Let’s Have an Honest Conversation.
If you’re pregnant or contemplating pregnancy, you’ve likely encountered a strict guideline: no alcohol, not even a sip. The message from doctors, midwives, and public health officials is unequivocal—drinking during pregnancy is unsafe. Honestly, I agree. The safest option is to avoid alcohol altogether.
But if that’s the case, why does this question keep resurfacing? Why do some women insist that their doctor or grandmother tell them a bit of wine is acceptable? Why do some studies indicate that low levels of alcohol may not be harmful? And why do some cultures maintain a much more relaxed attitude toward drinking during pregnancy than others?
Pregnancy advice is often given in absolutes—do this, don’t do that—without much explanation. However, I believe that women deserve more than just rules. You deserve accurate information, full context, and the ability to make informed choices based on facts, not fear. That’s what this article is about.
We will examine what the science shows, including the strong warnings from the medical community against alcohol consumption during pregnancy. We will also investigate conflicting studies suggesting that small amounts may not be harmful and discuss why these findings are debated. We will explore cultural and historical perspectives, including how attitudes toward alcohol during pregnancy have evolved. Additionally, we will address perspectives from midwives and alternative health practitioners, focusing on how they approach these discussions with real women experiencing real pregnancies.
By the end of this article, I aim to give you a complete picture—no scare tactics, no judgment, just a clear, balanced view of what we truly understand about alcohol and pregnancy.
Now, let’s get into it.
The Medical Consensus: Why Every Doctor (and Midwife) Says No
Let’s start with the basics. Alcohol crosses the placenta, meaning your baby is exposed to it every time you drink. However, unlike you, your baby doesn’t have a fully developed liver to process it. That’s why alcohol can disrupt fetal development and lead to serious complications, some of which can be lifelong.
What the Research Says:
- Miscarriage & Stillbirth: Drinking during pregnancy increases the risk, especially in the first trimester.
- Preterm Birth & Low Birth Weight: Alcohol use has been linked to babies being born too early or too small.
- Fetal Alcohol Spectrum Disorders (FASDs): These are a range of lifelong issues, including learning disabilities, behavioral problems, and physical abnormalities.
- Neurological & Psychological Effects: Studies suggest that even low levels of alcohol could be linked to higher risks of anxiety, depression, and attention disorders in children.
The CDC, NHS, March of Dimes, and most major health organizations have made it clear: there is no safe amount of alcohol during pregnancy. While some studies may suggest otherwise, the risk is significant enough that no expert will assert that even one drink is completely safe.
Wait—But What About Those Studies That Say a Little Might Be Okay?
This is where things become complicated. The prevailing message from medical organizations is that abstaining from alcohol is the safest choice during pregnancy. However, if that’s true, why do some studies imply that small amounts of alcohol might not cause harm?
These studies attract considerable attention, and I understand why. Nobody wants to feel guilty about having a glass of wine before realizing they were pregnant, and many women seek reassurance that modest amounts aren’t a significant concern. The notion that an occasional drink could be harmless is appealing because it challenges what can seem like a strict, one-size-fits-all rule. However, before jumping to conclusions, let’s examine what these studies say—and why they remain controversial.
Studies That Challenge the Zero-Tolerance Approach
Over the years, some research has suggested that light drinking may not lead to measurable harm. A few of the most cited studies include:
- 2013 Harvard Health Study: Found that minimal first-trimester alcohol use did not appear to increase the risk for certain pregnancy complications, like high blood pressure disorders, preterm birth, or low birth weight.
- 2012 Danish Study: Tracked 5-year-olds whose mothers drank lightly during pregnancy and found no significant impact on their executive function, which includes skills like memory, attention, and problem-solving.
These studies may sound reassuring, but they have limitations. Most were based on self-reported alcohol consumption, which can be unreliable. Many of the outcomes measured were short-term, meaning they didn’t track the children into later childhood or adolescence when subtle effects on brain development might become more apparent.
Newer Research Suggests Even Low Alcohol Exposure Can Have Effects
In contrast, more recent and more extensive studies indicate that even small quantities of alcohol could have long-lasting effects, primarily on brain development.
- 2020 University of Sydney Study: Found that even low alcohol consumption during pregnancy was linked to higher rates of anxiety, depression, and inattention in children at ages 9 to 10. This study, which pulled data from nearly 10,000 children, raises concerns about the potential long-term neurological effects of alcohol exposure.
- 2024 University of New Mexico Study: Discovered that low-to-moderate drinking during pregnancy was associated with shorter gestation and lower birth length. The study also found sex-specific differences, meaning male and female babies may be affected differently by alcohol exposure.
Why Do These Findings Contradict Each Other?
The inconsistency between these studies can be frustrating, but there are a few reasons why the research doesn’t always align:
- Differences in what’s being measured: Some studies focus on birth outcomes, like weight and gestational age, while others track long-term brain function and behavior. A baby may appear healthy at birth, but that doesn’t mean alcohol did not affect their brain development.
- Genetic and individual variations: Some babies may metabolize alcohol differently than others, making it difficult to pinpoint how much exposure is too much.
- The challenge of self-reporting: Many studies rely on women accurately remembering and reporting their alcohol consumption, which can lead to underreporting or inconsistencies.
So, What Does This Mean for You?
Ultimately, pregnancy is fraught with uncertainties. You can do everything “right”—eat well, exercise, and take your prenatal vitamins—and still encounter challenges beyond your control. However, when it comes to alcohol, this is one risk you can fully eliminate.
Some studies suggest that light drinking may not cause measurable harm, but that doesn’t change the more significant issue. There is no known safe amount of alcohol during pregnancy, and that is the key point—no one can tell you with certainty what level of alcohol exposure is truly risk-free.
In my view, when the potential consequences include miscarriage, preterm birth, or lifelong developmental challenges, the question isn’t “Can I get away with it?” but rather, “Is it worth it?”
Most doctors and midwives continue to give the same advice. If avoiding alcohol removes even the slightest risk, why not opt for the safer choice?
For some women, that answer is clear. For others, especially those who have heard from friends, family, or even previous providers that having a drink now and then is acceptable, it may require more contemplation. Ultimately, however, this decision is not rooted in guilt or fear. Based on today’s information, it’s about making the best choice for you and your baby.
And the best part? Pregnancy doesn’t last forever. A few months of avoiding alcohol is temporary, but the benefits of safeguarding your baby’s health can last a lifetime.
A Look at History: Alcohol and Pregnancy Through the Ages
It may seem shocking now, but there was a time when alcohol was not only accepted during pregnancy but recommended by some doctors. What we now recognize as a clear health risk was, for much of history, either misunderstood or completely overlooked.
Alcohol as Medicine for Pregnant Women
For centuries, alcohol served as a remedy for discomforts related to pregnancy. In some instances, it was even regarded as a treatment for certain pregnancy complications.
In the mid-20th century, doctors occasionally prescribed alcohol to prevent preterm labor. The belief was that alcohol functioned as a muscle relaxant, helping to alleviate uterine contractions. Before modern medications such as magnesium sulfate, some physicians recommended that women consume wine or even whiskey to slow down early labor.
Alcohol was once recommended to help pregnant women relax and sleep. A small drink before bed was believed to ease anxiety and promote rest, ideas we now recognize as risky due to alcohol’s impact on fetal development.
The Shift in Understanding: The 1970s and the Discovery of Fetal Alcohol Syndrome
Before the 1970s, the belief that alcohol could harm a developing baby was not widely acknowledged. Although excessive drinking was discouraged for social reasons, the scientific connection between alcohol and birth defects had not yet been confirmed.
This changed when researchers identified a pattern of growth deficiencies, facial abnormalities, and developmental delays in children whose mothers consumed significant amounts of alcohol during pregnancy. This discovery led to the formal identification of fetal alcohol syndrome in 1973 by American researchers Drs. Kenneth Jones and David Smith.
Once fetal alcohol syndrome was recognized, medical recommendations changed quickly. By the 1980s, public health organizations strongly advised against alcohol consumption during pregnancy, although it took decades for the message to gain universal acceptance.
Ancient and Cultural Perspectives on Alcohol in Pregnancy
Attitudes toward alcohol consumption during pregnancy have varied significantly across various cultures and historical periods.
Ancient texts, including the Talmud, cautioned against excessive drinking, although the reasoning was often linked to concepts of heredity instead of fetal development.
In some European countries, wine and beer are staples of daily life, and pregnant women are not necessarily discouraged from moderate drinking.
In some cultures, traditional folk medicine included alcoholic tinctures or herbal remedies that used alcohol as a base, which means pregnant women might have ingested alcohol without being aware of its risks.
Even today, cultural differences persist. Some countries, particularly in Europe, still maintain more relaxed attitudes toward alcohol during pregnancy, while others, like the United States, have adopted a strict “zero-alcohol” policy approach.
How Science Has Changed the Conversation
History demonstrates that medical advice continually evolves. As science progresses, our understanding of what aids or harms a developing baby also improves. Alcohol during pregnancy shifted from being a recommended treatment to a recognized risk factor for lifelong complications.
Today, decades of research have reinforced the dangers of prenatal alcohol exposure, and the medical consensus is stronger than ever. Avoiding alcohol during pregnancy remains the safest choice.
What About Other Cultures? Do Some Countries Drink More?
Attitudes toward drinking during pregnancy vary widely across different cultures. While medical guidelines in countries like the United States and Canada strongly discourage any alcohol consumption during pregnancy, some cultures have historically taken a more relaxed approach. These differences in perspective have led to significant variations in drinking habits among pregnant women around the world.
Where Is Drinking During Pregnancy More Common?
In some European countries, alcohol is deeply embedded in social and cultural traditions. Because of this, drinking during pregnancy has been more widely accepted, with some doctors and midwives advising women to limit consumption rather than eliminate it.
In the United Kingdom, approximately 28.5 percent of pregnant women report drinking alcohol during pregnancy. Some healthcare providers in the UK take a harm-reduction approach, focusing on limiting consumption rather than strict abstinence.
In Switzerland, around 20.9 percent of pregnant women report drinking. While official guidelines discourage alcohol use, cultural norms have made occasional drinking during pregnancy more socially acceptable.
Countries like France, Italy, and Spain traditionally have a more relaxed attitude toward wine consumption, including during pregnancy. While this perspective has begun to shift in recent years, occasional drinking is still more culturally accepted in these regions than in other parts of the world.
Where Is Drinking During Pregnancy Less Common?
In contrast, some countries have significantly lower rates of alcohol consumption among pregnant women due to stricter public health messaging and stronger social taboos.
In Norway, only 4.1 percent of pregnant women report drinking alcohol. This reflects the country’s strong public health campaigns, which emphasize the risks of prenatal alcohol exposure.
In Sweden, the rate is slightly higher at 7.2 percent, but still much lower than in many European countries. Sweden has a long history of strict alcohol regulations, and its public health policies strongly discourage drinking during pregnancy.
South Africa: A Public Health Crisis
One of the most concerning examples of high prenatal alcohol exposure is in South Africa, where fetal alcohol spectrum disorder rates are among the highest in the world. Some studies estimate that in specific communities, as many as 10 to 20 percent of children show signs of fetal alcohol spectrum disorder. This crisis is linked to cultural drinking patterns, poverty, and a lack of public health education about the dangers of alcohol use during pregnancy.
Does Cultural Acceptance Mean It Is Safe?
It is easy to assume that if something is widely accepted in certain cultures, it must be safe. However, history has shown cultural norms do not always align with medical evidence. Smoking during pregnancy was once considered normal. Giving infants whiskey to help them sleep was once a common practice. Both are now recognized as harmful.
Just because some cultures have a more relaxed attitude toward alcohol in pregnancy does not mean there are no risks. The biological effects of alcohol on fetal development are the same, regardless of cultural perspective. Scientific research, not social customs, should be the guide when making decisions about alcohol and pregnancy.
What Do Midwives Say About This?
As a certified nurse-midwife, I approach this topic compassionately and without judgment. Pregnancy is a deeply personal journey, and every woman deserves the space to make her own informed decisions. However, I also believe in being completely upfront with my clients. I strongly recommend complete abstinence from alcohol during pregnancy; it is simply the prudent thing to do.
That doesn’t mean I support scare tactics or shaming women who have questions about alcohol use. I have always strongly believed in informed consent. My role is to provide women with the most accurate information so they can make the right decision. Ultimately, this choice belongs to the woman carrying the baby.
That being said, there are genuine medical risks involved, and in my home birth practice, I maintain clear boundaries. If a woman consumes more than the occasional glass of alcohol, this could disqualify her from having a home birth with me. Home birth is safest when a pregnancy is low-risk, and regular alcohol use introduces potential complications that could jeopardize that safety.
A 2021 study on midwives in the United Kingdom found that most midwives strongly advised against alcohol use during pregnancy; however, many women were still unclear about the official guidelines. Some received conflicting advice from different providers, while others believed that if alcohol were truly dangerous, the messaging would be more forceful.
This is where midwives play a crucial role. How we deliver information is important. Women are more likely to take recommendations seriously when presented with respect and understanding, rather than with judgment or fear. Suppose a woman is uncertain about completely giving up alcohol. In that case, my approach is to engage in an open, honest conversation instead of making her feel she has already done something wrong.
As I see it, my job as a midwife is to ensure the safest possible pregnancy and birth for both the mother and her baby. One of the simplest ways to eliminate an unnecessary risk is by avoiding alcohol.
The Bottom Line: Is Any Amount of Alcohol Safe?
There is no proven safe amount of alcohol during pregnancy.
Could one glass of wine be harmless? Maybe. But could it also have effects that we do not fully understand yet? Absolutely. That is the problem: there is no way to guarantee a completely safe threshold. Some studies suggest that minimal drinking may not cause measurable harm, but newer research points to potential risks even at low levels.
The safest choice is to avoid alcohol completely.
Older studies that found no harm often had limitations, such as small sample sizes, short follow-up periods, or reliance on self-reported data.
More extensive, more recent studies show that even low levels of alcohol exposure can be linked to developmental concerns, including higher rates of anxiety, depression, and attention disorders in children.
Cultural norms do not change biological effects. Just because alcohol is more accepted in some parts of the world does not mean it is risk-free. Science, not tradition, should guide these decisions.
Pregnancy is a short time in your life, but the effects of prenatal alcohol exposure can last a lifetime. If avoiding alcohol removes even a small risk, is it not worth it?
Final Thought: This Is About Informed Choice, Not Judgment.
When it comes to pregnancy, few subjects spark as much debate as alcohol. Women receive conflicting messages from family, friends, healthcare providers, and scientific studies. Some are told that one drink will cause irreversible harm, while others are reassured that an occasional glass of wine is completely acceptable.
Here’s my belief: Women deserve the whole truth, not fear-based messaging. The reality is that the evidence overwhelmingly supports abstaining from alcohol during pregnancy, but that doesn’t mean we should shame or scare women into compliance. The best approach is to have open, honest conversations that empower women to make informed decisions.
I also believe that women deserve clarity, not outdated myths or fluctuating opinions. Medical recommendations have evolved as our understanding of prenatal alcohol exposure has increased. Decades of research now indicate that alcohol can impact fetal development, sometimes in ways that are not immediately apparent at birth. Therefore, most healthcare professionals agree that when there is uncertainty regarding the safety threshold, the most responsible choice is to avoid alcohol altogether.
Ultimately, every parent wants to do what is best for their baby. However, that doesn’t mean the choices are always straightforward, nor does it imply that there aren’t gray areas along the way. One of the simplest ways to protect a developing baby is by completely removing alcohol from the equation.
This conversation should be founded on compassion, science, and respect. Women deserve support, not judgment, and they are entitled to the confidence that comes from knowing they have made the safest choice for themselves and their child.
— Stay Strong! Jaelin —
Additional Reading
- Fetal Alcohol Syndrome: A Guide for Families and Communities by Ann Streissguth
- Message in a Bottle: The Making of Fetal Alcohol Syndrome by Janet Golden
- Alcohol During Pregnancy – March of Dimes
Note: Full disclosure: SHEis Online earns a small (very small) commission on any links in the article that take you to Amazon.
I would love to hear your thoughts on this subject; let’s talk in the comments!
About the Author:
Jaelin Stickels, CNM, WHNP, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of experience, Jaelin has had the privilege of helping several hundred women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area. Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process. Jaelin is finishing her doctorate and looking forward to being Dr. Jaelin in early 2025.
Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.
Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.
Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX
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