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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.

 

'Media scare stories over drinking during pregnancy are causing women to ask for abortions

BBC, The Independent, The Telegraph, and a number of other media sources are covering a recent report from the British Pregnancy Advisory Service.

The British Pregnancy Advisory Service provides help to women with an unplanned pregnancy or a pregnancy they choose not to continue with.

The organization recently reported an increase in the number of women considering an abortion because of fears about the possible harms of binge drinking prior to knowing they were pregnant. The organization is quoted as saying:

“Warnings that even one episode of binge drinking by a pregnant woman can cause lifelong damage to her baby are causing serious and unnecessary distress.  We are now regularly seeing women so concerned that they have harmed their baby before they knew they were pregnant they consider ending what would otherwise be a wanted pregnancy.”

The Telegraph interviewed experts and government officials to explore issues related to “pre-pregnancy test binge drinking.” Some of the issues discussed in the media coverage is the ambiguity in the research evidence about low levels of alcohol use during pregnancy, reassurance for women who are considering an abortion due to drinking prior to pregnancy awareness, and the reality that almost 50% of pregnancies are unplanned.

Binge drinking and pregnancy_ 5 myths busted - Telegraph'

Official advice on alcohol use during pregnancy in the United Kingdom, from the National Health Service, recommends that pregnant women should avoid alcohol altogether. However, if women choose to drink, they should drink no more than one or two units of alcohol (equivalent to a glass of wine) once or twice a week.

The British Pregnancy Advisory Service suggested that women’s concerns were spurred by a recent study stating that one episode of binge drinking was enough to cause considerable harm to a fetus. This type of reporting relates to ongoing discussions in the field of FASD prevention about the framing of messages about the potential harms of alcohol use during pregnancy. Some individuals and groups in the field are concerned that strongly worded messages (e.g., “Pregnant women should NEVER drink alcohol”) and the use of shocking or threatening images (e.g., a baby in an alcohol bottle) can have unintended consequences – such as unnecessary worry and fear throughout pregnancy or considering having an abortion.

While it’s important to inform women about the dangers of alcohol use during pregnancy, some researchers are suggesting that it might be helpful to be honest with women about the ambiguity in the academic research about low levels of alcohol use – rather than discouraging abstinence, this might help women to understand why official guidelines suggest that “the safest option is to not drinking during pregnancy” and that “there is no known amount of alcohol use during pregnancy that has been shown to be safe.”

For more on this issue, see an earlier post: Do concerns about alcohol use during pregnancy lead women to consider having an abortion? (February 1, 2013)

 

 

Screeshot - Telegraph_Feb 2 2014

Over the past couple of months, there has been media attention about a new legal test case going before the Court of Appeals in the United Kingdom. This case has raised concerns and discussion in Europe (and elsewhere) about punishing women who drink alcohol during pregnancy.

The case in the UK is arguing that a six-year-old girl who suffered brain damage due to alcohol exposure in the womb is the victim of a crime (grievous bodily harm). While this claim was initially overturned in December 2011, an appeal is going forward. If successful, women who drank during pregnancy could be convicted of a criminal act. Interesting, this is occurring even while current UK national guidelines on alcohol use during pregnancy state: “Expectant mothers should avoid alcohol – but if they do choose to drink, they should limit their consumption to one or two units a week.”

The European FASD Alliance released a position statement last week called “Drinking during pregnancy-who is responsible?

“The EUFASD Alliance does not agree that mothers who drank during pregnancy should be punished. We recognize that there are many reasons that women drink, for example not knowing that they are pregnant, or due to bad advice from their health care advisors or the press. We recognize that social pressures play a great role in encouraging women to drink.”

The position statement has been cosigned by a number of other organizations. See the position paper here on the European FASD Alliance website.

For more on punishing or criminalizing alcohol use during pregnancy, see early posts:

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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