How much decaf coffee is safe during pregnancy

To drink or not to drink coffee? That is a question pregnant women have pondered since 1980 when the Food and Drug Administration issued a warning, based on animal studies, to avoid or restrict caffeine intake during pregnancy.

The concern is that caffeine metabolizes more slowly during pregnancy, so caffeine blood levels remain high, even if consumption is decreased. Caffeine is rapidly absorbed from the digestive tract, distributes through all body tissues, and easily crosses the placenta. Animal studies have linked caffeine to increased rates of birth defects, low birth weight, stillbirths and miscarriage.

But a new study of 5,144 pregnant women by scientists at the State Department of Health, Kaiser Permanente Division of Research and UCSF has turned up some surprising results. The study found no significant increased risk for spontaneous abortion, or miscarriage, associated with caffeine consumption. Even among women considered heavy caffeine consumers (300 milligrams or three cups of coffee a day) miscarriage risk increased only slightly -- about 1.3 times the risk as noncaffeine users, according to the study in the September issue of the journal Epidemiology.

The study, however, found that women who drank three or more cups of decaffeinated coffee a day in the first trimester had 2.4 times the risk of miscarriage as those who did not drink decaf.

Researchers, however, are not urging pregnant women to pull the plug on decaf. The connection between miscarriage and decaffeinated coffee is more likely an �epidemiologic phenomenon,� says UCSF addiction expert and pharmacologist Neal Benowitz, MD, whose laboratory at SFGH conducts studies on caffeine metabolism.

�We suspect that the apparent risk associated with heavy decaffeinated coffee intake resulted from women with nonviable pregnancies experiencing fewer symptoms of pregnancy and consequently consuming more decaffeinated coffee,� the researchers said.

If a woman inher first trimester, for example, stopped feeling nauseous -- a potential sign that the pregnancy is in trouble -- she may be more likely to drink more coffee than a woman with morning sickness. Early in pregnancy, says Benowitz, women might be more motivated to substitute decaf for regular coffee because of concerns for the safety of the fetus.

Among the heavy decaffeinated coffee drinkers (three or more cups daily), the spontaneous abortion rate was 18.5% for the 27 women who had increased their consumption, 33.3% for the six women who had reduced to three cups per day, and 24% for the 25 women who had not changed their consumption since before pregnancy, reported lead author Laura Fenster of the Department of Health Services in Emeryville, California. The overall miscarriage rate for the women in the study was 9.7%.

The researchers could not link any chemicals in decaffeinated coffee or the process of removing caffeine to miscarriage risks.

If you’re pregnant, you’ve probably been told (hopefully by your doctor and not your barista) that you should limit your caffeine intake. But what about traditional coffee’s less caffeinated cousin — is decaf coffee safe during pregnancy? After all, maybe you’re craving the warmth and the taste of a steaming cup of coffee and not so much the caffeine (okay, that’s a big maybe, but you never know).

“There are no official guidelines on decaf coffee and pregnancy; having said such, I would advise consuming it in moderation,” Dr. Angela Jones, M.D., FACOG (who goes by Dr. Angela) tells Romper. Decaf contains a fraction of the caffeine found in caffeinated coffee — a decaf coffee has about 97% of the caffeine removed, per Healthline — which means it's not without caffeine entirely. You shouldn’t have unlimited amount of decaf coffee for this exact reason.

“Decaf coffee does contain caffeine (around 2 to 15mg per 8 oz cup), but a lot less than a typical 8 oz cup of regular coffee (which can contain upwards of 80-200mg per cup). It is advised to keep caffeine intake to less than 200-300 mg per day when pregnant,” Dr. Lucky Sekhon, fertility specialist and board certified OB/GYN from NYC, tells Romper via email. Dr. Sekhon also mentions that the 200-300 mg of caffeine is a guideline for pregnant people that remains constant in each trimester; so it doesn't matter if you're nine weeks pregnant or nine months, it's best to keep the caffeine under 300 mg (and some studies suggest keeping it under 200 mg to be safe). With that said, you’d have to really double-down on the decaf to go over your limit.

But if you find yourself at that 4 p.m. slump trying to decide between a decaf coffee or a lightly caffeinated tea (white tea is typically lowest in caffeine, per Garfield Medical Center, followed by green) it's probably best to reach for the decaf cup of joe. "Most teas' caffeine content ranges from 35-90 mg, which is much higher than a single cup of decaf coffee," Sekhon says. And while herbal teas are not typically caffeinated at all, some of the herbs in tea are not pregnancy-safe, including, as Dr. Angela tells Romper, fennel, borage, licorice, and motherwort. So when in doubt, decaf is totally safe to drink while pregnant (as long as you haven't already had 13 cups that day which would be unlikely, to put it mildly).

Studies Referenced:

The American College of Obstetricians and Gynecologists. (2010). Moderate Caffeine Consumption During Pregnancy. www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2010/08/moderate-caffeine-consumption-during-pregnancy