10 Most Asked Questions About Alcohol During Pregnancy

Maybe you’ve been trying to get pregnant for months and are hoping that it’ll be positive this time. Or maybe you missed your period for one, two, then five days and are starting to suspect something’s up. Either way, you go into the drugstore and buy a pregnancy test (The digital one? The one with the blue lines? One of each?). You rush home, follow the instructions (it requires a bit more agility than you realized), and…it’s positive!

Now the mental math begins. And no, we’re not talking about the “who’s the father” type of calculations — instead, we’re talking about the mental math of figuring out when you had your last drink. Was it a week ago? Last night? Earlier this afternoon with lunch? What if I drank during the two week wait? And what does all of this mean for your growing baby? In this article, we’ll explore the 10 most commonly asked questions about drinking before or during pregnancy.

Alcohol and Pregnancy: A Sensitive Topic

We’ve all heard that we shouldn’t drink when we’re pregnant, but many of us wonder just how seriously we should take this warning. According to the CDC (and to many other health organizations around the world), zero really does mean zero in this case. 

And yet statistics show that real life is more complex. According to the NIAAA “National Survey on Drug Use and Health,” nearly 1 in 10 pregnant women report current alcohol use, about 1 in 22 admit to binge drinking, and about 40% of those who report drinking any amount also use other substances (usually tobacco or marijuana).

Sometimes the best way to approach a difficult subject is by asking an honest question to open the space for conversation. So let’s explore the 10 most common questions about alcohol during pregnancy:

1. What Are the Risks of Drinking While Pregnant?

The biggest question of all has to do with the risks of drinking while pregnant. What is it exactly that makes it such a big no-no? Here’s the gist:

• Fetal Alcohol Syndrome (FAS). This one is by far the most serious problem when it comes to drinking while pregnant. NIAAA defines FAS as a “wide range of physical, behavioral, and cognitive impairments that occur due to alcohol exposure before birth.”
  
  At one point or another, we’ve all seen posters with the characteristic features of FAS — the thin upper lip with a smooth area underneath the nose, flattened nose bridge, and characteristic inner eye folds. Unfortunately, this condition often comes with developmental delays, neurological abnormalities, and behavioral problems. It affects 1 to 5 percent of all first graders around the country — a tragically high number for a preventable condition.
  
  According to a Trends in Cognitive Science article, the most severe form of FAS that results in the characteristic facial features happens in the first trimester. The third week is particularly crucial since this is when the neural plate — the blueprint for the central nervous system — takes shape. However, neurological damage can happen later in pregnancy as well, leading to a range of abnormalities that fall on the “Fetal Alcohol Spectrum Disorders” (FASD) continuum. 
• Risk of miscarriage. The other big risk (especially in early pregnancy) is miscarriage. According to an American Journal of Obstetrics and Gynecology article, our risk of having a miscarriage increases with each week of alcohol exposure throughout the first trimester, “even at low levels of consumption and when excluding binge drinking.”

For an in-depth look at FAS, as well as at other risks of drinking during pregnancy check out our blog: “What Are the Risks of Drinking Alcohol While Pregnant?”

2. What About Drinking After Conception Before Implantation?

Science says drinking after conception before implantation isn’t a great idea. At this stage, the soon-to-be zygote is a blastocyst — a “berrylike cluster” of rapidly dividing cells that forms about 5-6 days after an egg gets fertilized by a sperm cell. Despite the awkward-sounding name, this is one cool “berry!” The blastocyst already has the “rough draft” version of cells that will turn into the embryonic endoderm (the basis of the respiratory and digestive tracts), as well as the trophoblast (the precursor to the placenta).

According to the Arizona State University Embryo Project Encyclopedia, drinking after conception before implantation could lead the blastocyst to get released from the body instead of implanting into the uterus. In other words, the pregnancy could be over before we even know about it.

3. What About Drinking During the “Two Week Wait?”

The “two-week wait” is the 14-day stretch between ovulation and the time we would normally expect our period. This time can seem much longer to those hoping to get pregnant (“Did it happen this time?” “Do I feel any different?” “Is this weird craving for peanut butter a sign?”). But what about drinking during the two-week wait?

The guidelines are clear about alcohol during pregnancy, and drinking during the two-week wait is no different. According to the CDC, “There is no safe time for alcohol use during pregnancy. Alcohol can cause problems for the baby throughout pregnancy, including before a woman knows she is pregnant.”

4. “I Drank Before I Knew I Was Pregnant, What Do I Do?”

You might be thinking, “I drank during the two week wait — or even later on. What do I do now?” This is a common concern since so many of us don’t find out we’re pregnant until at least a few weeks (or even months into the process). The key is to do our best. Once we know we’re pregnant, it’s important to stop drinking. However, none of us are psychic (at least not most), and we can’t know what we can’t know.

So if you — like thousands of others — happened to have a few drinks before you knew you were pregnant, don’t be ashamed. Talk to your doctor if you have concerns, but try to focus on the present. Make sure you’re taking prenatal vitamins with folic acid, keep up your regular obstetrician appointments, and follow your doctor’s advice.

5. Can a Pregnant Woman Drink Wine?

Wine is part of many cultures and lives in the “food” category in many people’s minds (think French culture, the Mediterranean diet, or even Food and Wine magazine). And sure, it might be different from, say, a jager bomb or round of vodka shots, but not different enough, as far as pregnancy goes.

Recent studies show that no amount of alcohol is safe, and wine is no different. Experts agree that “No amount of wine during pregnancy is deemed safe and that consuming wine while pregnant should be avoided.”

6. What About Having a Glass of Wine While Pregnant?

Many people still see wine as different from other types of alcohol, and some even get confusing advice from their family members, friends, or even midwives, that having a glass of wine now and then is okay. (“Hey, I drank wine when I was pregnant with you and you turned out all right!”).

A study by BMC Pregnancy and Childbirth examined this common misconception and pointed out that despite the knowledge of FAS and other complications, many continue to drink during pregnancy. Wine in particular tends to look more “innocent” — while throwing back tequila shots at a bar would raise eyebrows, a sip of wine with dinner feels socially acceptable.

Here’s what some study participants said about the advice they received:

• “My midwife said that having a glass of red wine was actually better for the baby.”
• “My midwife said that if you’re craving a glass of wine to have a glass.”
• “I’ve heard people say that as long as you don’t have it in the first 12 weeks you should be fine, like a glass here or glass there.”

And while this “one glass of wine is fine” advice might come from good intentions in an effort to ease your pregnancy journey, it’s important to be clear about the facts. Wine is alcohol, and no amount of alcohol is truly safe at this time.

7. What About Drinking While Trying To Conceive?

Studies have been clear about this — alcohol affects fertility and can lower our chances of being able to conceive.

A study by the BMJ found that women who drank two bottles of wine per week (or the equivalent) had an 18% drop in fecundity (ability to conceive).

Likewise, a more recent study in Acta Obstetricia et Gynecologica Scandinavica compared nine studies on alcohol consumption (as well as caffeine intake) to see if either made a difference for women undergoing fertility treatment. As it turned out, women who had seven or more drinks per week were 7% less likely to end up pregnant after the treatment and 9% less likely if their partners drank at the same level! Caffeine, on the other hand, didn’t make a difference. (Hooray! That morning latte is still okay for now).

8. Can Alcohol Affect a Pregnancy Test?

The short answer is no — it’s not likely that alcohol would affect a pregnancy test.

According to the Cleveland Clinic, pregnancy tests look for human chorionic gonadotropin (HCG), a hormone that serves as a hallmark sign of pregnancy and can be detected in blood or urine. While our physician will probably do a blood test to confirm a pregnancy at the first obstetrician appointment, home tests are generally the “pee-on-a-stick” kind (thankfully). If we do everything right (sometimes easier said than done), they tend to be 99% accurate.

The chemical reaction that tests for the presence of HCG is pretty straightforward. It takes about three minutes (which can feel like three hours), and there’s a yes or no answer at the end. Booze or no booze, HCG is either there or it isn’t. That said, as we already know, it’s not great to have alcohol in our system if the test does end up being positive.

9. Should My Partner Stop Drinking If We’re Trying To Conceive?

For years, we thought that men had a freebie when it came to drinking and pregnancy. Other than saying no to booze for those nine months in solidarity with their partners, it was believed that alcohol doesn’t affect sperm in a way that could negatively impact the fetus.

Surprisingly, recent research shows this might not be true! Recent studies show that men’s drinking patterns could affect the pregnancy and health of the baby. A recent study in Andrology suggests that potential fathers’ drinking habits can also affect fetal development and IVF outcomes. Moreover, simply stopping isn’t enough! It takes at least a month to get into “baby-making” shape and undo the oxidative stress experienced by the liver during withdrawal.

As study author Michael Golding told News Medical:

“For years, there's really been no consideration of male alcohol use whatsoever. Within the last five to eight years, we've started to notice that there are certain conditions where there's a very strong paternal influence when it comes to alcohol exposure and fetal development … With this project, we wanted to see how long it would take for the effects of alcohol on sperm to wear off. We thought it would be a relatively quick change back to normal, but it wasn't. The withdrawal process took over a month."

10. What Do I Do If I’m Struggling To Stay Sober While Pregnant?

First things first — you’re not alone, and there’s no shame in admitting that you’re struggling. In fact, it’s a sign of courage and integrity to be able to be honest about this challenging subject.

Rest assured, there’s plenty of help available, and medical professionals, therapists, and online support communities (such as Reframe) are ready to help you on your journey. Start by talking to your doctor and consider inpatient alcohol treatment if you feel you can’t stop on your own.

It’s never “too late,” and every day that you can stay away from alcohol will drastically improve your baby’s chances of having a healthy brain and a healthy life. Do whatever it takes, even if you have to rearrange your life, take a leave of absence from work, and have difficult conversations with loved ones. This is the time to put everything else aside and focus on what’s best for the two of you.

Alcohol and Your Pregnancy Journey

Pregnancy is a unique time filled with a range of different emotions, sensations, concerns, hopes, and, most certainly, questions. It’s natural to worry about what’s best for you and your baby, and there should never be any barriers to having an open discussion about your concerns with those qualified to address them. We’re all human, and no pregnancy ever goes exactly as planned. (Spoiler alert: neither does parenting). The key is to do your best and stay as informed as possible.

This openness is especially important when alcohol is the subject. Our understanding of how alcohol affects pregnancy is always evolving, and what well-intentioned people might have believed decades ago (or might still believe today) might not hold up today. In the end, we do our best with the information we have, and that’s all anyone can ever ask of us. So be kind to yourself as you keep exploring this fascinating part of life. Best of luck on your journey!