Recording pregnant women's alcohol consumption is straight out of the Gilead rule book

·4-min read
Plan to record the alcohol consumption of pregnant women has been compared to
Plan to record the alcohol consumption of pregnant women has been compared to

A week before my daughter’s birth in July 2006, I went to the Savoy for my husband’s birthday. The staff made a fuss of me and my bump, before the sommelier wheeled over the champagne trolley, and I chose a delicious glass of chilled Ruinart Rosé.

No one batted an eyelid – no dirty looks, no judgement, just an air of celebration. Back then, it was acceptable for a pregnant woman to drink one or two units a week, with National Institute for Health and Care Excellence (Nice) guidelines in 2008 stating “at this low level there is no evidence of any harm to their unborn baby”.

Now, if the new Nice proposals go ahead, every drop of alcohol a woman consumes in pregnancy will be noted in her and her baby’s medical records, and pregnant mums toasting a birthday or final childfree days will be made to feel as if they have put their unborn baby’s life at risk.

The undoubtedly worthy aim of the new proposal is to prevent Foetal Alcohol Spectrum Disorder (FASD), a range of syndromes thought to affect 7000 babies a year. But is this kind of policing of women’s bodies is not the best way to go about it. Are we edging towards an authoritarian approach towards pregnant women, reminiscent of Margaret Atwood’s dystopian novel The Handmaid’s Tale?

While heavy drinking in pregnancy is a cause of FASD, there is limited evidence of the effect of low levels of alcohol. According to the NHS, a review of studies earlier this year found, “drinking alcohol in pregnancy may affect babies’ thinking in later life” but “did not answer the question of whether there is a low level of alcohol consumption that is safe during pregnancy”.

In fact, no one knows the answer. As a result, since 2016, abstinence rather than common sense has been the official advice. With this proposal, and under the justification of collecting data, GPs and midwives will be grilling women not only on the number of drinks they’ve had each week, but what kind.

Monitoring women’s alcohol consumption in this way is chillingly Gileadean: it reduces us to mere vessels.

We’ve already become used to the patronising struck-through silhouette of a pregnant woman on a bottle of Peroni, as if all baby carriers are feckless binge drinkers who need a cartoon to remind them getting wasted is a bad idea. But this level of intervention is unprecedented, with new mums facing the prospect of being blamed if their child develops a disability that may fall under the FASD umbrella.

Clinical psychologist Dr Oliver Sindall said: “Nice’s aim is to find out more about the effects of alcohol on the foetus, but this kind of blanket policing is not the way to go about it.

“There is a potential that someone who drank before finding out they were pregnant may find a professional making assumptions about their child further down the line.

“Parenthood comes with guilt and shame and there’s a danger this will increase anxiety. The answer is more support and education to all pregnant women rather than a sledgehammer approach.”

As ever, these patriarchal rules ignore the practicalities: that we may take months or years to get pregnant, or not find out immediately, or get pregnant by accident, all the while continuing our lives as normal.

The burden of guilt and anxiety on mums-to-be is already huge. It’s not just booze, brie or unwashed lettuce leaves we have to avoid: women are also being told there is no safe level of caffeine, either.

Now, all those mums-to-be whose lives are not a perfect round of freshly squeezed juices, vitamin supplements and antenatal yoga classes will also have to worry their night of conception piss-up has somehow harmed their child. Under these circumstances, who is going to confess to their real alcohol consumption to a medical professional?

I wonder if it has occurred to Nice that women are absolutely terrified of harming their unborn baby, and this fear alone will be enough to turn them off consuming alcohol. The minority who continue to drink heavily should be able to confide in their GP or midwife in confidence.

It’s no wonder the British Pregnancy Advisory Service says the plans are “disproportionate and unjustified”. It’s time to stop stigmatising pregnant women, and start supporting them instead.

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