CDC Drinking and Pregnancy Recommendations Draw Ire from Those It Is Meant to Help

A press release from the Centers for Disease Control and Prevention (CDC), a federal agency under the Department of Health and Human Services, is making national headlines for all of the wrong reasons.  The release, entitled “More than 3 million US women at risk for alcohol-exposed pregnancy,” appeared to have the best of intentions – proposing a number of best practices to help women prevent fetal alcohol spectrum disorders (FASDs) in their potential pregnancies.  In particular, the report notes that “Sexually active women who stop using birth control should stop drinking alcohol,” due to the fact that drinking while unknowingly pregnant can cause damage to the fetus.  However, many women viewed the report as insulting and another instance of the federal government having too much to say about women’s health choices.

The report starts by defining their at-risk population (which numbers 3.3 million) as women between 15 and 44 years old engaging in three practices: drinking, being sexually active, and not using birth control to prevent pregnancy. The report is not specifically about women who are actively trying to have a child, though the report notes that 3 of 4 women actively trying to have children also continue drinking.  The report is more about women who may become accidentally pregnant, and thus would unknowingly expose a fetus to alcohol.  From here, a number of contentions arise.

One contention is that the CDC is suggesting complete abstention from alcohol while the effects of limited drinking on fetuses is not a settled debate.  One response notes that it would be very difficult to do a study on the effects of alcohol on pregnancy because it would be unethical to conduct a double-blind experiment on pregnant women.  Furthermore, when limited studies have been done, there has been no link found between one to two drinks a week and fetal issues. Therefore, the recommendation of full abstention comes off as a pretense to otherwise try to control women’s behavior.

Another contention is that among the risks of alcohol consumption listed, the CDC included “injuries/violence” and “sexually transmitted disease.” As another response notes, there is a missing step in logic when one suggests alcohol consumption leads to violence and STDs. To say that puts all the onus on the woman for leaving herself open to such abuse, and not on those who would take advantage of someone who had been drinking.  There is no similar claim that men should also abstain from alcohol, whether actively using birth control or not.

Both responses recognize the ultimate goal of the report was noble – prevent FASDs. Furthermore, the report was lauded by some including the American College of Obstetricians and Gynecologists for its message of preventing FASDs. But by reducing women down to nothing but potential child-bearers, and saying nothing of the role men play in unwanted pregnancies or violence and STD spread, the CDCs ultimate point was lost on many.

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