Expecting Clarity: Alcohol, Fertility and Pregnancy

Part 3 of the ‘Women & Alcohol: A Life in Balance’ series

If there’s one thing I’ve learned, it’s that when it comes to pregnancy and alcohol, things get confusing fast. Mixed messages, old wives’ tales, judgment from all sides — it can feel like you need a PhD just to figure out what’s ‘safe’ or ‘okay.’ Whether you’re trying to conceive, just found out you’re pregnant or thinking about starting a family someday, the topic of alcohol can feel overwhelming, contradictory and honestly, pretty scary.

So, let’s have a real, down-to-earth chat about what alcohol really means during this stage of life.

You’ve probably heard it — or even said it yourself: “One glass won’t hurt,” or “A little wine now and then is fine.” The tricky truth? Science is pretty clear that there is no safe amount of alcohol during pregnancy. The trouble is, we don’t know just how much can cause harm to the foetus. Every pregnancy and every mum to be is different. So, best not to go there at all. It’s not about fearmongering, it’s about being informed. Surprisingly, in the UK, the Chief Medical Officer only added alcohol to the list of things you shouldn’t consume during pregnancy in 2016! So, it’s easy to see why we’ve been confused all this time. But the evidence is unequivocal. Drinking can cause permanent damage to the foetus; more on that later.

Now, what about before pregnancy — when you’re trying to conceive? Here’s where things get even more complicated.

Alcohol can affect fertility for both women and men, and often in ways we don’t hear about enough. For women, drinking — especially regularly or in higher amounts — can disrupt menstrual cycles, affect hormone levels and reduce the chances of ovulation. Basically, it can make it harder to get pregnant.

And for men? Alcohol can lower sperm quality, reduce testosterone levels, and affect libido. Yep, it’s a team effort — and alcohol impacts both sides of the equation. So, while the research isn’t 100% clear-cut, it’s safe to say that cutting back or avoiding alcohol when trying to conceive can improve your odds and set a healthier foundation for your future family.

Understanding how alcohol impacts fertility matters because it can influence the very start of your journey to parenthood. Reducing or eliminating alcohol before conception can boost your chances and help create the healthiest possible environment for your baby from day one.

I fell pregnant on my honeymoon. My husband-to-be and I both quit smoking six months before the wedding as we planned to try for a baby as soon as possible after tying the knot and, having the luxury of being able to plan, we wanted to do it right. We didn’t even consider changing our drinking habits, though. I’m pretty sure that I conceived on 9/11 (too much information – sorry). We were in Mauritius. We had drinks before dinner and watched the twin towers come down from the cocktail bar. It was a very subdued evening of course, so we retired early to bed and glugged a litre of champagne from the bottle before well, you know…

By the time we arrived home, I was already experiencing morning sickness and booked an appointment with my GP. I asked whether honeymoon levels of drinking could harm my baby and was told it was unlikely, otherwise I probably wouldn’t have got pregnant in the first place. Nice. There was no advice to stop or even cut down, no questions about my intake or whether I’d find it difficult to make changes. Luckily, I was so sick, even the thought of drinking made me reach for a bucket. So, other than a glass of champagne at a friend’s wedding seven months later, I was off the booze for the duration.

Drinking during pregnancy can lead to Foetal Alcohol Spectrum Disorders (FASD) — which covers a range of lifelong challenges like learning difficulties, behavioural issues and physical problems. It’s the most common preventable cause of developmental disability in the UK. Yep, that’s pretty heavy stuff. Of course, not all women who drink during pregnancy will be affected, there are other risk factors that contribute. Here’s what we do know: no alcohol means no FASD.

But here’s the thing — knowing the facts doesn’t have to come with shame or panic. It means you can make decisions with clarity, self-compassion and confidence.

If you’ve had a drink or two before you knew you were pregnant, please hear this loud and clear: You’re not alone (almost 70% of women have a drink during the first trimester) and you’re definitely not a bad person. Shame doesn’t help anyone — it just makes a hard situation harder.

What truly matters is what you do next. Talk openly with your healthcare provider, get the support you need and focus on what’s best for your health and your baby moving forward. You deserve kindness and understanding — from others and from yourself.

One of the hardest parts about alcohol and pregnancy is that society sends such mixed signals. From bottomless prosecco baby showers to friends who say their daily glass of wine calmed them and so was good for the baby and mothers and grandmothers who were advised to drink Guinness for the iron (for the record: vitamin supplements, not booze, is the way to go) it’s no wonder it feels confusing.

That’s why public awareness is so important. We need clear information — without judgment or stigma — so women (and their partners) can make choices that feel right for them.

Whether you’re cutting back, going sober or just figuring it out day by day, here are some ideas that might make things easier.

Find your special non-alcoholic drinks. I developed a taste for Kombucha or a Citrus and Moringa Nekta during the day and peppermint and liquorice tea in the evening. Whatever you fancy - sparkling water with a splash of fruit juice, mocktails, smoothies? Treat yourself to something that feels celebratory, not drinking shouldn’t mean missing out.

Practice your polite “no, thanks.”  “I’m not drinking tonight,” or “I need to be fresh for work tomorrow” work perfectly. Having a few go-to ways to say no can be useful if you’re not ready to let on that you’re trying for a baby or already pregnant.

Surround yourself with people who support you. Let friends and family know where you’re at so they can cheer you on instead of pressuring you. Plan ahead for social situations. If you know there’ll be lots of alcohol flowing at a party or dinner, decide your limits beforehand and bring your own non-alcoholic drinks if that helps.

Give yourself grace. This is about progress, not perfection. It’s totally normal to have mixed feelings or slip up — take it one day at a time. Seek professional support if you want it. Chatting with your midwife, doctor or local alcohol recovery service can give you tailored guidance and peace of mind.

One more thing: alcohol can be found in breast milk, so if you’re breastfeeding it’s best to avoid alcohol.  If you do drink however, you can express milk beforehand, wait until the alcohol is out of your system (your liver can process just one unit per hour), discard the next express of milk and then return baby to the breast. Cheers!

What’s Next

Up next, we’re tackling Wine O’Clock? Alcohol, Stress and the Modern Mother — where we’ll explore why so many mums reach for that glass and what else might help.