Curled up in bed reading a new novel about Vanessa Bell and Virginia Woolf called Vanessa and Her Sister, I came to a section about Bell’s pregnancy in which she is instructed by her doctor to wear a corset and drink champagne. In the middle of navigating my own pregnancy, I laughed out loud. Indeed just like all the scenes of drinking, smoking pregnant women on Mad Men, this fictional advice—based on the author’s historical research—indicates how much the medical establishment’s guidelines for pregnant women shifts with the sands of time.
Those of us whose pregnant moms were urged to drink Guinness to bring in milk are all too aware of this paradox: today’s pregnancy gospel is tomorrow’s joke. So even on the surface, it’s clear why the CDC faced such a backlash with its recent guidelines urging all women of childbearing age to avoid alcohol unless they’re on birth control. Headlines ranged from the sober “The CDC’s Alcohol Warning Shames and Discriminates Against Women,” to the viral “The CDC Can Rip the Wine Glass Out of My Childbearing-Aged Hand” to my favorite: “CDC: Pregnant Women Should Go In A Bubble And Seriously Not Even Move It Could Be Dangerous.”
On the other end of the spectrum, the Christian Post had its own take: “New CDC Recommendations Acknowledge Life Begins at Conception?” while the Daily Caller offered a characteristic “Women Freak Out When CDC Recommends Not Poisoning Their Babies.“
The latter category of headlines is telling. This wave of fury from women isn’t really just about drinking and pregnancy; it’s about something a bigger phenomenon linking misogyny, the “pro-life” movement and guidelines for pregnant women. Everyone I talked to in the past week, pregnant or not, teetotaler or happy lush, raised her middle finger to the CDC. This is not because we don’t care about the health of kids or because we’re glued to our vodka cocktails. Instead, it’s because the framing of the guidelines is the perfect example of a culture that wields shame and guilt rather than information and trust when it comes to reproductive health.
The recommendations came in a too-familiar package, as Rebecca Solnit noted in an essay on the language of these warnings: one free of male involvement, even explicitly encouraging “her” to use condoms. ”Women seem to get pregnant here as a consequence of consorting with booze, not boys,” she writes, noting that like “pro-life” policies, such guidelines are less about protecting children than about “hating on women,” which “requires narratives that make men vanish and make women [into] magicians producing babies out of thin air and dissolute habits.”
Her critique was echoed in a cartoon that re-framed the new guidelines, this time for men: “Drinking too much for men includes any alcohol use by men who might be violent,” it read, and featured a doctor’s silhouette saying, “The best advice is to stop using alcohol when you start getting violent.” Of course, a world in which these recommendations are remotely feasible outside of parody is impossible to imagine. The CDC’s recommendations reminded us that it’s still much more politically expedient to shame every potentially fertile woman in America about margarita night than it is, for instance, to push society to meet our needs with better birth control and comprehensive sex ed.
From a pregnant perspective, what galls about the recommendations is the way they infantilize a group of us who are already thinking this issue through carefully. Personally, I came to a deliberate decision to have a few glasses of wine while trying to conceive after I spent time on the internet re-learning how exactly, day-by-day, a pregnancy progresses. Implantation, the burrowing of the fertilized egg into the uterine lining, happens around 7-10 days after ovulation. Logically, that means a potential blastocyst isn’t even synced up to its mother’s bloodstream until well after conception and even after that, it gets nourishment from the yolk sac for a while.
Since I was tracking my cycle, I figured I would abstain fully from drinking once that initial 10-day post-ovulation window had passed, and otherwise, I’d keep my consumption lower throughout the month. At a wedding in Colorado around my pre-ordained cutoff point one month, I felt dizzy—and it could have been the altitude, but I felt confirmed in my choice to lay off the sauce (and eschew the newly-legal green stuff, even though I will note again that I was on vacation in Colorado and flying to Washington State the next day, sigh).
Most of my trying-to-conceive friends have taken variations on this approach, drinking only until they know they’re pregnant (“drink til it’s pink”), going to town on the bar tab during their periods and then sobering up for the rest of their cycle, or cutting down throughout the month. Some have opted for abstaining entirely, and many switched back and forth between one or another choice. All these decisions, made in consultation with partners and doctors, involve a calibration between honoring our present-day lives and desires on the one hand and preparing to get pregnant on the other—knowing the latter is a process that might take months or years of angst.
For many women, an occasional drink while trying to conceive is psychologically important, a way of saying, “I’m a person, now, whatever happens.” Weighing risk against psychological benefit extends to all of the “don’ts” of pregnancy, too. For instance, a friend who was pregnant in Japan ate sushi as the locals did, while a friend with Scandinavian heritage went into the sauna with her family. Others drink lattes, eat a ham sandwich, sleep on their backs, or have a glass of wine. And out of the public eye, doctors often support decisions that reduce stress, even if they contravene official recommendations. At a party a few weeks back, a doctor even looked at my belly and said, “Ahh, third trimester, now you can start drinking with dinner.”
All this nuance in our actual lives begs the question of what the CDC should be recommending for future parents and kids. My vote would be a bigger emphasis on widely-available, affordable birth control, including expediting approval of “the male pill” (dear lord, please) and encouraging better variations on current hormonal methods. The agency should indeed be very explicit in reminding people of all gender identities about the fact that once birth control stops, it can take either no time at all or a lot of time to conceive.
And why, again, aren’t they aggressively advocating comprehensive sex education? Knowing the biology of reproduction is essential to understanding the damage that might potentially be done at various stages—fetal alcohol syndrome included. The mechanisms of potential fetal harm should be common knowledge, not shrouded under the veil of vague, all-encompassing warnings.
People weighing the decision to start a families deserve the most information with the least bias, even if that means letting us grapple with the areas where the conventional wisdom and the science are at odds. Alternative options have presented themselves: Emily Oster’s new book, Expecting Better, which summarizes all the available studies for contentious pregnancy issues from eating cheese to epidurals, is becoming something of a new bible for my peers.
The book was slammed widely in some circles, because Oster states that there’s no evidence of harm from moderate drinking later in pregnancy. But Expecting Better is actually more than the “you can drink!” book. Its anxious author scanned all the available data, gave her readers the information she found, and then let us decide for ourselves what to do for our future families. Comparing an anecdotal epidural vs. a non-medicated birth, she is honest that the choice can go either way: “Same evidence, two different decisions, two happy moms.”
“There is no good evidence that light drinking negatively impacts your baby,” she writes about booze, but is much firmer on tobacco, where she sees conclusive evidence: “Smoking during pregnancy is dangerous for your baby.” Sometimes, Oster notes that evidence points slightly in one direction, but is still not enough to cause worry: “If anything, you should probably me more concerned about gaining too little weight than too much,” she writes at the end of her chapter on weight gain, another weapon of shame with which pregnant women are harassed. “But, mostly, chill out.” Those last two little words are so precious to hear if it’s at all possible to hear them. Essentially, Oster treats “expecting parents” like the adults they are, which is all that Americans want from the CDC.
Sarah M. Seltzer is a writer of fiction, journalism and criticism in New York City and the Editor-at-Large at pop culture website Flavorwire.
Illustration by Jim Cooke