Ironically, I didn't even need caffeine before I was pregnant. Most mornings my mental cobwebs used to clear themselves within a half-hour without chemical help. So when, during my first appointment, my midwife asked how much caffeine I drank, I blithely replied, "oh, maybe a few cups a week." This minimal amount pleased her greatly.
Then came extreme pregnancy fatigue, bringing with it the need to either ingest a daily cuppa or sleep away the entire morning. It also brought paranoia and mixed messages. My GP was adamant that caffeine was forbidden during the first trimester, while Motherisk at the Hospital for Sick Children says up to two cups of drip coffee a day presents no risk. My mother-in-law is a notorious tea fiend, so I asked her how much she ingested while incubating her three healthy adult sons. "Oh, in those days we drank wine," she said airily, before guessing that she probably drank less tea then than the eight daily cups she enjoys now.
I decided that a morning coffee or tea was fine. Last weekend, I even had a second in the evening before heading to a birthday party, needing energy to socialize sober for four hours while my friends ran up a huge bar tab. "You need to be careful with that," said one of them, sipping his fourth pint. "You can't have too much caffeine."
His tone wasn't judgmental, just matter of fact. The idea that pregnant women (and our unborn offspring) are delicate flowers holds fast in the North American psyche, matched by a conviction to share opinions on their delicacy with the women themselves. I've been advised against lifting things, climbing stairs or riding a bicycle. I've been told not to eat seafood, whether raw or cooked, mayonnaise (either fresh or jarred), fruits with thin skins that absorb pesticides or, um, rice (the last according to a friendly taxi driver). When I remarked to my mom that a very pregnant woman in my yoga class did a perfect handstand, she replied "You'd better not think of doing anything like that!" Never mind that I didn't have the co-ordination in the first place.
These concerns come out of a desire that every baby be born perfectly healthy. But many of them don't have evidence to back them up. Too often, studies of a small sample of specific women morph into draconian recommendations for all pregnant women, everywhere. Recently, an American economist, Emily Oster, and a British science journalist, Linda Geddes, performed similar studies, compiling information from multiple experiments to try and turn tiny, untrustworthy data points into big, reliable ones. Each came to the same conclusion – there is very little airtight information on the risks of many activities pregnant women might be interested in. Ms. Geddes smashes a well-circulated stat that says home births are three times as likely to end in death than hospital births. Prof. Oster found no good evidence on the risks of sushi, and ate it herself while pregnant.
Both women decided that the mandate to drink absolutely no alcohol is extremely overblown. Ms. Oster ends up advising that women have "no more than one drink a day," while Ms. Geddes is ok with "one or two units, once or twice a week." Both found that the subjects of most studies on Fetal Alcohol Syndrome Disorder are alcoholics, binge drinkers or also using drugs, making them irrelevant to most women. Meanwhile, one Danish team proclaimed that the five-year-old kids of well-educated moms who drank lightly (up to four drinks a week) were actually less likely to have behavioural problems, hyperactivity, peer problems and emotional difficulty than the children of mothers who abstained entirely. Cheers to that.
This isn't a suggestion that extreme caution give way to extreme abandon – I won't be sitting in a hot tub eating oysters and drinking champagne anytime soon, alas. It's merely a request to treat pregnant women like human beings. Most of us are cautious, well-informed adults and we care about the wellbeing of our children far more than you ever could.