In our view, Sarah Richardson and colleagues understate the risks of alcohol consumption during pregnancy (Nature 512, 131–132; 2014). Fetal alcohol spectrum disorders are among the three leading causes of intellectual disability (C. O'Leary et al. Dev. Med. Child Neurol. 55, 271–277; 2013).

Alcohol can disrupt brain development throughout pregnancy, often without causing the recognizable facial changes of fetal alcohol syndrome. The child can experience life-long cognitive and behavioural effects as a result (see, for example, S. N. Mattson et al. Neuropsychol. Rev. 21, 81–101; 2011).

A recent meta-analysis of 34 published cohort studies has revealed an association between moderate levels of alcohol exposure in utero and behavioural problems during childhood (A. L. Flak et al. Alcohol Clin. Exp. Res. 38, 214–226; 2014). The study authors conclude that there is no known safe amount of alcohol that can be consumed while pregnant.

Thoughtful discussion of the risks of drinking alcohol during pregnancy is likely to enhance, rather than restrain, women's freedom in the long term.