I am always surprised to see how people react to the whole topic of drinking alcohol during pregnancy. I drink -just the tiniest bit, after the first trimester (during which the organs form) has passed. I’m not talking getting drunk here, I’m talking having a few sips of something, such as to taste a good wine or being part of a celebration. Yes, only a few sips, like the amount they pour into your glass when you’re first supposed to get a taste of a bottle and approve it before the waiter then serves everyone else. I’m not downplaying this, I wouldn’t be OK with real drinking during pregnancy, or any dangerous behavior for that matter, of course not. But I like drinking, and I appreciate getting a little taste, and I know the amount of alcohol ingested is truly minimal.
Some cultures seem to be much more relaxed towards this –in Italy, when M ordered half a bottle for dinner, they would systematically still bring me a glass, and start to pour some for me, even though I was quite visibly pregnant at this point. Most of the time I would stop them before and point to my belly, but sometimes I would just go ahead and drink this very small amount, not even enough to give me the slightest buzz. However, here, I find people to be a little hysterical about this. "You’re drinking?," they exclaim with incredulous eyes. Or if I ask someone if they do that too or if their partners do, most people just shake their heads in disbelief, as if I had just asked if they were smoking crack while knocked up. "Of course I don’t drink! You’re not supposed to drink!"
No one has to drink if they don’t want to, obviously. But I generally find people to not really stop and rationally think about or interpret public health recommendations as part of a larger context. It’s known that consuming large amounts of alcohol can damage the fetus. Since however it was never really possible to establish the amount of alcohol that could be considered safe, and because it’s wise to use more caution than perhaps necessary when it comes to everything pregnancy-and-baby-related, guidelines usually prone abstinence (although not everywhere). But this is how public guidelines work, people: advisers who issue these recommendations always have to consider their audience to be not-so-smart, and systematically dumb them down while striping them out of any nuance. In this case, it’s pretty obvious that saying "drinking just a little is really most probably fine" could have all kinds of interpretations – a little is 5 occasional sips for me, but could be 3 drinks a day for a usual heavy drinker, or maybe there could be a danger that once someone starts, they wouldn’t really be able to stop after a small glass, and so on. Hence, the total prohibition message, which at least is clear and prudent, but, hey, as it’s been said in many places (including this recent article), has always been "a precaution," not based on established science.
The other problem I find is that the no-drinking message has become way too singled out and emphasized, to the detriment of a lot of other potentially dangerous behaviors many pregnant women are completely unaware of. The way I see it, your behavior and lifestyle during pregnancy has to be a well thought-of, comprehensive one, that doesn’t stop at alcohol (or smoking) alone. There are so many things that could be harmful to your baby, and probably a lot more so than minimal drinking… I’m especially thinking about exposure to heavy metals, VOCs, chemical substances, hormone and endocrine disruptors, etc. I posted about that last year, when I learned that children get 50% of their lifetime exposure during their first 5 years of life, including in utero, and this scared me a great deal and brought me to a new awareness of these things.
Therefore, it’s really probable that the pregnant women who think they are safe since they are not drinking and find my behavior irresponsible (but that’s alright, I feel quite secure about this and its effect -or lack thereof- on my baby), will eat canned tuna often during their pregnancy. Not many people seem to know that, but it is loaded with mercury (some kinds more than others) at doses that many experts deem very unsafe not only for pregnant women (it goes straight through the placenta and directly attacks the fetus), but even for women who plan to become pregnant in the next few years (see for instance the excellent book by Marion Nestle, What to Eat). The problem with mercury is that not only is it extremely dangerous, but it is cumulative in your body, never being eliminated or going away (like alcohol does quickly). These women may also get their hair dyed, or get their nails done at places where very strong solvents are used. Even usual nail polishes you use at home contain harmful VOCs (I now use the water-based, non-toxic brand Acquarella), and bottles should not be opened while pregnant or even in the presence of children. Pregnant women also nearly always paint at least the nursery, right, if not the whole house when the arrival of a new baby leads them to a new place… Well, unless you choose a non-toxic brand, which are few and expensive, the paint fumes will also expose your baby to a lot of VOCs. Then, there are the cosmetics: parabens and phthalates are increasingly viewed as culprits for hormonal disruptions, but there are also other ingredients that should not be used while pregnant, including retinol and salicylic acid (a common acne treatment)… Sunscreen? Some ingredients like oxybenzone have been recently found out to penetrate skin cells (despite longtime claims from manufacturers that it didn't) and potentially damage your DNA when exposed to light, and many experts have strongly advised against using them for children, although you don't hear that anywhere in the public sphere. And what about the big coffee drinkers, or the pregnant women who are always surrounded by smokers? Not to mention all the over-the-counter and prescription medicines…
I mean, I don’t want to sound alarming here. These are just realities of life you should at least be aware of, and it's kind of impossible to shield oneself from all of this. The fact is even if pregnant women did all that (I certainly did several of these while pregnant with LP), chances are their baby will turn out fine. As mine will, even with the few sips of wine that make mommy happy.
Wednesday, July 14, 2010
That big pregnancy taboo
Subscribe to:
Post Comments (Atom)
15 comment(s):
You are fascinating and thought-provoking as always.
I haven't drunk any alcohol in nearly 2 years, since I started trying to get pregnant. I've never been much of a drinker and alcohol has always felt really toxic to me so it hasn't been an enormous sacrifice. Now that I'm 22 weeks I don't feel like there's any reason for me not to drink (in the way you do, occasional sips) but I won't because the smell alone makes me feel kind of ill. I do however have the tiniest amount of real coffee sometimes and like you with wine, I don't think it's a big deal although I would never drink a whole mug.
I think when you struggle to get pregnant you will do everything that might make the smallest difference to your outcome and I will admit to being horrified to hear about other women going through fertility issues continuing to drink a couple of glasses of wine a week, it just didn't seem worth the risk to me.
But in a healthy, easy pregnancy a little wine or beer doesn't seem like the worst thing you can do. I'm terrified of chemicals in conventional cleaning products and cosmetics and get very judgey about people using them around children, non-organic food, particularly dairy produce freaks me out and we're painting our building site with only eco paint, although it costs a fortune.
I agree with most parts of this post. I agree that a sip isn't going to do anything after the first trimester. Since there is no established dose response, the rule of thumb is before trying and during the first trimester: nothing. But what of women who don't know they're pregnant and have a drink? I'm just posing a hypoethical question.
Another rule of thumb I've heard: if you get a buzz, the baby feels it, too. So if you get a buzz, you've had too much. But that's hardly scientific. I think some people are too relaxed about alcohol. But there are, like you've pointed out, many who panic at the though of alcohol during pregnancy.
Okay, last thing: a story. I had a friend who was refused to be served coffee while pregnant. Yes, there's evidence that too much coffee is bad for the baby, but that refers to multiple cups a day of coffee, not one cup! I am indignant that that coffee shop employee refuse to serve coffee! Would he/she feel the same way about tuna?
People are very quick to judge in our society, especially when it comes to a pregnancy.
And as if on cue, this video about environmental toxins during pregnancy has just come out:
http://www.enviroblog.org/2010/06/your-green-guide-to-pregnancy.html
Very good points. I have a friend who has made many of the same points that you have. She also would have a few sips of alcohol {wine} here and there while pregnant and used to tell me all of the stories of how people reacted to her, the stares, the words, etc.
I always figured that I would give alcohol up when I get pregnant but I'm not ruling it out completely. I mean, I'm a woman who likes to drink and I always imagined that it would be hard to give it up for so long. But I am willing to do it of course if that's the safest bet.
Another friend of mine who is pregnant told me that the reason she new she was pregnant was because she suddenly for seemingly no reason at all couldn't even stomach the thought of alcohol. She was a frequent drinker and her husband brought her over a glass of wine at a party and she said it seemed almost toxic to her. She only found out after that she was pregnant. Interesting...
All those people who are categoric about not drinking... is it their 1st pregnancy? I find that around me, most women relax about this subject from the 2nd pregnancy on. That is, if they chose to have more than one child! During my 1st pregnancy, I had ONE sip of wine ONCE, at my birthday. This time, I occasionally had a few sips, just as you described.
I'd like to draw attention to your reasoning here though, if I may play the devil's advocate for a while. You refute here the recommendation not to drink alcohol at all during pregnancy because it's only a precaution and not based on scientific evidence. I hope that you realize that on many environmental and health issues, that same argument--lack of sound science-- is used by government instances for not regulating substances or practices, and by profit-making companies for not stopping using some ingredients in cosmetics, paints, household products and so on... I always find it awkward when people who usually care about such issues and would usually like organizations to be more on the cautious side, put precaution aside when it suits them... Of course, on alcohol during pregnancy, the lack of "official" evidence (which would be next to impossible to gather, as it would be unethical to conduct studies where large numbers of pregnant women would be made to drink various amounts of alcohol so that the incidence of foetal alcoholic syndrome could be calculated as a function of drinking intensity; plus really good evidence comes from blind or double-blind studies, and the effects of alcohol are so easily felt that blinding the "subjects" would be nearly impossible) is balanced by the abundant anecdotal evidence from previous times and from countries where the view of alcohol consumption during pregnancy differ from here, such as France or Italy. But still, this is the same kind of anecdotal evidence that make us worry about chemicals in our food and environment, but that often isn't enough to bring officials to regulate about those chemicals...
Your absolutely right. And given that you're some sort of an authority on this, your opinion really matters to me.
I guess I was trying a bit to turn this on my favor because it suits me. Like I said, regardless of the recommendations, I feel totally OK about this, otherwise I wouldn't do it and especially wouldn't expose myself publicly by confessing of it here!
But bottom line, I think we do need more accurate, up-to-date and honest recommendations on many more topics than just refraining from drinking and smoking.
I think, in general, recent attitudes about everything involving child rearing are extreme. You can't drink while pregnant, you can only use certain bottles, but you should never be using bottles anyway because you should ONLY breastfeed for fear of nipple confusion and formula is the devil, and never, ever let your kid watch TV and by all means teach them to read before they can even talk...I could go on forever. I mentioned spanking once on a blog and people were ready to jump down my throat. It's just nuts.
Feel free, have a glass of wine. I won't judge or tell!
I was born in 1962 (yes, I'm old), my sister in 1964, and I know my mom drank when she was pregnant with us -- never a heavy drinker, it was probably the occasional beer or glass of wine. And though I don't think she smoked at that time, plenty of people in my family did. Honestly, given current attitudes, it's a wonder my sister and I didn't come out with points on our heads! As it was, I weighed 8 lbs 9 ounces, and my sister was 8 lbs 11. And healthy as horses ever since!
Improved understanding of toxins aside, I do wonder if some of the societal craziness around pregnancy and childrearing has to do with the overall shift in women's roles. When my mom had us, it was expected that women would have kids -- it was an ordinary thing, and was treated as such. (And yes, I'm leaving out the other attitudes that women had to face in those days, for the sake of a comment of reasonable length.)
Now, though the pendulum on having kids hasn't swung completely to the other side, many women put off childbearing until "later," have difficulty conceiving, or don't have kids at all. So it's become more "special" or out of the norm, and society seems to have attached a whole bunch of expectations to it that don't necessarily do women a lot of good.
As you said, Marie-Eve, a lot of recommendations are dumbed-down. And as a feminist, I'm not OK with that. I think women need to make their own decisions, based on the best available information. It irks me no end when others actively disapprove of a woman's behavior for any reason!
I drank a half dozen times, never more than a glass (usually not even) and it felt like the right balance, for me.
And while I followed "some" of today's advice (for example, stayed away from foods with listeria)....I disregarded others, for example, I ate seafood, in reasonable quantities. I think it's about taking educated choices. Sure, it's possible to attempt to live in a bubble and to make lists and lists of things that you will not do.....but in the long run, those lists seem to change from decade to decade and from country to country....and common sense usually swings people back around.
I hope you are feeling well
I agree with Lucie that many women go "by the book" for the first pregnancy and then understandably relax for the next one(s). Part of the issue with alcohol for some women may be the idea that having one drink will lead to wanting another, so it's best to just avoid it altogether during pregnancy.
There is definitely a lot of pressure and judgment around pregnancy. One day when I was pregnant with my first, I was in the grocery store looking at oven cleaners. Our oven needed to be cleaned, but I wasn't planning to do it myself.
A total stranger stopped in the aisle and said "If you're pregnant, you shouldn't be going anywhere near oven cleaner! It's completely toxic, etc. etc."
I guess people who say these things are trying to help, but it doesn't feel great to become a public target for their anxiety.
Me again! I came back to read some comments.
I would like to point out there IS empirical evidence about drinking and smoking while pregnant.
With drinking, there is no dose-response at which FAS (fetal alcohol spectrum) can develop. That means there's no "safe dose" below which you know the baby will be fine. (WHich is the same with carcinogens: there's no safe dose, so the typical recommendation is to avoid carcinogens as much as you can.) In the absence of empirical dose-response relationships with alcohol during pregnancy (and as Lucie pointed out, we're not likely to get any data), public health policy tends to be to recommend avoidance. Hence the policies to avoid alcohol.
And there IS empirical evidence for smoking and pregnancy. Women who smoke even occassionally during pregnancy are more likely to have a low birth weight baby, children with asthma (even if they quit smoking), and - here's the kicker - even if they quit smoking during the pregnancy, these women's GRANDCHILDREN are more likely to have asthma. SO if you smoke occassionally in your pregnancy, but quit before the baby's born, your grandchildren are more likely to have asthma and permanent lung effects. That is incredibly scary, to me, as both my mom and mother-in-law smoked occassionally during their pregnancies. And both quit smoking later. (And I have asthma.)
(My background is public health, and I have a masters degree in health science. I can point out resources/websites if you'd like to learn more about either research I talked about.)
Wow, I feel so lucky to have such brainiac friends and cousins (that would be Lucie, which PhD I believe is in similar field than yours, Krista). Thanks for making me smarter and better informed girls!
I'm planning to drink a little during pregnancy (though you're right, probably not during the first trimester). All the research seems to show that you can even have full glasses of wine with no harmful effects, and that you can even go on up to two BINGES without effects. It's multiple binges that becomes a serious problem.
So, achem, no, I won't binge, or even have full glasses, but I'll drink a little. I think my mom drank a little. She gets eye-rolly at the no drinking bit. But then... I'm not planning on not drinking during the conception phase unless it becomes totally necessary. And.... I'll probably keep dying my hair. We use really low-tox stuff, semi-perm blah blah blah. But yes, most kids end up just FINE. It's only medications that really concern me.
I think of it as starting laid back parenting in the womb. And at least around here, the world needs more laid back parents. Lordy.
In sum - I think you're sane, yes? And you're FRENCH (Canadian) for goodness sake, I think that should be your excuse if anyone bothers you about it.
I drank all through my pregnancy. My mother-in-law poured me a tall glass of white wine when I was six weeks, and when I gave her a look of disbelief, she said "I drank through both my pregnancies, and I smoked fags! Don't be ridiculous." A very European attitude, indeed.
I only drank wine (mostly red), and only a glass (sometimes two) two or three times a week. I ate deli meat and soft cheeses as well. I drank coffee every day. If I got judgmental stares, I stared back.
I totally agree with what you say about govt warnings lacking nuance. They have to, as you say, because so many people lack the nuance to make reasonable decisions. In my case, I made the decision to be more relaxed, to return to the attitudes of a hundred years ago regarding food and drink, while being more careful about the modern toxins you discuss.
Jack, by the way, is perfectly healthy in spite of all my radical pregnancy behavior!
I have sips now and then of wine and I have tasted some beers we brought back from Quebec(I have my own little beer stash for after baby arrives!)having a pregnant nose and taste buds really makes those sips super enjoyable. I have even had a half glass of a white, which I slowly savoured for over an hour.
I drank coffee the whole way through. During the first trimester it was a small half decaf, now I will have a medium or large. Before I was pregnant I would drink several large coffees a day. I also go out of my way to only drink the organic coffee. I thought someone would say something to me but no one has.
There are so many things we should avoid in general and not just while pregnant. Some are easier to avoid than others.
Post a Comment