The CDC started a bit of a firestorm recently by making a simple suggestion based on sound public health principles. Because damage to the developing nervous system can result from alcohol consumption even before a woman knows she’s pregnant, the only way to completely avoid risk is to act as if you’re pregnant all the time (assuming you’re sexually active and your methods of birth control are “iffy”).
The brain and nervous system are high priority systems in human development, and we don’t waste any time getting started with them (see image above). Pregnancy tests start providing accurate results within 7 to 10 days of conception, but many women wait until their period is a month late before testing.
Efforts to protect the developing embryo are not new. We have enough concern about the impact of insufficient folic acid on the risk of spina bifida (failure in the caudal closure of the neural tube, again at about three weeks following conception) that we inundate the whole public with folic acid by adding it to processed foods, just in case some percentage of that public could be pregnant. In Sweden, where folic acid is not added to processed foods, one large-scale study indicated that higher levels of folic acid were associated with greater risk of colon cancer. The American medical establishment continues to feel comfortable with folic acid supplementation, even though American studies use mice while the Swedish study used people. Increasing people’s risk of colon cancer, assuming the Swedes are onto something, seems much bigger than suggesting women stop drinking.
The CDC is certainly swimming upstream by making even a stronger case against alcohol, though, given the fact that many women ignore existing recommendations anyway. Alcohol is strongly addictive, and it appears that sizeable numbers of pregnant women either can’t or won’t quit. They smoke and use drugs during pregnancy, too.
I’m not sure that the CDC was talking to those women, though. Their message seemed to target women who want to maximize their chances of giving birth to a healthy infant, are willing to do whatever is necessary to accomplish that, and might otherwise be unaware of how early brain development proceeds in the embryo.
20 Comments
jessicametzinger · February 7, 2016 at 8:18 pm
It’s been known for a long time that alcohol consumption during pregnancy is harmful to the embryo, so I don’t see why people are so fired up about this. Many women choose not to drink while they’re pregnant so that they don’t hurt their baby, so it only makes sense that if you think you have a chance of being pregnant you should stop drinking altogether. It’s saddening to me to think that there are women who don’t want to give up drinking before being completely sure that they’re pregnant– it seems like a small price to pay for having a healthy baby.
Minnie · February 7, 2016 at 10:23 pm
When I first heard of this reporting, I was a bit upset and taken off guard. I read about it in a class filled with others who felt the same way I did: another authority power telling women what to do with their bodies as if all it is to do is become pregnant and give birth. Do not get me wrong, the findings from the CDC is not something people should ignore. However, in the articles that I read that presented the findings, it didn’t simply report what birth control and alcohol can do to the future of a child, it quickly went on to say all women need to stop drinking alcohol. There was one or two articles I read that did report the findings, then suggest what women should do if they see themselves getting pregnant later in their lives. The controversy of what the CDC reported was how they reported in my opinion.
Laura Freberg · February 8, 2016 at 3:46 pm
I agree that the information the CDC is using has been well-understood for many years. I do see where standards for what is okay during pregnancy have loosened lately, including the increased acceptance of the use of prescription and over-the-counter drugs, so maybe the CDC felt that more emphasis was needed. Some of my students report hearing that their pregnant friends doctors are telling them that “a little bit” of alcohol is not a big deal. The question is what is a little bit, though.
I’m not sure I would view this as a question of autonomy. I’m the last person to like being told what to do, but if science tells me that something is a good idea for me or my child, I’m going to listen.
BrittanyNelson · February 14, 2016 at 1:14 pm
I disagree with these doctors telling pregnant women that a “little bit” or even any alcohol while pregnant is okay. As an expecting mother, you are not only responsible for your life choices, but also your baby’s. It is not fair to subject the baby to alcohol consumption no matter how addicted the mother is. Telling pregnant women that they can consume a little is a slippery slope. I am thankful that some members of our society would look appalled to see an obviously pregnant women drinking or consuming drugs, but before the pregnancy is physically noticeable the responsibility falls on the mother to look after another life that is not her own.
annaliseconroy · February 14, 2016 at 8:19 pm
I have known a lot of friends from high school that have lived fairly risky lifestyles by drinking and using drugs consistently, and found out they were pregnant unexpectedly. Knowing that their child was being exposed to all of the various teratogens during the first few weeks is completely heart breaking. Because of this unknown impact on exactly how much alcohol or a particular substance is needed to cause an impact, I agree with the CDC’s suggestion to stay away from all alcohol and drug use while even the possibility of becoming pregnant is present. I think every parent should want to give their child the best chances possible and do everything in their power to raise a happy and healthy offspring.
hannahphelps · February 24, 2016 at 12:11 pm
As mentioned in prior comments, I do not completely understand the strong reaction to the CDC’s claims about the dangers of alcohol consumption during pregnancy and the recommendation to stop drinking prior to pregnancy test results verifying one is carrying. I do think there is a misconception that the initial stage of pregnancy is not effected by alcohol consumption to the degree the embryo is in later stages, therefore meaning it should not be a concern when one is implying trying to get pregnant. The CDC brings up an important concept: a mother begins her role as a mother before knowledge that she has a child. If a couple is trying to conceive, they must be prepared for the baby during the entire process and understand how prenatal drinking can affect the child.
isabeltung · February 26, 2016 at 8:22 am
Even though it has been known for long time now that alcohol consumption has consequential and creates adverse health problems for pregnant women, I don’t think it is wrong of CDC to be making a big deal out of this right now; there are times when we need to center our attention back on an issue that has not been solved and to and make sure we have not come to take the issue of alcohol and pregnancy lightly in this generation.
Laura Freberg · February 26, 2016 at 10:39 am
A more recent study, albeit with rats, showed that even small amounts of alcohol during pregnancy raises the risk of alcoholism in subsequent generations: http://www.ncbi.nlm.nih.gov/pubmed/26876534
We obviously need more data, but these findings support the caution expressed by the CDC. It’s one thing to drink yourself, and take the consequences, but it’s another to have a big negative impact on your children and even grandchildren.
arklipp · April 23, 2016 at 3:41 pm
It would be interesting to know the effects of alcohol stimulation of GABA receptors on fetuses and if there is much correlation with that and the effects of fetal alcohol syndrome. Do you know any research that has been done on that? Also, can alcohol moved through the umbilical cord to the fetus increase the percentage of anacephaly or spina bifida?
victoriatonikian · May 1, 2016 at 10:02 pm
I think for women who are actively trying to have a baby and are not on any kind of birth controls it is a safe bet to steer away from alcohol until you either have the baby or decide to stop trying and go back onto birth control. But to subjugate the entire female population and tell them not to drink is a little far fetched. The impacts of alcohol on a fetus have been known for quite some time now and I believe that any responsible adult would be cautious of having alcohol if she believed she could be pregnant. I understand not drinking if you are not trying to prevent a pregnancy through various measures but for those who are on birth control I don’t think this is a valuable piece of advice.
Bcrowley712 · May 2, 2016 at 8:37 pm
I did not know that Folic Acid was dumped into process foods, and although the article is about women and alcohol it is interesting to note that women take loads of folic acid vitamins as well and even that is sometimes not sufficient enough for the baby. I agree with Victoria that telling women who are trying to get pregnant to not drink at all while trying is a bit more realistic than targeting the whole female population to never drink again in case of an accidental pregnancy.
evanwilliams600 · May 10, 2016 at 12:06 pm
I actually discussed this with my mother, wanting her input on whether or not women should act as if they are pregnant all the time. She told me that she didn’t know that she was pregnant with me until about a month into her pregnancy, and she didn’t alter her drinking patterns until she was absolutely sure she was positive. I had no developmental issues. In fact, I was born with a perfect Apgar score. I do concede that everyone is different, and I may be a rare case, but my mom believes that anything in moderation, even within the first few weeks of pregnancy, usually won’t be completely detrimental to the fetus. I think it would be extremely interesting to conduct/read about a study that compares drinking in moderation vs. drinking heavily vs. not drinking at all during pregnancy. Does anyone know of any studies that have been done on this subject?
apivetti · May 11, 2016 at 10:51 am
Although CDC’s suggestion for women to consistently check for pregnancy if sexually active may seem unrealistic, it is not arbitrary. Not knowing about ones pregnancy into a month or more can or can’t have outstanding affects on the development of the fetus. Although many women, my mom included, believe a glass of wine here or there doesn’t disrupt one’s pregnancy, such recent findings suggest otherwise. Understanding that alcohol can generate failures in the caudal closure of the neural tube, as early as about three weeks following conception is enough of a scare for me to never want to drink during my pregnancy. This also encourages me to regularly check for pregnancy when it may be possible.
alexandrabush · May 31, 2016 at 11:51 am
With seeing how bad alcohol affects the embryo it is astonishing, at least for me, that women would continue to do so. My grandmother grew up in a generation where drinking and smoking was considered normal during pregnancy. My mother blames everything wrong that my dad does on his mother’s heavy drinking throughout her pregnancy with him. I do not see how people could have even thought that drinking would be okay for an embryo. It has negative adults on healthy adults, so why would it be good for an embryo. The CDC had the right idea of informing the public, but took the wrong path by being too extreme with their suggestion of how women are expected to act.
bailey_arthur · May 31, 2016 at 3:19 pm
I do not think the CDC were saying anything revolutionary in that if there is a possibility you might become pregnant do not drink. Alcohol is a relatively large problem for the US and I think that people need to be reminded of the possible consequences it can have on a unborn child. The lengths the US went to in order to produce enough folic acid in a woman’s diet to reduce the risk of spina bifida were huge compared to the lengths a woman has to go in order to avoid fetal alcohol syndrome or other negative developmental facts. I do not think the CDC were saying women should not drink, but rather that woman who may become pregnant because they are trying or not using protections should avoid alcohol. However, it does scare me that the increased folic acid diet in the US may lead to an increase in colon cancer. It seems like a hard balance between public safety and the consequences folic acid supplements have in the US.
lwickwir · June 1, 2016 at 2:51 pm
Honestly, in this day and age you can find multiple ‘scientific’ articles approving and disproving a lot of things–one of those things being drinking alcohol while pregnant. Most women know the risks of drinking alcohol while pregnant and if some women believe that it’s okay based on articles they’ve read, then that’s their decision. Personally, I wouldn’t drink alcohol when I become pregnant because when I’m ready for a child I want to make sure I did everything in my capabilities to make them as healthy as they can be.
LaurenTaylor · November 30, 2016 at 10:51 pm
I’ve grown up believing in the no alcohol rule during pregnancy. In my family, we have always suspected someone to be pregnant if they were not drinking at a family party. It was always custom for us to not drink during the whole nine month process. Although, I always wondered about those few weeks when the woman had not yet known she was pregnant. Would alcohol consumption during that time have an effect on the baby? I have a friend who recently had a baby, in which she wasn’t aware that she was pregnant for 3 months. Luckily the baby turned out okay, but there could have been some serious adverse affects while she was drinking and smoking during that time where she was unaware of her pregnancy.
Charlene Niku · December 5, 2016 at 10:05 am
I thought it was basic common knowledge that a pregnant women should not consume alcohol during her pregnancy so I am shocked to hear that this was news to some women. If a pregnant woman drinks alcohol, she is putting her baby’s life in danger. It is worthwhile to consider that cutting back on alcohol is beneficial even before becoming pregnant, but it is imperative to know that drinking alcohol while pregnant is dangerous. I don’t think women should be upset or angry to receive beneficial information that can reduce health risks for their babies. There are many consequences related to drinking alcohol, and I think its important for women, whether expecting to expect or not, to consider them. The “simple suggestion” provided by the CDC is more of a necessary precaution that should be taken by sexually active women.
emilyknighton · December 1, 2017 at 1:47 am
That is so interesting; I didn’t realize how early-on brain development starts. Sometimes I feel really lucky to be growing up during a time like now, because so many of the things that people didn’t realize were health risks are now pretty common knowledge. I think it’s safe to say that throughout the parts of my life where I’ve been able to comprehend as much, I’ve known that drinking alcohol and smoking were unsafe choices for a pregnant mother to make at any point during her pregnancy. What’s frightening, though, is to think about how many women are unaware that they’re pregnant, yet are continuing to smoke or drink because they have no idea. The damage that could be done accidentally seems daunting. In a way though, over-exposure to added folic acid in processed foods is accidental damage too, and not just to a baby. There are definitely areas where it seems like the health risks are either ignored or we still just have no idea that they’re there. It definitely frustrates me that there are so many cases where the information is ignored, and then the general public is left in the dark unless you’re an individual who’s extremely aware of everything all the time. BPA use in plastics is a good example. The BPA-free “fad” was beneficial in some ways, but I think a lot of people never really understood what BPA is, and still probably don’t. It wasn’t until I took a physiology course last spring actually, where I learned what the risks of too much BPA exposure actually are. While they are more mild than some other dangers, I wish that the government would impose tighter regulations to keep the general public safe from toxins, rather than waiting until it’s absolutely clear that a substance is bad and it’s already too late for some unlucky individuals. Especially in a case with something like colon cancer where the causes can be so ambiguous.
monjazeb · March 5, 2018 at 10:30 am
I agree that the information the CDC is providing is guided towards women who have the best interest of their infants in mind and want to take all the necessary precautions to ensure their baby is healthy. The difficulty here is that if a woman isn’t planning a pregnancy she may be risking the chance of her infants health without knowing it.