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I'm a bit slow responding to the recent CDC advice that any woman of reproductive age not using birth control should avoid all alcohol. The awesome Rebecca Kukla responds at the bottom of this article: “We don’t tell pregnant women not to drive cars, even though we are much more certain that there’s a nonzero risk to their fetuses from each car ride than from each drink,” she said. “The ideal of zero risk is both impossible to meet and completely paralyzing to try to meet.” Kukla argues that such guidelines are also excessively punishing. “The idea that the pleasures and routines that make up women’s days are mere luxuries that are not worth any risk whatsoever is patronizing and sexist,” she said. “And it would also turn their lives into complete hell if really taken to [its] conclusions.” There's also an interesting thread of Feminist Philosophers here. I am extremely perturbed by this advice. It looks to me like another example of the excessive policing of women's behaviour, assuming that a woman's life (whether she is pregnant or not) should be governed by her function as a baby incubator, and adopting an approach to risk which is totally at odds with our reasoning in other walks of life (i.e. all the stuff that our philosophy of pregnancy and motherhood work criticises). I'm currently working with Elselijn Kingma on a paper arguing that in cases such as drinking alcohol during pregnancy we treat pregnant women as violating the strongest deontological constraint, the constrain against doing harm (rather than merely allowing harm or failing to benefit), but that deontological distinctions such as those between doing and allowing and harm versus benefit, do not apply easily to pregnancy. These distinctions are at home when looking at interaction between two separate, clearly bounded individuals and that is not what you get in pregnancy. This means that our characterisation of pregnant women's behaviour as doing harm (and our subsequent treatment of the women) is often unjustified. However, in discussing this on social media, I have been told that the CDC is reacting to important new evidence and that although there are serious problems in the presentation of the advice, there may be something substantial here. I haven't had time to explore this claim properly (son off nursery with bug, busy weekend with children, now playing catch up), so I'm officially withholding judgment until I know more. We do need to remember that restrictions on the pregnant come at a cost even if it sounds like very little to ask. Pregnant women aren't just asked to give up alcohol, they are told to watch their diet, to do neither too little nor too much exercise, to consider avoiding sunscreen "just in case", to avoid stress, ... The cumulative effect is exhausting. I am also worried about the emotional effect on women trying to get pregnant - perhaps for years - of being required to act as if they are pregnant. I gave up everything when I was trying to conceive, from alcohol to omelettes, I even tried to get them to let me off going through the scanner at the airport. (They refused.) Trying to becoming pregnant basically took over my life and I became very unhappy. I know that I am not alone. I worry that advice like this might make things worse. I think we need to very clear on the risks before we endorse this kind of advice.
2 Comments
10/27/2016 05:47:09 pm
However, even with more research being undertaken, questions remain.
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Fiona Woollard
10/28/2016 08:38:36 am
I definitely agree that there are still lots of questions about how we should think about alcohol and pregnancy.
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