Don't Shame Pregnant Women for Drinking Coffee

A new study misses the point.

Women who are pregnant or planning a pregnancy should completely avoid caffeine, according to a study published in The BMJ, a British medical journal.

Its findings, though, were quickly picked apart by skeptics who are sick of women being warned that almost everything they do—other than sip wheatgrass smoothies—is a risk to their kids.

"I don't think we need to worry about coffee," says Clare Murphy, a spokesperson for the British Pregnancy Advisory Service. "I think we need to worry about this relentless pursuit of pregnant women and regulating of pregnant women's choices."

Murphy is the top signatory of a letter signed by about 20 professors and public health advocates objecting to the paper, which is actually a meta-analysis of several earlier studies relating caffeine and pregnancy. The analysis was conducted by James E. Jack, a professor of psychology at Reykjavik University whose life's work seems to be excoriating caffeine. Consider his full-length book on the topic (his second): Understanding Caffeine, which concludes that "current scientific evidence indicates there is no safe level of regular use," according to its description on Amazon.com.

He's not a Starbucks kind of guy, in other words.

His BMJ piece looked at 48 studies out of 1261 on the subject. Of those 48, Jack reports, the majority found no safe level of caffeine for pregnant women. (Though about a fourth of them found caffeine had zero effect.) He blames caffeine for "tens of thousands of avoidable negative pregnancy outcomes per year in the USA alone."

That is quite a claim. But as Joan Wolf, a professor of women's and gender studies at the University of Texas A&M, points out, "You can cherry-pick 48 studies on a topic and get that study to tell you anything you want it to tell you. This was so clearly written by someone who has an axe to grind. It stunned me that this even got through."

Wolf has spent much of her professional career tilting against research that seems bent on telling moms they must be ever more vigilant and selfless, and is the author of the book, Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood.

The problem is that in a culture enamored of shame and blame, especially when it comes to moms, it is this kind of research that gets funding and attention.

"Often the media are blamed for sensationalist headlines," says Murphy.  "But if you trace it back, the scientists themselves are writing studies and conclusions that [they know] will get into the paper. And the whole issue of pregnant women's behavior is a very rich area for this kind of material."

It's also a very rich area for proposed regulation. Murphy says that her country's National Institute for Health and Care Excellence (NICE) recently published guidelines "whereby they want a woman's entire alcohol history through the entire pregnancy—from a glass of beer they had before they knew they were pregnant—to be all documented and transferred onto a child's health record."

The clear implication is that anything a mom does can and will be held against her if a child exhibits problems.

For women, this kind of blame is horrible.

"I had miscarriage after miscarriage," says Nancy McDermott, author of the new book, The Problem with Parenting: How Raising Children is Changing Across America. Thanks to science, she says, "We found out what it was. It had nothing to do with caffeine. But when you're in that position, you're paranoid. I blamed myself because I carried the groceries home. I was sure that's why I had a miscarriage." Actually, she found out, it was because of a certain kind of blood clotting. (She is now the mother of two kids.)

But most women who miscarry will never learn why it happened, leaving ample opportunity for self-flagellation.

"The idea that you can control every aspect of your life or your children's life is part of a much broader dynamic that has all of us monitoring and surveilling ourselves all the time," says Wolf.

It may have a lot of others—doctors, health officials, baristas—monitoring and surveilling us, too.