moderately actually had children with better mental health than did those who didn't drink at all.

But a recent study published by the National Institutes of Health showed that women who drank during the first trimester had an increased risk for miscarriage. And the American Congress of Obstetricians and Gynecologists (ACOG) states that drinking during pregnancy increases the risk of miscarriage, low birthweight and stillbirth. The studies--and the debates--go on and on and on.

This is one issue where there's more gray than black and white. Hugh Gilgoff, M.D., a pediatrician with more than 15 years' experience at the Mount Sinai Medical Center in Brooklyn, says: "In a purely scientific manner, you can ask, Can alcohol pass from mom to baby? There is absolutely no debate on this. Yes, it can for sure. Can the alcohol that passes from mom to baby cause any adverse effects on that developing baby? Again: Yes, there is absolutely no debate on this."

The reality? You're a soon-to-be-mom and you already know you're giving up a lot. You give up your freedom way before the baby arrives. Sure, your partner can indulge in a beer or two, even a few spicy tuna rolls or hot yoga, if desired. But you have to exercise more caution. In addition to cutting out all those dangers, you're supposed to take a giant vitamin, gain only a certain amount of weight, and prepare your entire life for a new human being. "Many doctors feel like the mom gets left out during the nine months of pregnancy, when it is all about the baby (and that's just the beginning), so doctors don't necessarily want to limit a woman's right to decide what to eat and drink," Dr. Gilgoff says. This is why we dive deeper, and we study and debate the subject.

All of this makes for a hot-button issue. In spite of this data, though, the major organizations—including the Centers for Disease Control and ACOG—have not changed their position on alcohol exposure in pregnancy. In fact, the Institute of Medicine has said that alcohol use during pregnancy is even worse than cocaine or heroin use. That's a pretty big statement.