Can you drink while you’re pregnant? What if you drink yourself into bed with someone and continue cyclical drinking habits weeks or even months before realizing you’re pregnant? For some reason, there is still an overwhelming muddle of answers from experts, obstetricians, and researchers. While some say absolutely not, others say perhaps small amounts of alcohol during pregnancy won’t harm the baby.

But if you’re going to become a responsible mother, why risk your baby’s health at all? If you try to justify your glass of merlot at dinner and are unable to abstain, you may have a drinking problem. Researchers have found if you’re a drinker with an unplanned pregnancy, there’s a good chance you’ll pop the cork.

"More than half of pregnancies in the U.S. are unintended, which is significantly higher than the rate in many other developed countries," the study’s coauthor Sarah C.M. Roberts, assistant professor at Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, said in a press release. "Women with unintended and unwanted pregnancies appear to have higher levels of binge drinking before pregnancy recognition, but once they discover their pregnancies, they appear to behave similarly to other pregnant women in terms of quitting and reducing alcohol use," Roberts said. "There is also some evidence that women may be substituting alcohol for drugs once they discover their pregnancies."

Researchers from the University of California, San Francisco analyzed the change in alcohol use before and after 956 women found out they were pregnant. The study will be published in the November 2014 issue of Alcoholism: Clinical & Experimental Research and is the first to examine changes in alcohol use among pregnant women who wish to terminate their pregnancies. The five-year study followed a group of women who were seeking abortion, and although most of them received the abortion, many were denied and continued their pregnancy.

Researchers were concerned about the official recommendations on alcohol use during pregnancy, especially for habitual drinkers who became unexpectantly pregnant. It may take two or three months for a woman to figure out she’s pregnant, and if she’s considered a binge drinker there’s a very good chance she’s drinking in the first trimester. The Centers for Disease Control and Prevention (CDC) has a no tolerance policy when it comes to recommending women abstain from drinking during pregnancy. However, it explicitly says, “There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant.”

"These recommendations advise complete abstinence from alcohol during pregnancy," Roberts said. "These messages seem less relevant for women who have consumed alcohol after conception, but prior to discovering pregnancy — especially women who thought they would terminate their pregnancies, but were unable to. Health education messages for women who have already consumed alcohol during their pregnancies need to focus on changes women can make in their alcohol use moving forward, and also on helping women understand the risks associated with the amount of alcohol they've already consumed during their pregnancy."

Education is usually the key to preventing unwanted pregnancies or protecting the fetus. The CDC even suggests women should not drink if they are sexually active or aren’t using birth control, in case she becomes pregnant before she realizes it. Those who continue to drink aren’t even sure what a single drink is and pour themselves a 10-ounce glass of wine or a double shot mixed drink. Women should be seeking help before they become pregnant," the study’s coauthor Lee Ann Kaskutas, a research scientist with the Alcohol Research Group at Berkeley, said in a press release.

"Half of unintended pregnancies are terminated,” Kaskutas said. "Yet more than a quarter of births are from unintended pregnancies. Thus, this study makes a huge contribution because this is not a small, 'fringey' understudied population — it is 27 percent of the live births in the country. Binge drinking isn't good for anyone. Women of child-bearing age should be thoughtful about binge drinking, especially if they are not using contraception and especially if they live in an area of the country where access to abortion is limited or nil.”

Many women who were binge drinkers before they became pregnant will drink moderately or continue to binge drink during their pregnancy. According to researchers, there aren’t a lot of interventions that effectively reduce drinking among pregnant women despite it being well known that binge drinking is harmful to the fetus.

Some women even replace their drug habits with alcohol because they think it’s less harmful, when in fact marijuana has shown to have no serious effects on the fetus. They may also be afraid of being drug tested while pregnant, and the fear of getting caught drives them to believe there is safety in alcohol. It couldn’t be further from the truth.

Alcohol in the mother’s blood will pass to the baby through the umbilical cord, which can result in miscarriage, still birth, and lifelong physical, behavioral, and intellectual disabilities known as fetal alcohol spectrum disorders.

Source: Roberts SCM and Kaskutas LA. Alcoholism: Clinical & Experimental Research. 2014.