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In 2016, the UK Chief Medical Officer with endorsement from the Royal College of Midwives updated advice on drinking alcohol during pregnancy, stating:

“I want pregnant women to be very clear that they should avoid alcohol as a precaution. Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant.”

This month, the Centre for Pregnancy Culture Studies (CPCS) and others have been getting a lot of press for the claim that women are being unnecessarily frightened by this most recent advice and may be terminating pregnancies because of it (see post below for facts on this). They say that women who choose to drink at low levels during pregnancy are being stigmatized when the facts don’t support the guidelines.  Further, they claim “the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign.” (The Guardian, May 17, 2017)

That they see alcohol as a normal activity that women should have a right to, does a disservice to both feminism and to alcohol education. There is definitely here a reluctance to examine alcohol as a substance that has the potential to negatively affect health in all situations, and is a teratogen in the context of pregnancy.  More, rather than less, discussion of alcohol on men’s and women’s health, and not only in relation to preconception and pregnancy would be welcome.  Canada’s Low Risk Drinking Guidelines could inspire more public consideration of what we know and don’t know about alcohol.

CPCS’s comments were in tandem with a larger Policing Pregnancy conference held last week. And on points of pregnancy policing, we agree. Facts show that policing pregnancy increases stigma and pushes women to the margins so that they don’t get the help they want [1]. Women should not be policed for their actions in pregnancy, rather they should have access to information and conversations that can support their decisions.

Preconception and prenatal health care with a caring and knowledgeable health care provider is critical to helping women have the best health and pregnancy possible. How many women have the kind of discussion of alcohol and the care they deserve?

As one opinion writer noted in response to the coverage, the tinkering with alcohol guidelines for pregnant women is not the harm here – it is the lack of services and care that pregnant women receive. https://www.theguardian.com/commentisfree/2017/may/20/i-can-cope-with-drinking-advice-but-not-bad-care

 

For more information, see these earlier posts:

Policing or Supportive? Why We Should Test Pregnant Women for Alcohol Use, July 7, 2015

Do Concerns about Alcohol Use during Pregnancy Lead Women to Consider having an Abortion? February 1, 2013

References

  1. Poole, N. and B. Isaac, Apprehensions: Barriers to Treatment for Substance-Using Mothers. 2001, British Columbia Centre of Excellence for Women’s Health: Vancouver, BC.

 

The Women Want to Know project encourages health professionals to routinely discuss alcohol and pregnancy with women and to provide advice that is consistent with the National Health and Medical Research Council’s Australian Guidelines to Reduce Health Risks from Drinking Alcohol. This is the first national campaign targeted at health professionals since the Alcohol Guidelines were last updated in 2009.

A survey of 300 health professionals conducted prior to the project  found that one in five health professionals had not heard of the Guidelines and more than two in five (45%) were aware of the Guidelines but not familiar with the content.

The guidelines state that  ‘Maternal alcohol consumption can harm the developing fetus or breastfeeding baby’ and ‘For woman who are pregnant or planning a pregnancy, not drinking is the safest option’ and ‘For women who are breastfeeding, not drinking is the safest option’.

Research has also shown that 97 per cent of Australian women want to be asked about alcohol use during pregnancy.

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The Women Want to Know project was developed by the Foundation for Alcohol Research and Education (FARE) in collaboration with leading health professional bodies across Australia and is supported by funding from the Australian Government Department of Health.

There are two main components to the project: (1) resources to support health professionals in discussing alcohol use and pregnancy with women, and (2) accredited training.

Resources from the Women Want to Know project include:

In addition three online e-Learning courses with Continuing Professional Development accreditation are available for health professionals through the:

Read the press release from the Foundation for Alcohol Research and Education here. Learn more about the project and recently developed resources here.

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Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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