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Drinking while pregnant: Economist, doctors debate moderate consumption

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'Expecting Better' by Emily Oster
Book cover courtesy of publisher

Economist Emily Oster's conclusions on the safety of drinking in moderation during pregnancy led to a contentious debate on The Daily Circuit Wednesday.

In her new book, "Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong — and What You Really Need to Know," Oster sifted through studies on the effects of alcohol on a fetus.

"It's very clear that drinking to excess, actually even a couple times during pregnancy, is a problem, and I think we should be thinking about how we can help women who are struggling with these issues," she said on The Daily Circuit.

But Oster said she wanted to know about the risks of drinking a glass of wine with dinner on occasion.

She summed up her findings on Slate:

I summarize two studies in detail in my book: 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 drink up to a drink a day. I summarize two others in less detail: one looking at IQ scores at age 8 and a more recent one looking at IQ scores at age 5. These also demonstrate no impact of light drinking on test scores. 

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.)

On The Daily Circuit page, Abby in St. Paul said she was grateful for Oster's book. She started reading it two months ago when she found out she was pregnant. 

Emily Oster
Emily Oster, author of "Expecting Better"
Photo courtesy of Matthew Gilson

"It is so empowering to have all data and to be able to make my own informed decisions about my health--not just to feel I have to blindly follow a doctor's advice," she wrote. "I felt totally comfortable having a small glass of wine with my family on a recent trip to Europe, and that I wouldn't be harming my baby."

Oster's conclusions drew sharp responses on The Daily Circuit:

Jeff Wozniak, University of Minnesota pediatric neuropsychologist: "There's really no safe level of alcohol during pregnancy," he said. "She's ignoring a large body of animal research that shows that alcohol has effects on brain development and we can very clearly measure these things in animal models."

Virginia Lupo, chair of the Department of Obstetrics and Gynecology at Hennepin County Medical Center: "I am a high-risk ob-doc and I sure lean on the side of caution. God forbid a woman would have a child that had some kind of problem and would end up thinking back, 'Gee, maybe it was that glass of wine I had every Sunday...' I'm on the side of we don't know what is safe and I really lean toward safety for the baby."

A caller: "As a woman who had a child die from congenital defects when she was 5 months old, I can tell you I question every day what I might have done wrong even though my doctors have been very clear, saying to me, 'There's nothing you could have done,'" she said. "I just don't understand what is so important about drinking, what is so important about these risks? There's no going back. Once that child is affected, there's no going back."

Oster wrote the book after going through pregnancy based on research-based science instead of  conventional wisdom.

"When I was pregnant, it was enormously important to me to make the right choices, but I just wasn't comfortable assuming those choices were the ones dictated by the 'rules,'" Oster wrote for Time. "As an economist by training, I was used to making decisions by getting all the data, and then combining it with an understanding of the pluses and minuses of a choice for me personally. This isn't how pregnancy seemed to operate, but it's how it should work."

LEARN MORE ABOUT PREGNANCY:

• An Economist's Book Will Blow Up The Myths About Pregnancy, Starting With Drinking Alcohol And Coffee
Oster found enough evidence that she personally felt comfortable with a glass of wine now and then, and continuing to drink three to four cups of coffee a day when she felt up to it. Her 2-year-old daughter is perfectly healthy. (Business Insider)

• How A Pregnant Woman's Choices Could Shape A Child's Health
Pregnant women hear a lot about things they should avoid: alcohol, tobacco, chemical exposures, stress. All of those have the potential to affect a developing fetus. And now scientists are beginning to understand why. One important factor, they say, is something called epigenetics, which involves the mechanisms that turn individual genes on and off in a cell. (NPR)

• 'What to Expect When You're Expecting': Top 10 Changes in New Edition
First released in 1984, the New York Times bestseller has now sold more than 17 million copies, and it is estimated that more than 90 percent of expectant mothers have read it. (ABC News)

• Top 10 Things No One Tells You About Labor and Delivery
We talked to women who've been there to find out what they wish someone had told them before they went into labor. (Discovery Health)