HealthPregnancy & Childbirth

The CDC Can Rip the Wine Glass Out of My Childbearing-Aged Hand

New CDC recommendations released Tuesday state that all women of childbearing age should abstain entirely from alcohol, unless they use contraceptives. Come again? On first reading, one might think that they are on to something. Everyone knows that drinking during pregnancy is bad. Well…the research is actually mixed. But, aside from attempting to address the real problem of Fetal Alcohol Spectrum Disorders, which can have lasting impact on children, it makes a lot of bad assumptions about women, it’s unrealistic, and it might not be entirely evidence-based.

38447My first thought when reading the report was that this type of government recommendation sounds like something out of The Handmaid’s Tale. In Margaret Atwood’s 1985 dystopian novel, a theocratic dictatorship takes away women’s rights and separates them into classes. Fertile women of childbearing age are kept as handmaids for reproductive purposes by the ruling class after a large portion of the female population becomes sterile due to pollution and sexually transmitted diseases. They live under strict control of their wealthy male captors, and are treated as vessels for potential life.

While the U.S. government has not yet formalized restrictions on what I can and can’t do as a woman of childbearing age, this culture shift – viewing women as vessels for potential babies – scares me. I am an adult human. I am whole. I am not less important than my potential future unborn fetuses. To suggest that is offensive. I am not going to make a slippery slope argument, because I think we’ve already reached the bottom of the slope. Our culture doesn’t value women and girls.

It’s true – about 50% of pregnancies are unplanned – but it’s wrong to assume that women will continue with an unplanned pregnancy. It also assumes that a women has access to comprehensive sexuality education and contraceptives. And that it’s safe for her to take contraceptives. And that she wants to. And that they will work for her. I LOVE contraceptives, but they aren’t for everyone, nor should someone be shamed into using something to control her fertility. The alternative is completely unrealistic and unfair. No alcohol for 30+ years.

I thought the report was bad enough without this sexist, disgusting infographic.

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From CDC Factsheet on FASD: http://www.cdc.gov/vitalsigns/fasd/index.html

Did you know that alcohol puts all women at risk for sexually transmitted infections and unplanned pregnancy? Why? Because they make stupid choices about sex when they are drinking? Wouldn’t the same be true for men? Or do you only care about women, because of their role as incubators?

And is a complete prohibition on alcohol use during pregnancy even warranted? In 2012 BJOG: An International Journal of Obstetrics and Gynaecology published five papers resulting from the CDC funded Lifestyle During Pregnancy Study. The results? No serious effects on neurodevelopmental functions in five-year-old children whose mothers drank low to moderate amounts of alcohol in pregnancy.  I know, I was surprised, too.

It all comes down to trust. Can public health professionals trust that women, when provided with information about risk, will make healthy choices? It seems that our society has reached a point when the answer to that question is no.

Featured Image Credit: Stephen Train

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Steph

Steph

Steph recently traded single parenthood to two awesome kids (3 and 7) for marriage to a great guy with two awesome kids (5 and 10). Their adventures in parenting are set in a tiny town in the middle of a corn field. Their newest edition is due in February 2017. In late 2015 she left her stressful, more than full-time job with a victim services agency to pursue writing and activism. When she's not busy writing, chasing kids around, cleaning up messes and engaging in social justice warfare, Steph enjoys snuggling, making pies, engaging in debates on the internet, yoga, and fitness. A recovered natural parent, Steph now considers herself a semi-crunchy peaceful parent and trusts science, evidence and common sense to lead the way. She has been actively involved in the reproductive and women's rights movements for more than 20 years and is a passionate pro-choice feminist.

24 Comments

  1. February 3, 2016 at 4:58 pm —

    Wait, WTF?

    How can you have an unintended pregnancy from having a drink or two? I’m drinking wine and whisky, not sperm, and even if I decided to have semen with Vodka, that’s still not how you get pregnant.

    That “infographic” handily blames women for all the horrible things men tend to do to them when drunk. Fuck that shit.

    And cheers.

  2. February 3, 2016 at 9:59 pm —

    “Oh hey I’ve had a single alcoholic beverage- time to jump on any penis within squinting distance herp derp women amiright?!”

  3. February 4, 2016 at 2:38 am —

    I’m glad Giliell brought up the way the “risks” of women drinking is worded. “Injuries/violence” as a listed risk reads to me: “You ladies have a higher risk of being assaulted if you’re drunk so, you know, don’t do that. It is clearly your responsibility to prevent people from violating your bodily autonomy and they never do that when you’re sober.”

    Also, I would hope that doctors understand miscarriage isn’t a risk to a baby, but I obviously need to adjust my expectations.

  4. February 4, 2016 at 7:21 am —

    The infographic is also heteronormative, victim blaming and sexist as fuck. Might as well have said – women shouldn’t make any choices at all. And if they do? Bad things will happen to them and their future children. Even if they don’t plan on having any.

  5. February 4, 2016 at 10:14 am —

    I think that this article fits the topic neatly. It talks about the Zika virus and how the whole responsibility gets shifted on the (fertile cis) women as if we git pregnant all by ourselves.

    Just like that CDC sheet, rape and assault and pregnancy seem to be things that happen to us like the weather.

  6. February 4, 2016 at 9:26 pm —

    Hello, I’m a woman and future health professional (within a year). I have seen a lot of variations of the same arguments you posted. I am flabbergasted and scared that so many women feel this way, and are offended that something so obviously true is ‘impinging’ on our rights to drink alcohol. fact #1 unprotected sex can results in babies. fact #2 If an unplanned pregnancy occurs, a woman will find out weeks if not months into her pregnancy, during which she may have been exposing the fetus to alcohol.  fact #3 Alcohol causes birth defects.

    The CDC offers health guidelines to the WORLD on what is best. Some more facts that have evaded or been ignored the author and other women: Most heterosexual sex around the world is NOT protected. Many hundreds of millions of men and women do not have access to, or are discouraged from using contraception. Most women do not have access to safe and legal ways to end pregnancies. SO with that all being said if you are a health professional or know ANY WOMAN EVER who is having unprotected sex and drinking why is it wrong to tell her to stop drinking if she’s choosing not to use contraception, or unable to find any. What are the other options that are feasible? Is there an alternate universe in which you live in which abortion is accessible to all the billions of women in the world, and is an easy decision to make? I think people like you put very little thought into why this recommendation was made, and the very real consequences to people (mothers and children) who have suffered because they did not take the right precautions.

    I think you are delusional along with your other readers and I’m thankful that you don’t have other people’s lives in your hands.

    • February 5, 2016 at 3:35 am —

      The CDC offers health guidelines to the WORLD on what is best. Some more facts that have evaded or been ignored the author and other women: Most heterosexual sex around the world is NOT protected.

      Uhm, are you aware that the CDC is a US Government organisation stating that their mission is “to protect America from health, safety and security threats, both foreign and in the U.S. “?

      I’m sorry to break it to you, but the USA are NOT the world and the CDC is NOT talking about Peru, Guinea Equatorial, East Timor and Kasachstan.

       fact #1 unprotected sex can results in babies.

      Fact#1: unprotected sex can result in pregnancies. There are a hell lot of steps between one and the other. Fact #1.5 using contraception can also result in pregnancies. As a “future health professional” you should know that. IIRC the majority of people seeking abortions used 1 or more forms of contraception. Do you recommend that no fertile person with a uterus ever drink alcohol? Because that’S the logical consequence.

      fact #2 If an unplanned pregnancy occurs, a woman will find out weeks if not months into her pregnancy, during which she may have been exposing the fetus to alcohol.

      Fact #2: 1 week between implantation and missing a period is not week. Just because I’m currently “2 weeks pregnant” as counted from my last period does not mean I’m actually carrying an embryo. Yes, in very rare cases it may be months. Do you think it makes sense to regulate millions of women’S behaviour for the freak case of somebody only noticing their pregnancy when their water breaks?

      fact #3 Alcohol causes birth defects.

      Fact #3: You’re missing an auxillary. Can or may cause birth defects. As Steph noted, there is no 1:1 relationship and the evidence that any amount of alcohol causes birth defects is simply not there (if there was white people would probably have died out long ago). Nobody denies that FADS exists, but it’s also a rare condition.

    • February 7, 2016 at 4:55 am —

      As Gileill pointed out, the CDC is American, and not every international health organization shares the belief in prohibition while pregnant.  Our ob-gyn said that if we were in Europe, she’d say a half glass every night would not be a problem.

      To say that Alcohol causes birth defects is like saying water poisons.  It is true, but there is a safe amount to consume.

      • February 7, 2016 at 5:36 am —

        You know, I’m not even against a “better be safe than sorry” recommendation for people who actually are pregnant or trying to get pregnant. Because people are really, really terrible about judging what a “small to moderate amount” actually is. But this “don’t drink ever in case you might be pregnant and don’t know” is just bullshit.

  7. February 4, 2016 at 10:58 pm —

    Ad hominem attacks are not really a great way to get your point across. The fact is, the CDC recommendations and accompanying infographic are insulting, sexist, heterosexist, victim-blaming and not based in science. As a future health care professional, you may know that women don’t have broad access to contraceptives worldwide. Are they supposed to abstain from sex unless it’s for procreation? The same thought was put into this as the “Just Say No” and “Abstinence Only” strategies, which have both been shown in research to not be effective. If the CDC had said, we’re concerned about birth defects in babies born as a result of unplanned pregnancies and offered free contraception and plan B and a plan for every young person and adult in America to receive comprehensive sex education (including men), I would have said – “hell, yeah.” But, instead, they did this. They were wrong. Also, there is no evidence that alcohol use at the time of conception or before a positive pregnancy test impacts anything. As a future health care professional, you need to temper your advice with a dose of reality. Shaming women is not how you get them to comply with your recommendations. Additionally, implying that alcohol use by women causes violence against women is fucking wrong. Where are the men in this argument?

  8. February 5, 2016 at 4:58 am —

    This sort of Public-Health-Level warning is a perfect example of ‘worst first’ thinking, and deeply patronising – it robs all women of their agency because some women don’t have any.

    A very similar but less politically loaded situation exists in the recommendations provided for salt use. Untreated high blood pressure is, in fact, deadly and since the symptoms tend to be easily ignored and resemble those of just being old & out of shape, there are undiagnosed cases.

    The plainly idiotic response of the CDC is to advise everyone to reduce their sodium intake from the currently accepted 2300mg down to about 1500mg. This means that the vast majority of us with functioning kidneys and/or doctors who check our blood pressure are supposed to change our behavior because of the small number of people who never take advantage of BP screenings at the mall and haven’t been to the doctor in ten years.

    So, in the much more value-laden world of pregnancy, a small number of out-of-control women who might be putting a kid at risk for FAS means everyone’s supposed to act like a nun. There are so many logical gaps in this that it’s a joke. It’s possible that the powers that be introduced this policy as a means of raising awareness & reducing harm, but that makes it even more insulting.

    But hey, judging pregnant women & moms is fair game, it’s what we do.

  9. February 5, 2016 at 6:15 am —

    I’ve been thinking bout all the other things we need to keep women from doing if we took this approach to its logical conclusion.

    No more raw milk cheese, salami, smoked salmon, sushi or medium or rare steaks. You might be 3 months pregnant without knowing and listeriosis and toxoplasmosis are real dangers. Also, I’m sorry, no more cats.

    A broad range of jobs is now also closed. Everything where you work with chemicals that might be dangerous. After all, you might be pregnant without knowing.

    The same is of course true for working with small children. They often have contagious diseases and those might endanger the fetus (in Germany your doctor can actually ban your employer from letting you work for the sake of the pregnancy. You get paid about 70% of your income (and often more).

    Also, no more grocery shopping. Heavy lifting is dangerous for a pregnancy. You must have somebody else to carry the bags, just in case you become pregnant and don’t notice.

    Horseriding is also very dangerous for pregnant people. No more horseriding. Or walking the stairs. I once fell down the stair while pregnant. Very dangerous. Same as driving. A normal accident that would just result in minor injuries can kill you if you’re pregnant because the placenta ruptures. Which wouldn’t be that bad, but ruptured placentas tend to kill the fetus! And you might not even know that you’re pregnant! Clearly, fertile women should never enter a car.

     

    • February 7, 2016 at 6:26 am —

      Don’t forget all the various fruits and veggies which have caused listeria outbreaks in the past…  And no eating at Chipotle.

  10. February 5, 2016 at 9:36 pm —

    “Well the research is mixed [in regards to drinking during pregnancy is bad]” Is the same logic Republicans use to deny human induced climate change. Are you suggest its worth taking the risk of ruining a potentially healthy child development to get your buzz on?”To suggest that is offensive…” Sorry, being offended is no grounds for scientific public health institutes to restrict making recommendations on disease control.”I LOVE contraceptives, but they aren’t for everyone…” Science is based on statistically derived data. Statistics speak to large groups and generalities. So saying this doesn’t illegitimize their suggestions. “Did you know that alcohol puts all women at risk for [stds]… Wouldn’t that be the same for men?” The information is provided to reduce the likelihood of FASD, seems pretty logical that since they’re speaking to women they might include some other related information.”Can public health professionals trust that women, when provided with information about risk… It seems that our society has reached a point when the answer to that question is no.” It seems that the CDC is just providing information, and making suggestions based on scientific findings. Are you suggesting they not spread helpful information to society?

    • February 6, 2016 at 10:39 am —

      So, I reply knowing that it’s likely you didn’t read my article fully or check out the research that I linked. The body of research related to the impact of light to moderate drinking in pregnancy shows no impact or BETTER HEALTH OUTCOMES. In this case, the CDC is ignoring the results of their own funded study (linked in the article). This “Not a single drop of alcohol” mantra is not evidence-based and to expand that recommendation to all women of childbearing age who aren’t using contraception is ridiculous. Not all women have access to or can use contraception. I guess they should not drink until menopause. Does the CDC support abstinence only education for teens and young adults? No. Because these programs don’t work. AND they aren’t realistic. The infographic does not reference FASD exclusively. It also blames women drinking for experiencing violence, getting STDs and unplanned pregnancy and ignores the possibility that women might terminate unplanned pregnancies. It also ignores the role men play in those things. The CDC providing info is one thing. The CDC making this recommendation without also considering likelihood of adherence, access to education, contraception, and abortion care and the role of men in pregnancy, is paternalistic and not evidence-based as a public health strategy.

  11. February 5, 2016 at 11:05 pm —

    A friend of mine in university had terrible trouble with these kinds of assessments back in university. Every single visit to student health services, for any reason, involved a 10 minute interrogation as to whether she was sexually active (yes) and using birth control (no) *freakout* until she managed to get across to them that she was only sexually active with women.

    Everything has a cost. How much time to we steal from dealing with actual health concerns to lecture women on the new zero-tolerance alcohol policy? How many people will die because the doctor did not have time to deal with a valid concern, or to squeeze in that one extra patient?

  12. February 6, 2016 at 6:16 pm —

    The reason they don’t want women of childbearing age drinking is because one they might have unprotected sex because well men y’know. I mean men can’t help themselves if they see a woman with a drink in her hands it means she is ripe for sex and if they are at all attracted they might make the woman pregnant has nothing to do whether they (the men) had a drink or not. (Please note this is a sarcastic comment on the current perceived culture where women are automatically held responsible for any action a man has with regards to her body etc.)
    Seriously however there is research that show a moderate amount of wine can be healthy for you. There is a question that arises for me though what is the alcohol effect on sperm? I mean it does take both sperm and egg to create that foetus they are so concerned over.  I admit there has been a suggestion that women who are pregnant should not smoke or drink because of the possible damage.

    Keep in mind also the tendency of some men to use date rape drugs would not be changed by women not drinking alcohol. Nor would the chance of getting abused by a man who has been drinking  changed all that much by remaining sober.

     

  13. February 7, 2016 at 11:27 pm —

    So, I’m a doula. And normally, I am quietly protesting the limitations on preggo folks, because everyone loves to put their oar in, and no one likes to say to our Blessed Baby Vessels, “It’s still your body. Have some sushi and blue cheese. Teach the kid good taste from the get go. Or, Cheez Its and Faygo. Or vegan sausage rolls. Whatever floats your boat!” I firmly believe that people who are gestating deserve a pat on the back and a break for the freaking hard, important work their bodies are doing. Particularly when it comes to agonizing over going off, say, crucial antidepressants, I tend to lean toward the parent’s health first and foremost.

    I agree that the infographic is offensive. But I don’t agree that the recommendation is offensive, since one of the things we do know about alcohol(and some drugs) during pregnancy is that they can be safe later, but the first trimester is really the vulnerable period for the fetus. We are still in the Dark Ages when it comes to understanding a lot of things about the uterine environment and maternal health and the lifelong effect on the fetus. But it’s not unreasonable to recommend the things that have become clear. (Also not unreasonable to work on doing it in a nonsexist way, AHEM, CDC.)

    Let me ask some questions. Is anyone here heterosexually active, not on contraception, and a drinker? That is, in the target demographic? If you are or were in that demographic, otherwise yourself, and this recommendation concerned you, what choices would you make? Would you feel compelled to quit drinking? To start some form of contraception, or attempt to prevent conception otherwise?(AKA, prayer, vasectomy?) Would you talk to a doctor?

    Many women, particularly those who aren’t planning to get pregnant, don’t know they’re pregnant for six to eight weeks. That’s a month and a half to two months. Obviously we are only talking here about women who will not abort, as we’re not concerned with the health and well-being of those fetuses. And of course some people conceive while using contraception, but they are much less likely, and they have every right to expect that they won’t.

    The CDC rolled out recs for men who might become fathers, as well, advising them to stay away from alcohol and drugs. They work with the EPA to reduce levels of toxic chemicals, and I guarantee you they’re scrambling to keep Zika from getting a toehold in the US right now. Birth defects have gone down significantly due to groups like the CDC, and while I’m grateful they can’t force any of us to stop drinking or take oral hormones, I am also grateful they can give us good advice.

    • February 8, 2016 at 4:10 am —

      I am heterosexually active, have an occasional drink (more on this later) and our method of birth control is condoms, <a href=”https://www.guttmacher.org/pubs/journals/3429402.html”>which is by far the biggest offender when it comes to unplanned pregnancies among contraceptive using folks</a>.

      As you can see, 1/3 of those seeking abortions did use contraceptives. One in three American women (I ain’t one) will have an abortion during their lifetimes. Now add those who decided to have the baby and you will come to a huge percentage of women who have an unplanned pregnancy during their lifetime despite using contraceptives.

      According to your own claim, people who don’t plan to get pregnant notice later in the pregnancy than people who are and who know they’re at risk. Which gets us back to this “might be pregnant”: quite obviously everybody with a working uterus who has sex with people with working testes and penises.

      So, let’s get back to myself. I use condoms. Even the perfect use failure rate is 2%, the typical one is a whooping 18%. Should I have to stop drinking now* because I have an 18% chance of getting pregnant in any given year (and lemme tell you, I’m fertile as a rabbit) and might not know I’m pregnant until week 8 or so?

      Apply the CDC logic here, please.

      I promised to get back to the amounts, which is one of the greatest failures of that CDC sheet. They define “too much” both for habitual consumption and single session consumption. That’s OK and makes sense. But then they simply list risks for “too much”, lumping both kinds of too much into one and act like those risks apply to either. While they completely miss “alcohol addiction” as a very serious risk.

      I think we can all agree that you are at a higher risk of tripping and falling when you’re drunk. Only that 9 drinks over the week, especially when consumed regularly and evenly, will not make you drunk. And yes, alcohol lowers your inhibition. It typically doesn’t make you do things you are actually opposed to. People who think that drunk driving is bad do not suddenly change their opinion once they’re drunk. Which makes me wonder: If they put STDs and unplanned pregnancies on that list, what about car crashes?

       

      *Way under the habitual “too much” but probably once or twice a year over the single session too much.

    • February 8, 2016 at 10:30 am —

      I’m heterosexually active, not on contraception, and a social drinker. Based on both my own research and my medical professional’s advice, I have 1-2 drinks per day, a few times a week (if I feel like it.) I’m aware of my cycles and if I become pregnant I’ll know about it by week 5 or so. Before that time, any alcohol in my bloodstream is not going to be available to the embryo, as the placenta won’t have developed yet. If it has any impact at all, it will be to cause a spontaneous miscarriage or failure to implant: an all or nothing effect.

      The CDC could have advised people like me to be aware of our cycles (with accurate information about normal variance in cycle length) and encouraged pregnancy testing so that we can make informed lifestyle decisions. It could have focused its message on binge drinking and heavy regular drinking. Instead it put out a message that gives the completely false impression that a few drinks in the weeks before you can even test positive could cause permanent damage to your baby. Badly done.

      • February 14, 2016 at 3:00 am —

        That second paragraph is perfect – it’s exactly what was floating around in the inchoate mess I call my mind, but couldn’t put into words. I work with doctors, and they’re all convinced that everyone who is not a doctor needs to be spoken to in words of one syllable or less. Insulting, and as you say, badly done.

    • February 9, 2016 at 9:10 am —

      I think I fall in that target demographic you talked about and I do drink alcohol and I don’t use contraception and I have regular sex. I have not been on contraception for over ten years and I have had one child over this course of time. I will not go on birth control as I would be happy to have more children and yet I will not pursue fertility treatment for  a number of reasons and in the meanwhile, pass me a glass of wine while I make dinner. All of which I have discussed with the doctor and I feel well enough informed about.

      I think we are in complete agreement with the disappointment with this infographic. Instead of talking about fertility, stages of pregnancy, hormones, child development and family planning that works for individuals and their SO’s it just totally misses the boat and passes out misinformation.

      Consumption of alcohol, would be a good conversation to have with a well informed health care provider along with any other thing you do regularly in your life that maybe unhealthy. I just hope that the health care provider comes with science and not the kind of dated ‘sage advice’ that my mom or grandmother would have about alcohol and pregnancy.

      • February 9, 2016 at 4:29 pm —

        That’s another aspect I totally forgot: Some people have to try for years to get pregnant. Should they have to completely arrange their lives around the possibility of a pregnancy (while suffering disappointment every single month)?

  14. February 9, 2016 at 8:46 am —

    So, the first infographic was filled with misinformation and then is followed by terrible advice that is to be used by doctors. WHAT! This is so disappointing. It really makes you wonder if these people know how women get pregnant, not alcohol, SEX! Oh my. I could get this kind of misinformation from my mom as a teenager, not the kind of medical information I would expect from my health care provider. Where is the actual information, the education on how pregnancy works, how alcohol works on the body, anything worthy of science that should come from a doctor’s mouth. It is completely missing. BOOO!

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