Wine and the Expectant Mother

Since a television and newspaper campaign began in the United States, sponsored by various anti-alcohol groups, many readers have been asking about drinking wine during pregnancy.

Daniel Rogov
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Daniel Rogov

Since a television and newspaper campaign began in the United States, sponsored by various anti-alcohol groups, many readers have been asking about drinking wine during pregnancy.

First, let me state clearly that I have no medical expertise whatsoever, and will answer the question only as one capable of reading and understanding present medical research and distinguishing it from moralistic propaganda.

Since 1990 every bottle of wine, beer and spirits sold in the United States has carried the warning that "the Surgeon General advises that women should not drink alcoholic beverages during pregnancy because of the risk of birth defects". Hundreds of newspaper articles and television talk shows have been convincing women that if they have a single drink during pregnancy, there is a chance of their baby being born deformed, retarded or alcoholic.

It appears, however, that the American medical authorities and media have not been telling women the entire truth. The official message remains "don't drink at all during pregnancy" but a great deal of recent research and a re-examination of the alcohol-pregnancy issue shows there is no conclusive evidence that moderate drinking during pregnancy can harm the fetus.

Doctors David Whitten and Martin Lipp of the University of California at San Francisco say "the campaign against drinking during pregnancy started in 1973 when several studies showed that heavy drinking during pregnancy can cause the condition known as Fetal Alcohol Syndrome. These studies indicated that the children of many alcoholic mothers were born with a cluster of birth defects. "What the government conveniently chose to ignore" say Whitten and Lipp, is that this syndrome is extremely rare - 3 occurences in every 100,000 births, and even then only when the mother drinks abusively throughout her pregnancy".

Lipp and Whitten, whose book, "To Your Health", was published in 1995, are among an increasing number of doctors and researchers who feel that pregnant women have no reason to fear drinking a glass of wine every day. Contributing editor Thomas Matthews wrote in a special issue of "Wine Spectator" magazine devoted largely to this controversy: "There is even new research that shows moderate drinking during pregnancy may actually help the development of the child after birth".

No one questions the fact that the consumption of large amounts of alcohol during pregnancy can harm the fetus. It has been well established, for example, that the children of women who drink more than 3 - 4 glasses of wine daily show significant decreases in birth weight and length than those of women who drink 1 - 2 glasses daily. It is also widely accepted that having five or more drinks per day is especially dangerous to the fetus. Here, however, agreement ends, and Genevieve Knupfer of the Alcohol Research Group in Berkeley, California says that part of the problem comes about because many of the studies that reported adverse effects on the fetus used imprecise methodology.

In several studies researchers arbitrarily defined "heavy drinkers" as women who had more than one glass of wine daily. Dr. Michael Samuels of New York's Doctors Hospital says more bluntly that the data has been "turned around for the purpose of frightening women", and that birth defects of any kind occur in 3-5 percent of babies born in the United States and only 1-2 percent of those can be related to drinking alcohol. Based on the data of Samuels and other medical researchers, it becomes clear that less than 0.1 percent of all birth defects are related to alcohol, and that more than 90 percent of the affected children are born to women with a history of severe alcohol abuse.

More than this, not a single study carried out since the mid-1980s has shown a direct correlation between moderate alcohol consumption and birth defects. One study, of 33,300 California women showed that even though 47 percent drank moderately during their pregnancies, none of their babies met the criteria for Fetal Alcoholic Syndrome. The authors of this study concluded "that alcohol at moderate levels is not a significant cause of malformation in our society and the argument that moderate consumption is dangerous, is completely unjustified".

Then there are the studies that indicate light to moderate drinking may actually improve the chances of successful pregnancies. A 1993 study in the "American Journal of Epidemiology" by Ruth Little and Clarence Weinberg concluded there were fewer still births and fewer fetus losses from early labor in women who consumed a moderate level of alcohol. Dr. Martha Direnfeld of Haifa University believes some alcohol can protect against preterm birth. Alcohol, used properly, is know to stop unwanted uterine contractions and so "has saved many pregnancies that might otherwise have spontaneously aborted," she says.

Dr. Robert Sokol of the National Institute on Alcohol Abuse in Detroit has shown it is light drinkers and not abstainers who have the best chance of having a baby of optimal birth weight. In their book "Alcohol and the Fetus" Doctors Henry Rosset and Lynn Wiener have presented data showing that children of moderate drinkers tend to score highest on development tests at the age of 18 months.

Despite these and many other findings the United States government, the American Medical Association, the British Medical Association and the vast majority of American and English doctors continue to recommend complete abstention from wine, beer and spirits during pregnancy. An examination of why reveals that the discussion is as emotional, ideological and political as it is medical.

Well-respected wine writer Janis Robinson has said that "in a male dominated society, men feel entitled to lecture pregnant women on how they should best discharge their responsibilities to their unborn children". In a similar tone Katha Pollit, writing in "The Nation," said "all of these warnings allow the government to appear to be concerned about babies without having to spend any money, change any priorities or challenge any vested interests."

No one says there are no risks at all in drinking alcohol during pregnancy but as Thomas Matthews stated in his article in the Wine Spectator: "It is important to ask, risky when compared to what?" In her recently published book "The Myths of Motherhood", Shary Turner indicates that alcohol is far from the only risk factor pregnant women are warned against. Other items on the list include caffeine, chocolate, raw oysters, unpasteurized cheese, tropical fruits, drugs that alleviate cold symptoms, nail polish, suntan lotion and hair dye, all of which in some amount may harm the fetus.

Turner's conclusion is that "the only risk-free pregnancy is one that is meant less to benefit the baby than to imprison the mother in anxiety and self-reproach". In the absence of 100 percent certainty about the issue, many continue to insist that abstinence is the best advice to give pregnant women. Others, however, see this attitude as illogical and have concluded that the risks and benefits associated with light to moderate regular wine consumption compare quite favorably with most other activities of daily life. Doctors Whitten and Lipp write that "light, regular wine consumption, or one or two glasses of table wine per day can be part of the healthy life style for most people, including pregnant women".

Several years ago, when researching a similar subject, gynecologists Howard Carp of Herziliya and Martha Direnfeld of Haifa also indicated that women who were drinking healthfully before pregnancy are not putting their fetuses in danger if they go on drinking in the same way during pregnancy. Dr. Carp said "an occasional glass of wine or any other drink is fine, no problem at all, and those women who drink a glass of wine once or twice a week with their meals or at kiddush should not feel any guilt or fear at all."

Like Dr. Carp, Dr. Direnfeld acknowledged the harm of drinking in excess but feels that "a reasonable amount of alcohol, say a glass of wine per day, will not harm the baby". It is true that all of the evidence has not yet been gathered, but it is difficult not to see the logic of the conclusion of the Wine Spectator: "When it comes to drinking, evidence demands interpretations and decisions require judgment. Women are capable of choosing for themselves."