"I don't think we need to worry about coffee. I think we need to worry about this relentless regulating of pregnant women's choices," says Clare Murphy. Murphy is director for external affairs for the British Pregnancy Advisory Service and top signatory of a letter signed by about 20 professors and public health advocates objecting to the piece "Maternal caffeine consumption and pregnancy outcomes: A narrative review with implications for advice to mothers and mothers-to-be."
Implications indeed. The study — actually a meta-analysis of several earlier studies of caffeine and pregnancy — is by Jack E. James, a professor of psychology at Reykjavik University whose lifework seems to be excoriating caffeine. Consider his full-length book on the topic (his second), "Understanding Caffeine: A Biobehavioral Analysis," which concludes that "current scientific evidence indicates there is no safe level of regular use," according to its description on Amazon.
So, he's not a Starbucks kind of guy.
His BMJ piece looked at 48 studies out of, he writes, 1,261 on the subject. Of those 48, he reports, the majority found no safe level of caffeine for pregnant women. (Though about a fourth found "no or inconclusive associations.") 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 Texas A&M professor of women's and gender studies Joan Wolf 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." 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 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, it is this kind of research that gets funding and attention. Scientists know this. "Often the media are blamed for sensationalist headlines," says Britain's 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 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: Anything a mom does can and will be held against her anytime a child exhibits any problems.
For women, this kind of blame is a knife — or perhaps now a coffee spoon — in the back. "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.)
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.