CLOSE A CDC study has revealed that women who can give birth and are not on contraception should not drink at all. USA TODAY 
 
 Paintings are seen through a glass of wine held by painter Lynn Kata Thursday, July 17, 2014, in La Grange, Illinois. (Photo: Alyssa L Schukar, for USA TODAY) 
 
 Women of childbearing age should avoid alcohol unless they're using contraception, federal health officials said Tuesday, in a move to reduce the number of babies born with fetal alcohol syndrome. 
 
 “Alcohol can permanently harm a developing baby before a woman knows she is pregnant,” said Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention. “About half of all pregnancies in the United States are unplanned, and even if planned, most women won’t know they are pregnant for the first month or so, when they might still be drinking. 
 
 "The risk is real. Why take the chance?” Schuchat asked. 
 
 The CDC estimates 3.3 million women between ages 15 to 44 are at risk of exposing a developing fetus to alcohol because they drink, are sexually active and not using birth control. Even when women are actively trying to get pregnant, three in four continue drinking after they stop using birth control, according to the CDC report. 
 
 There is no known safe level of alcohol at any stage of pregnancy, according to the CDC. The American College of Obstetricians and Gynecologists recommends women abstain completely from alcohol while pregnant. 
 
 Alcohol use during pregnancy "can cause lasting physical, behavioral and intellectual disabilities that can last for a child’s lifetime," according to the CDC. These disabilities, known as fetal alcohol spectrum disorders, affect up to one in 20 school children, according to the CDC. 
 
 When pregnant women drink, "alcohol can quickly reach the fetus’s underdeveloped liver and brain through the placenta," said Mark DeFrancesco, the president of the obstetrician-gynecologist group. 
 
 Babies with fetal alcohol syndrome are more likely to be born small and to develop problems of the heart, kidney and brain, according to the CDC. Damage to the brain can lead to low IQ and learning disabilities, attention problems, hyperactivity, poor reasoning and judgement, as well as poor ability to communicate in social situations. All of these problems can lead to mental illness, substance abuse and other lifelong problems. 
 
 Alcohol use in pregnancy costs the USA $5.5 billion a year, according to the CDC. 
 
 Doctors "should routinely screen women regarding their alcohol use, both before and during pregnancy, and should provide support for women to stop use of alcohol when planning a pregnancy or when becoming pregnant," DeFrancesco said. 
 
 Some women who hope to become pregnant take prenatal vitamins, but don't think about their alcohol use, said Wanda Filer, president of the American Academy of Family Physicians. "Hopefully, this is the sort of report that will make people stop and think," Filer said. 
 
 Still, Filer acknowledged telling young women to completely abstain from alcohol could be a tough sell. Alcohol plays a role in many conceptions, after all, even among married couples. 
 
 "Some women will take this advice," Filer said, "and some will not." 
 
 The American Beverage Institute, a restaurant trade association, criticized the CDC's advice. "The CDC’s view on alcohol is incredibly puritanical," said Sarah Longwell, the group's managing director. "The more prohibitionist the agency’s stance, the less seriously the public will take its message." 
 
 Read or Share this story: http://usat.ly/1X0LdRT ||||| More than 3.3 million women are at risk for alcohol-exposed pregnancies, which can result in birth defects, developmental disabilities, miscarriage and fetal alcohol syndrome, according to a U.S. Centers for Disease Control and Prevention report published Tuesday. 
 
 What's more, three out of four women who reported wanting to get pregnant "as soon as possible" continued drinking alcohol. 
 
 News agencies and social media, however, focused on a secondary part of the report, which warned women who aren't trying to get pregnant that alcohol exposure could harm unborn babies if they accidentally did get pregnant. News agencies interpreted the report as a mandate that all women of childbearing age who aren't on birth control shouldn't drink. At all. Ever. 
 
 Jezebel, Elle and USA Today all expressed (righteous) outrage at the idea that a government agency should suggest an entire population of adult women stop drinking because of theoretical fetuses. 
 
 Just one problem: That's not quite what the CDC said 
 
 "We definitely didn't make any recommendations for women who are pre-pregnant," said Lela McKnight-Eily, an epidemiologist and clinical psychologist on the Fetal Alcohol Syndrome Prevention Team at the CDC. 
 
 "It's more a matter of women knowing and being informed that if they are drinking alcohol, sexually active and not using birth control, that they could be exposing a baby to a teratogen, and that could cause fetal alcohol spectrum disorders," McKnight-Eily said. 
 
 The warning was really directed at the three out of four women who reported wanting to get pregnant "immediately," but who said they continued drinking as they tried to conceive. 
 
 It was intended to inform women about the risks of alcohol and pregnancy (both expected and unexpected) -- not to control the behavior of women who aren't trying to have a baby. 
 
 "Women should have conversations with their health professionals about drinking alcohol and their health, in general, "McKnight-Eily added. "Particularly if they are planning to get pregnant or trying to get pregnant, this should be part of the conversation that they're having." 
 
 McKnight-Eily declined to comment on the Internet backlash unleashed by the report. 
 
 What the report really said 
 
 The report rightly noted that half of pregnancies in the United States are unplanned, and found no difference in alcohol consumption between women who were trying to get pregnant and women who weren't. 
 
 While the report did note that sexually active women of reproductive age who drink alcohol and don't use birth control are at risk for alcohol-exposed pregnancies, the thrust of the warning was directed at the group actively trying to conceive. 
 
 “Every woman who is pregnant or trying to get pregnant -- and her partner -- want a healthy baby," Coleen Boyle, director of CDC’s National Center on Birth Defects and Developmental Disabilities, said in a statement. "But they may not be aware that drinking any alcohol at any stage of pregnancy can cause a range of disabilities for their child." 
 
 Who's at risk 
 
 According to the report, which surveyed more than 4,000 non-pregnant, non-sterile women between ages 15 and 44, the highest risk for alcohol-exposed pregnancy was in women between the ages of 25 and 29, who were married or cohabitating, and had given birth to one child previously. Women who smoked were at a slightly higher risk of having an alcohol-exposed child than nonsmokers. 
 
 There also was a link between a mother's education and alcohol-exposed pregnancy. That finding tracks with previous CDC research showing that alcohol use during pregnancy is twice as common among women with college degrees than among women with high school diplomas or less. 
 
 Experts say the guideline isn't realistic 
 
 "People can take six months to get pregnant. They can take a year to get pregnant," Amy Bryant, an assistant professor of obstetrics and gynecology at the University of North Carolina, told The Huffington Post. "Personally, I think it’s a pretty unrealistic mandate." 
 
 Despite the paternalistic undertones many saw in the CDC's message, Bryant noted that the agency is simply trying to give clear guidance to women about their reproductive health. 
 
 "They see the cases of fetal alcohol syndrome," she said. 
 
 Advising women about drinking during pregnancy is particularly fraught, since drinking during pregnancy hasn't been studied much, largely for ethical reasons. As a result, the CDC takes a hard-line stance: No amount of alcohol is safe during pregnancy. 
 
 "It's really unclear what the effect of alcohol is on miscarriage and on conception," Bryant said. "It’s probable that that one glass of wine is not going to do anything, but you tell women that it’s safe to drink in pregnancy and then you end up with all this fetal alcohol syndrome -- and it is entirely preventable." 
 
 While the CDC team could have framed the recommendation better, the new report is in line with the agency's long-held stance on alcohol during pregnancy. 
 
 "There isn't a new guideline. It's been recommended for decades that women not drink during pregnancy," McKnight-Eily said. 
 
 "We think that there are a lot of mixed messages out there, and we want to give women a clear message that there is no safe time, there is no safe amount or type of alcohol to drink during pregnancy." 
 
 In trying to cut through this misinformation and simplify mixed messages for women, the CDC's public health message got confused, giving many the impression it was more punitive than clarifying. 
 
 "They really do want people to be aware, even in early pregnancy, alcohol can affect a fetus," Bryant said. "But I think it's a little excessive to say that any woman who's not on contraception shouldn't drink." 
 
 7 Things To Know About Women And Alcohol 7 Things To Know About Women And Alcohol ||||| Julie: Using birth control if you're drinking and fertile was just something the agency told doctors to “recommend.” The only category of women to whom they straight up said, “Don't drink,” was women who are "trying to get pregnant or could get pregnant." But the phrase “could get pregnant” could apply to an awful lot of women. 
 
 As of this writing, the CDC homepage blares “Alcohol and Pregnancy: Why Take the Risk?” but what the report is really asking is “Alcohol and the Ability to Get Pregnant: Why Take the Risk?” 
 
 Won't somebody think of the hypothetical children? 
 
 Olga: The fact that the headlines coming out of the announcement fall along the lines of, “Young women should avoid alcohol unless using birth control” speaks to the lack of finesse in this statement. Consider, for example, this quote: 
 
 “Alcohol can permanently harm a developing baby before a woman knows she is pregnant,” Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, told reporters yesterday. “About half of all pregnancies in the United States are unplanned, and even if planned, most women won’t know they are pregnant for the first month or so, when they might still be drinking.” 
 
 "The risk is real,” she added. “Why take the chance?” 
 
 Why do it? Why is it that whenever public-health officials talk about alcohol, they act like they’re Puritan robots from outer space who could never understand earthlings’ love of distilled spirits. “Why take the risk?” is a naive question. Both men and women drink alcohol because it is extremely fun. 
 
 The debate over the risk of drinking while actually pregnant, meanwhile, is as old as time. In recent decades, medical science has taken a much more conservative stance on this issue. Alcohol is considered by most doctors to be a leading cause of preventable birth defects and developmental disorders in the U.S. As one pediatrician put it to me last year, “the very worst thing that a mom could do during pregnancy is drink alcohol.” And women are drinking more in general, so it’s logical that this issue would be on the CDC’s radar. 
 
 Julie: The American Academy of Pediatrics has taken a hard line on this, saying in October 2015 that “no amount of alcohol intake should be considered safe” at any point in a woman's pregnancy. Fine. The science of drinking during pregnancy is contradictory and confusing and a “better safe than sorry” approach to official policy is reasonable until the research is clearer. On a policy level. 
 
 On an individual level, pregnancy is an exercise in abstinence. Women are told to give up not just alcohol, but caffeine, too. And seafood and lunch meat and soft cheeses. And sometimes, things that are much harder to go without. Jane Marie wrote a heartbreaking essay in Cosmopolitan about going off her depression and anxiety medication while pregnant. 
 
 Why? Mainly because we can't do controlled drug studies on pregnant women and babies, duh. Therefore, we don't know what happens to a developing fetus when, say, the mother needs to take 300 milligrams of Wellbutrin every morning, 25 milligrams of Trazodone at night, and 5 milligrams of Valium as needed for fear of flying and wide open spaces and heights. Your guess is as good as mine, literally, and guessing and mothering don't mix well. 
 
 But when a doctor says “it's safer for you to go off your antidepressants,” that is a guess. “It is not safe for you to have one glass of wine for nine months” is a guess. Plenty of women have weighed the risks for themselves, made an (informed) guess in the other direction, and turned out just fine.
– A warning too far? The Centers for Disease Control and Prevention has taken a lot of heat this week for a press release warning that more than 3 million American women of childbearing age who drink alcohol and don't use birth control are at risk of exposing a potential baby to fetal alcohol syndrome. "About half of all pregnancies in the United States are unplanned, and even if planned, most women won't know they are pregnant for the first month or so, when they might still be drinking," warned CDC Principal Deputy Director Anne Schuchat. "The risk is real. Why take the chance?" The CDC and the American Academy of Pediatrics say there is no safe amount of alcohol that can be consumed during pregnancy. The warning caused a backlash, with the Atlantic labeling it "Protect Your Womb From the Demon Drink" and USA Today noting that "alcohol plays a role in many conceptions, after all, even among married couples." Lela McKnight-Eily, however, a member of the CDC's Fetal Alcohol Syndrome Prevention Team, tells the Huffington Post that the intention wasn't to order millions of women to use birth control or stop drinking completely. "We definitely didn't make any recommendations for women who are pre-pregnant," she says, explaining that the warning was aimed at raising awareness of the risks among women who are actively trying to conceive. (Recent research suggests that for pregnant women, a coffee a day won't affect child IQ scores or behavior.)