About four weeks into my first and so far only pregnancy, I was prescribed Promethazine, a drug often given to cancer patients struggling with extreme nausea from chemotherapy. For me, morning sickness fluctuated between mildly miserable and totally incapacitating, and I was grateful for something — anything — that might make it better. Promethazine definitely did the trick, but it also felt like a knock-out drug, so I limited my intake to bedtime the night before days when I absolutely had to be productive.
I never questioned the safety of the drug because it was prescribed, seemingly without hesitation, by a doctor I trusted. More than a year later, I looked it up online and saw that it was classified by the FDA as a Pregnancy Category C medication, meaning that its risks to the fetus are unknown. What is known, according to the FDA, is that Promethazine can cause fatal respiratory depression in children under age two, and that several cases of gangrene requiring amputation have been linked to its injectible form.
Now, you can probably find comparable horror stories about any drug on the market — from aspirin to Accutane — if you look hard enough. But there was only one ingestible that took me down that rabbit hole during pregnancy, and it wasn't Promethazine, sleeping pills, pain killers, goat cheese, lunch meat, bacon, tropical fruit, coffee, or herbal tea. It was alcohol. From the moment I got the definitive "you're pregnant" on New Year's Day 2009 (causing me to ruefully ditch my Bloody Mary), the question of whether and how much I could drink was the background noise I heard for the next eight months. What follows is an account of life in the rabbit hole.
February, March, & April: Not a Drop to Drink
In February, when I was almost ten weeks pregnant, I was scheduled to attend a wine writers' conference — a four-day affair at the Meadowood resort in Napa Valley. By this point I was seriously struggling with morning sickness — I had lost weight, rather than gaining any — so the idea of being wined and dined at lunch and dinner, with afternoon tastings and winery tours in between meals, was daunting to say the least.
It had gotten hard enough just tasting wines for Wineau, my column at the time in the Express. I was used to spitting out the wines I wrote about, so consumption wasn't the issue, but lately even the act of sitting down to face three bottles of $10-and-under Cabs and Chardonnays was enough to make me wretch. For the column, I had been leaning heavily on Peter, my husband, co-taster, and resident winemaker. But at Meadowood, I was on my own. And sitting down to taste three wines once a month was nothing compared to four solid days of wine flowing everywhere you looked.
At the conference's welcome dinner, the guy to my right quickly introduced himself as Wolfgang Weber, senior editor at Wine and Spirits magazine. With his pressed tweed sports coat and perfect hair, Wolfgang was not a dinner companion who inspired breathless confessions. I didn't let that stop me, however, and our initial conversation went something like this:
Wolfgang: Hi, I'm Wolfgang Weber, Wine and Spirits.
Me: I'm pregnant!
After gauging Wolfgang's level of interest in my news — which was, appropriately, nil — I cast about for another confidante and soon found one in Laura Holmes Haddad, the "grrl" behind the blog GourmetGrrl and author of Anything But Chardonnay: A Guide to the Other Grapes. At the same conference a year earlier, Laura had explained to the group at the welcome dinner that her participation would be limited because she'd just had a baby. Laura will understand, I thought, so when I caught her eye at a reception the next night, I forgot that we didn't know each other and repeated my offense with Wolfgang.
Me: I'm pregnant!
Laura: Nice to meet you.
Even if my social skills seemed to be on the fritz, at least Laura got it — as I knew she would. Soon we were dishing about wine, work, pregnancy, breastfeeding, and how those things could possibly fit together. And we broached the topic that was increasingly on my mind:
Can you drink while you're pregnant, and if so, how much?
I had, of course, asked my ob-gyn the alcohol question before coming to the conference — not because I wanted to drink, but because I knew that in that setting, with those people, I'd feel like a contestant in a pie-eating contest who'd recently sworn off sugar. My doctor had said that sips were okay, but that until I hit my fourteenth week of pregnancy, a full glass was inadvisable. After that? There's no amount known to be safe, she'd said, but if it were her pregnancy, she'd probably have one glass of wine a month.
One glass a month! The bleakness of this suggestion didn't hit me until I was fake-drinking Sauvignon Blanc with Laura as she told me that, although she hadn't felt like drinking until her sixth month, at that point she'd felt okay drinking a glass a day.
Shortly after the Meadowood retreat, I was working on a piece for Taste, the semiannual food-and-drink-oriented special section of this newspaper. My topic was Dr. Salvatore Lucia, a Berkeley grad and Bay Area-based epidemiologist who wrote seven books on wine and health before his death in 1984. Lucia has been something of a folk hero to me ever since I stumbled upon his Wine Diet Cookbook in the early 1990s and fell in love with his impassioned manifesto on the healing powers of wine — which he called "the most important medicinal agent in continuous use throughout the history of man."
As I revisited Lucia's body of work for my article, the question of drinking and pregnancy loomed ever larger. At this point — fully into my second trimester — I was feeling lots better than I had a month ago. Still, because of my doctor's cautious comments about alcohol consumption, I was spooked — and hadn't consumed more than a sip of wine since New Year's Eve.
I was spooked, but I was also thoroughly confused. Dr. T had said that she'd have one glass of wine once a month if she were pregnant, while many of my friends with kids say they drank more often than that during their pregnancies. Still, Dr. T is a doctor, and my friends, for the most part, are not. Dr. Lucia was a doctor, too, but he's been dead for 25 years.
So I googled it.
Now, granted, I'm not a big troller of online forums on any subject, but I was shocked by the volume of information available on alcohol consumption during pregnancy. And by information, I mean both thoughtful articles written by medical professionals and rants from posters who say they can't understand why a woman would risk the health of her unborn child for any reason — never mind a reason as selfish as her love of a glass of wine with dinner.
Sanctimommies — those legions of woman who seem to lurk online, just waiting for the perfect moment to pounce and declare how badly you're screwing up your kid — love the issue of drinking and pregnancy, and in the forums I perused, their comments ranged from mildly moralistic to downright scary. I found myself — somewhat randomly — taking solace in a web site called NetDoctor, which seems to be the British equivalent of WebMD. NetDoctor advises no drinking during the first trimester and a limit of one or two units a week thereafter. (A 4-ounce glass of 12-percent-alcohol wine is about 1.5 units). NetDoctor also has this to say about Fetal Alcohol Syndrome: It affects "about one-third of babies born to women who drink at least 18 units of alcohol per day during pregnancy (that's equivalent to about 18 small glasses of wine or nine pints of beer, lager or cider per day)."
I took this in, and thought about the range of options between one glass of wine a month and eighteen a day. But I also thought — a lot — about Fetal Alcohol Syndrome. Dr. T brought it up the day we first discussed alcohol and pregnancy, and she had mentioned the mental retardation, abnormal facial features, and problems with growth, learning, memory, vision, and hearing that can plague a child who is born with the syndrome. This was, of course, why I wasn't just going with my gut and having a glass of wine more frequently than she'd suggested. And I understood her logic: There's evidence that more than one drink a day is bad and that any drinking at all in the first trimester is bad; there's just no data on the impact of less than a glass a day later in pregnancy. So why risk it?
No surprise that that's not the view I encountered on the Women Wine Critics Board. There I stumbled upon an article published in January of 2006 by an Israeli wine critic named Daniel Rogov entitled "Wine and Pregnancy: Lies That Women Are Told." The gist of the article is this:
Although the official message is "don't drink at all during pregnancy," a great deal of recent research and a re-examination of the alcohol-pregnancy issue show that there is no conclusive evidence to demonstrate that moderate drinking during pregnancy can harm the fetus.
Rogov's premise is backed up by a chorus of medical professionals, and though the article is dated, today the author says he still stands by every assertion he made. Around the time of its publication, the article got a positive mention on at least five other wine blogs, including two of the best known: Fermentation and Vinography. Since then, it has prompted hundreds of comments (lots of accolades, more than a few Sanctimommy rants), the most recent of which was posted on August 2nd of this year. Clearly, I'm not the only one thirsting for someone to tell me I'm allowed to drink.
Then there's the Berkeley Parents Network. I quickly became enamored of a thread entitled "Do European Women Give Up Drinking?" It was the plaintive request of one local pregnant woman who was missing her wine with dinner and wanted to know whether the expats on the forum abstain from alcohol during their pregnancies. As I noted their responses — "No regular drinking (i.e. every single day)," "No binge drinking," "Not hard liquor; stick to wine or beer" — I became vaguely aware that it was the sense of deprivation, and not the actual absence of alcohol from my life, that was getting to me.
Please bear in mind that despite all this googling, soul searching, informational interviewing, and strategizing, I still had yet to drink a glass of wine. This finally happened in April, and the wine in question was a 2006 Mayro Murdick Carneros Pinot Noir. I drank it in Philadelphia, where my sister was throwing a winemaker's dinner (with Peter presiding) to raise money for a local nonprofit. The Pinot was lovely, but by the time the last sip was gone, I had made a tragic discovery. I don't like wine because of terroir-specific fruit flavors, long finish, or strong aging potential. I like wine, primarily, because it's an intoxicant. And this teeny glass of Pinot simply hadn't done the trick.
This discovery led to two depressing thoughts. The first was that professionally, I'm a bit of a fraud. I don't refer to myself as a wine critic and would never claim to be a wine expert, but as it turned out, I'm not even a wine writer — I'm simply a wine drinker who writes. The second depressing thought was that I'd have to wait a month for my next glass of wine.
May & June: First Do No Harm
The occasion of that next glass was a decadent dinner at San Francisco's One Market restaurant with Peter and four friends, all of whom are doctors. I eagerly anticipated this dinner — not just because I was inhaling food by that point or because I love those friends and never get to see them. I was excited because they are doctors who love wine, and because one of them is an ob-gyn and another was pregnant at the time. And I happened to know, from Pregnant Doc's first pregnancy, that she takes a dim view of the medical establishment's party line on the topic that I was very much hoping we'd discuss.
Sure enough, drinking and pregnancy was just about all we discussed for the first hour or so of the meal. Everyone assembled thought that Dr. T's one-glass-a-month guideline was extreme, although the ob-gyn in the group was much less strident than the others on the topic. She said that when the issue comes up with her patients, she tells them about the differing guidelines — abstinence here in the United States, a more relaxed view in parts of Europe, etc. Having presented all that (conflicting) advice to her patients, she then says, essentially, "You're a smart person, use your best judgment." And I guess that's what Dr. T had been trying to do. She'd told me what she knows is bad for the fetus, and what she would do if she were pregnant, but she'd stopped short of calling any of that advice. The difference was that Ob-Gyn Friend had left me feeling empowered to trust my instincts. It didn't hurt that across the table from me, Pregnant Doc seemed to be enjoying her glass of wine, and she'd already had a daiquiri.
Just then, Pregnant Doc's husband spoke up. "Look, there is no better-tested drug in the history of civilization than alcohol," he said. "There's this misguided idea that if a lot of something is really bad for you, then a little bit of the same thing is probably a little bad for you. And that just has no basis in fact."
Side note: When I told Pregnant Doc's husband that I was writing this article, he e-mailed me an Anatole France quote he found pertinent to the topic:
"If fifty million people say a foolish thing, it is still a foolish thing."
July & August: The Home Glass
Once I was firmly in my third trimester, I decided that it was okay to have a small glass of wine once a week, and I started to do this on Saturday nights.
In early August, I had the first of the weekly doctor's visits that would continue until I had the baby. Dr. T was booked, and the doctor I saw instead was one that my cousin and another close friend had raved about. I immediately understood why: She seemed both extremely knowledgeable and totally down to earth, and she patiently listened to every question I asked. When I told her that the due date wasn't the best timing because of my husband's profession — September 3rd is often when harvest starts, and that means twelve-hour days and weekend work for Peter — her response was surprising. "Wow — your husband's a winemaker? I hope you've been drinking during your pregnancy!"
I knew better than to consider this advice. By then, I actually wasn't sure that OBs give advice anymore, so litigious is our society in general and so lawsuit-plagued is their specialization in particular. No, this doctor was just being a human being, expressing her hope that an activity that had presumably brought us joy as a couple pre-pregnancy had not been driven out of our lives by medical scaremongering.
Or at least that's how I chose interpret it.
The next day, Peter and I spent what felt like a lifetime at Babies"R"Us, and by evening, I was frazzled and exhausted. But I was also feeling emboldened by the previous day's doctor visit, so when I poured myself my Saturday glass of wine that night, it was not small. Instead, it was what a friend and I like to call a "home glass" — so named because you are unlikely to get a pour this generous anywhere but at home, when you yourself are doing the pouring. I'm not going to say it was a third of a bottle, because that just sounds obscene. But four ounces it wasn't.
The next morning, my water broke, and by 8 p.m. that night, I had a daughter.
A couple of weeks ago, I told a close friend that I don't just love Willa — I really like her, too. The friend smiled politely but looked a little confused. Love, I get, said the look. But she's one. What's to like? I didn't know how to explain it without sounding like an annoying cliché. Still don't, in fact. So I'll skip the recounting of my goofy, heart-swelling devotion to this tiny willful person, except to say that of course — of course! — if I had to go nine months, or nine years, or the rest of my life without a glass of wine to ensure her well-being, I would. I also understand the argument that green-lighting moderate alcohol consumption in pregnancy might send a message that any amount of alcohol is okay, with potentially devastating results. But I'm just not convinced that the prohibitive nature of pregnancy in the modern age — what I recently saw referred to on BabyCenter.com as "bubble-wrapped pregnancy" — is always necessary or healthful.
I'd love to say that at the moment of Willa's birth, the joys of motherhood completely eclipsed my preoccupation with how much it's okay to drink, but that's not how it went. Because then came breastfeeding, and even more conflicting advice. Drink in moderation, don't drink, only drink with meals, pump and dump, drink right after she nurses, drink while she's nursing. ... Peter finally got so fed up with my ruminations on this issue that on New Year's Eve 2009, he bought breast milk test strips and stuck one into a bottle I'd pumped about an hour after having a glass of wine. It wasn't even a home glass, I swear, and yet it turned that little sucker pitch-black. As in: Don't even think about giving this to your baby.
Another New Year's Day, another virgin Bloody Mary.