Policing pregnant women: moralism dressed up as evidence

A paper published this week in the journal BMJ Open, called ‘Prevalence and predictors of alcohol use during pregnancy’, reported the following findings: first that, in one study, ‘delivery of a low-birth-weight infant was not associated with alcohol use’; second that, in two studies, ‘we found evidence that women who delivered low-birth-weight infants were less likely to drink alcohol’; and third that, in all three studies, ‘For preterm birth, we did not find strong evidence of an association with alcohol use in any of the three cohorts’.

As the paper shows, most women drink very little alcohol after the first three months of pregnancy. However, most women drink more normally early on in their pregnancy, a time in which lots of women don’t realise they are pregnant. It has been suggested over the years that preterm birth and low birth weight may have something to do with drinking in early pregnancy, but this paper seems to suggest this claim is untrue.

This is reassuring news for women, but you wouldn’t know it from the media coverage. A Telegraph headline read, ‘Pregnant women should be tested for alcohol amid binge-drinking fears. One in three pregnant women admit to binge-drinking in the first three months of their pregnancy.’ Yes, that’s right, a paper that presents evidence that contradicts the link between drinking during pregnancy and problems at birth has ended up providing the rationale for carrying out drugs tests on pregnant women, as if they were broodmares.

This was no media spin or misrepresentation of what the authors wanted to communicate; it followed directly from the message the researchers decided to transmit. Going back to the paper, the discussion of the findings opens this way: ‘Our findings show a high prevalence of alcohol use during pregnancy… these findings illustrate low adherence to alcohol guidelines advising complete abstinence from pregnancy.’ And it is this ‘finding’ – and only this – that the researchers claim is important. That women have a few drinks during their first few weeks of pregnancy, that they are not completely abstinent from the word go, and so, horror of horrors, do not adhere to ‘the guidelines’, is apparently the big news.

In our book Parenting Culture Studies, my co-authors and I argue that we live in a highly risk-conscious society, in which ‘experts’ have completely detached ‘risk’ from the probability of something actually going wrong. This, we contend, results in a powerful impulse both to moralise about the ‘risky behaviour’ of parents, and would-be parents, and police and regulate their behaviour. This latest story provides a very clear example of what we mean. It has become the role of such ‘experts’ to pry and poke about into the habits and lifestyles of pregnant women, turn what women do when they don’t adhere to ‘the rules’ into a focus for moral outrage, and then argue that the lives of women should be monitored and policed further still.

In response to this paper, Clare Murphy of the British Pregnancy Advisory Service (bpas) told the Telegraph: ‘We would be extremely wary of any measures which sought to further police pregnant women’s behaviour.’ We should indeed be wary. It is high time we had some resistance to the idea that pregnant women and mothers should simply do what they are told by ‘the rules’, and, worse still, that they should submit themselves to the gross invasion of privacy that would be blood tests during pregnancy.

Dr Ellie Lee is a reader in social policy at the University of Kent, director of the Centre for Parenting Culture Studies (CPCS), and co-author of Parenting Culture Studies. (Order this book from Amazon(UK).)