Coffee and Wine, Is It OK During Pregnancy?

When Emily Oster, an economist, got pregnant with her now two-year-old daughter, she wanted to know more about all those rules handed down to women once they find out their pregnant.

Only two cups of coffee a day! No alcohol. Beware deli meats.

Being pregnant, she said, felt a lot like being a child, so she decided to take a deep dive into research covering everything from wine and weight gain to prenatal testing and epidurals. What Oster claimed she found was some of the mainstays of pregnancy advice are based on inconclusive or downright faulty science.

Some of her conclusions? Weight gain during pregnancy is less important than a woman's starting weight and not gaining enough may be more harmful. Light drinking is fine (up to two glasses of wine a week in the first trimester and up to a glass a day in the second and third trimesters). And much of the evidence supports having three to four cups of coffee daily, which made Oster very, very happy.

As I am a mother of three and and advocate for healthy living with never drink three to four cups of coffee a day whether I was pregnant or not. Too much of anything is not a good thing and we tend to depend on unnatural remedies to keep our bodies going. And as for alcohol, even if it's wine I still would not have a glass day - pregnant or not! 

In Oster's new book, "Expecting Pregnancy", not all of her findings are counter to standard medical advice. And she happily reports in "Expecting Better,"  that her 2-year-old is healthy and happy.

Below is an excerpt from a conversation Oster had with the Associated Press:

AP: Have you written the "Freakonomics" of pregnancy?
Oster: I think it's right that it feels a little bit like 'Freakonomics' because Steve (Levitt) and I are both economists, but the goal here was really to write down an approach that was right for me. The approach being thinking carefully through all of these decisions, getting the best data that you can and then structuring the decision in a way that takes into account your personal preferences, tolerance for risk and all the kinds of things that we should be thinking about every day.

AP: Do you anticipate blowback from women and doctors because you're an economist and not a medical professional who helps manage pregnancies?
Oster: For sure but I certainly do not envision women reading this book and saying, 'Oh, like, I can deliver my own baby now, right?' I think that there's a real sense in which pregnancy should be something that you do with your doctor, but I think that for a lot of women the time you have with your doctors is limited and it can be difficult to get all of the answers to your questions.

AP: Are most pregnant women ill-informed? Are doctors and other pregnancy professionals lax in keeping up to date on research that might lead to more specific recommendations?
Oster: I think we see sometimes where practice lags behind recommendations. Not all practitioners, obviously. As an example, in the case of prenatal testing, even though more recent recommendations don't favor the 35-year-old cutoff as much, that's still a highly practiced thing, so I think there's a sense in which there is some slow creep of knowledge.
I actually think pregnant women are really well-informed but I think that there's a tremendous amount of confusing and conflicting information out there. You could read every pregnancy book and every pregnancy website and come away thinking on some topics I have no idea what the real facts are.

AP: That leads me to the vices, including alcohol. You and ACOG differ on that one. ACOG recommends no alcohol.
Oster: I think we can all agree that heavy drinking and binge drinking, even occasionally, is very dangerous, and I certainly say that in the book. What I found is there are a large number of quite good studies with a lot of women that show having an occasional glass of wine does not seem to pose a problem, that children of pregnant women who drink occasionally have similar or in some cases even better outcomes than children of women who abstain. This is a very personal choice. In some other countries the recommendations are it's OK.

AP: The editors at Parents.com have already called some of your recommendations flat-out dangerous to pregnant women, particularly your views on alcohol and caffeine consumption.
Oster: Many of the OBs that I have spoken to and many of the women who I have talked to about the recommendations from their doctors have told me that the doctors say, 'Yeah, it's fine to have a couple glasses of wine.' This is a conversation which will continue to evolve.

AP: What were some of the surprises when you started digging into the research?
Oster: One thing that came up that I found quite surprising is that a number of women that I knew who have been pregnant were put on bed rest. When I started looking into that more I found the evidence doesn't really support any benefit from bed rest in terms of preventing preterm labor. I think that lately doctors have started moving away from that pretty extensively. It has some negative impact, particularly around issues of muscle atrophy and other medical reasons.