Can I drink wine if I'm pregnant?
It’s a question many people ask as soon as they find out they’re pregnant, but what’s the real story behind drinking alcohol in pregnancy? Is it safe to have just a drop, or should we give up completely? Senior NHS Midwife, Hannah O’Sullivan shares some of the research on the subject…
Is it safe to drink wine in pregnancy…. depends on who you ask, right?! The conversation around alcohol in pregnancy is confusing. It is also fairly contentious I find. And I think I know why!
In 2016 the UK’s Chief Medical Officer changed the advice around drinking alcohol in pregnancy, and whilst trying to conceive. If you know me at all, you will know that I love to bang on about evidence-based care - and there is evidence to underpin current advice.
Miscarriage is 3 times more likely in pregnant women and people who drink more than 5 units a week during their first trimester. Lots of studies found that drinking alcohol, even in small amounts, impacts male and female infertility - although it is not clear why. But the fairly recent change in advice means that lots of people you know, maybe even you yourself in an earlier pregnancy, will have been given different advice about ‘safe’ amounts to drink in pregnancy. This has resulted in confusion and mistrust in the advice.
In the UK, drinking alcohol is a deeply ingrained cultural practice. Vast numbers of us drink significantly more than is considered to be healthy. Drinking alcohol is often equated with being fun, being someone who enjoys a good time - while on the flip side, not drinking on a night out is often met with derogatory comments about being boring etc. Cutting out alcohol can feel like the first step on the road to becoming a grown up parent, and that can be hard to accept; consciously or otherwise.
SO what do we know? Alcohol freely crosses the placenta, undeveloped fetal livers are not able to process alcohol. Drinking alcohol in all stages of pregnancy can have negative impacts on babies in utero. Not all babies will have Fetal Alcohol Syndrome - characterised by abnormal facial features, learning disabilities and growth issues - but there is no way of being confident what volume of alcohol will have an effect.
Alcohol affects the development of white matter in the baby’s brain and so impacts their brain development. Although the more alcohol that is consumed the higher the risk, Fetal Alcohol Spectrum Disorder is an umbrella term that also encompasses developmental delays and issues such as hyperactivity, difficulty with social interaction, language and memory problems. Fetal Alcohol Syndrome lies at the extreme end of this spectrum. Many of the difficulties caused by FASD may not be immediately apparent at birth, but can be diagnosed as the child grows older.
What we don’t know, however, is if there is a ‘safe’ amount of alcohol to drink during pregnancy. There is no research to tell us confidently how much is too much, which is why many people choose to give up completely. Ultimately, though, this needs to be a decision you make for yourself based on the information you have. If you’re finding giving up drinking harder than expected we’d always recommend speaking to your midwife who will be able to help you access support.
There are lots of great books on the subject now too, including a growing #sobercurious movement online with loads of resources and inspiration for ways to wind down and relax without alcohol. Some of our recent favourites include The Sober Girl Society Handbook by Millie Gooch and Sunshine Warm Sober by Catherine Gray.
Get more advice about alcohol in pregnancy in Hannah’s General Health In Pregnancy workshop in The Ultimate Birth Pack.
