Every time I write about alcohol and pregnancy, I receive abusive messages. More so than when I write about abortion or if I use the word “patriarchy” in a publication read by men. When the charity I run intervened in a landmark court case (arguing against setting a legal precedent that could criminalise drinking in pregnancy), I became accustomed to feeling the burn of primal rage and disgust from the world that seemed entirely disproportionate to my take on the matter: give women clear, evidence-based information and then trust and support them to make the best decisions they can for their families.
I’m not the first person to discover that nuanced discussion around the decisions women make about their bodies during pregnancy is unwanted. There’s only ever room for a very simple narrative: women who drink are bad, reckless, dangerous mothers. Researchers discovered that pregnant women who drink are up there in the most hated groups of people. Less popular in researchers' popularity tests than cheating spouses, drug addicts, fathers who abandon their children and illegal immigrants.
Given the current UK advice that pregnant women should abstain from alcohol entirely, the silence around what the evidence base really tells us about mild to moderate drinking and the epidemic of “pregnant women banned” icons appearing on beer bottles, it’s perhaps understandable that the sight of a woman with a full uterus and full pint leads to critical stares or even refusal of service in pubs.
Combine this with the responsibility we assign women to be perfect (and the largely free rein given to male parents to do whatever the hell they like) and it’s not surprising that a mother’s sip of merlot inspires censure that a father’s total abandonment of his child does not.
Nine years ago, when I was pregnant with my first baby, the official advice around alcohol was different. In 2009, it was OK to have a couple of units a week. But, in between my pregnancies, that advice changed (despite no new evidence emerging) and, when I chose to continue to drink occasionally the second time around, I found some people hostile and judgemental. I did it anyway.
I was too sick for the first trimester to bother with anything other than dry crackers washed down with bad temper. But once that had passed – and I stopped feeling as if my bones were made of lead – I enjoyed a couple of units some weeks without the tiniest smidge of guilt or worry. Most days, I didn’t feel like alcohol. But sometimes I just wanted to be me – not a giant womb on legs, just an adult woman having a cold glass of wine because it was 7pm and sunny. And, having read the research on alcohol and foetal harm and factored in my life, it was a decision that felt entirely safe and appropriate for my individual situation, my sanity and my baby.
At BPAS, we see women who are so concerned about the impact of relatively low levels of alcohol consumption that they are considering ending a pregnancy
As Katherine O’Brien of BPAS explains, those who advocate instructing pregnant women to abstain completely (despite there being little to no evidence of harm caused by light drinking) seem to assume that their advice is harmless or protective. Yet there are real consequences. “At BPAS, we see women who are so concerned about the impact of relatively low levels of alcohol consumption that they are considering ending a pregnancy.”
I’ve thought hard about the honest information women need access to and included that, instead of blunt scaremongering, in my new book, Your No Guilt Pregnancy Plan. Making it clear to pregnant women that the advice to abstain from alcohol entirely is a “precautionary” approach might not win me any friends in officialdom, but I think it’s urgently needed context. Women need to know that the rationale for the current advice is that there isn’t enough evidence of where the safe drinking limit is and there are concerns that they may underestimate their consumption and drink more units than they think. I trust women (with support if needed) to become familiar with the facts and question marks and make their own choices. For many, empowered with this real and detailed knowledge, avoiding alcohol will be the right and safest choice for them. But it needs to be their own informed decision, not one based on fear, shame, spin or infantilism. And I believe that this shift will encourage an expectation in women’s health to treat us with respect based on the adult-to-adult relationships that should exist between us and our caregivers.
I refuse to tell women what they should do when it comes to drinking, giving birth or feeding their babies, believing it’s better to arm them with facts, options and tools to make their decisions in a world that wants to tell them what to do. Isn’t that, after all, how to prepare them for the complex joys and challenges of parenting itself?