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Blood alcohol tests in pregnancy: what do women lose when their bodies are scrutinised like this?

When women are increasingly scrutinised and shamed for the way they tend to actual or potential foetuses within them, it is not paranoid at all to feel this legislation as the cold hand of a threat laid on women’s backs.

I have lots of good memories of my first trimester of pregnancy. Critically, I didn’t know I was pregnant, so my memories include things like downing pints of Guinness with my boyfriend and our mates, and slamming around on the student union dance floor to Ante Up. When I learned I was pregnant and first considered the possibility that I might not have an abortion, one of the things I blurted out to my GP was: “I can’t have this baby, I’ve drunk so much.” And my sensible, kind GP replied, kindly and sensibly: “That doesn’t matter.”

She was right. It didn’t matter, just as for most women it doesn’t matter. About six months later, I had a perfectly healthy baby who has grown up to be a perfectly healthy child and now a perfectly healthy teenager. Increasingly, this attitude is not deemed to be enough. A new BMJ study urges that “new policy and interventions are required to reduce alcohol prevalence both prior to and during pregnancy”, despite the same report conceding that “most women who consume alcohol do so at lower levels where the offspring growth and development effects are less well understood”. It concludes that there is “urgent need for a biological marker of gestational alcohol use” to counter the vagaries of self-reporting in large-scale population studies.

In other words, we don’t know that pregnant women’s general level of drinking is causing any problems to either the women themselves or their babies, but we should act as though it does just in case, and we should find ways to monitor women at the level of their blood and piss in order to collect the evidence to justify this. The natural solution to any problem, after all, always seems to be the extension of greater public controls over women’s bodies: if severe alcohol consumption is bad for foetal health, then why shouldn’t we try to stop all potentially pregnant women from drinking? We gain healthy babies, and we lose… Well, what do we lose?

The idea of women as humans with our own wishes, desires and ethical intuitions has always been precarious at best. We are understood socially as wives or as mothers, small orbs of pale fire catching our meaning from the masculine suns we circuit, amanuenses to others who somehow count more than we do, who are deemed to be entitled to not only our unpaid work, but also to our affections and even to our bodies. And women do not get to refuse these demands lightly.

When it comes to sex, for example, the generally accepted social standards on what is a “yes” and what is a “no” undergo a massive, and very specific, revision. In order to prove that an act of intercourse was an assault, a woman must convince police, CPS and eventually jury that she refused in a such a way that her rapist could not “reasonably believe” that she consented. As the linguist Deborah Cameron points out in The Myth of Mars and Venus, this is not at all how yes and no function in regular conversation: “in everyday contexts, refusing is never done by ‘just saying no’. Most refusals do not even contain the word ‘no’. Yet in non-sexual situations, no one seems to have any trouble understanding them.”

A similar logic prevails when it comes to pregnancy. In any other situation where one human’s life depends on the physical sustenance provided by another’s body, we accept that the second party has a right of refusal – even if it means the death of the first. Blood donation is voluntary. So too bone marrow. Even post-mortem organ donation is opt-in (although that will change from December this year in Wales, at least). But when the body in question is female, and the one reliant on her is a foetus, suddenly the stakes change: she cannot simply refuse, but must instead convince two doctors (twice as many as need to approve any other procedure) that continuing the pregnancy would do her more harm than ending it.

I’ve given birth, and I’ve given blood, and one of those things is substantially more traumatic and life changing than the other; but then, one of them is only possible for a female body, so the effects don’t seem to be considered in the same way. And this issue of possibility is at the centre of the discussion about drinking and pregnancy, because most women – post-puberty, pre-menopause – have the possibility of becoming pregnant. Only 55% of pregnancies are planned, which means that pretty much every fertile woman is encroached on by that BMJ edict to reduce drinking “prior to pregnancy”. After all, we’re all just one collision of gametes away from conception. Step away from the gin bottle, ma’am.

It is curious that the concern is only to control women, rather than (say) address the general boozing culture of which both sexes partake. But the monitoring of female behaviour runs deeper than a little sexist censoriousness. It is written in our laws. The 1861 Offences Against the Person Act – still on the statute and still the basis of abortion law in Britain – includes these words:

“Every woman, being with child, who, with intent to procure her own miscarriage, shall unlawfully administer to herself any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, and whosoever, with intent to procure the miscarriage of any woman, whether she be or be not with child, shall unlawfully administer to her or cause to be taken by her any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, shall be guilty of felony…”

The language is old and ungainly, but what it means is this: it remains a criminal offence for a woman to attempt to end her own pregnancy; it remains a criminal offense for another person to supply the means to end a pregnancy, outside of the specific restrictions of the Abortion Act, whether or not the woman is actually pregnant. This is the legislation under which a woman in Northern Ireland (where the Abortion Act does not apply) is currently being prosecuted for helping her daughter to obtain an abortion.

Alcohol elevates the risk of miscarriage. It is, arguably, a “poison or other noxious thing”. When women are increasingly scrutinised and shamed for the way they tend to actual or potential foetuses within them, it is not paranoid at all to feel this legislation as the cold hand of a threat laid on our backs. As long as we are treated as potential mothers by default – in our laws and in our culture – women will be denied the dignities and freedoms that we call human rights. Nothing could matter more.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.

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Can Philip Hammond save the Conservatives from public anger at their DUP deal?

The Chancellor has the wriggle room to get close to the DUP's spending increase – but emotion matters more than facts in politics.

The magic money tree exists, and it is growing in Northern Ireland. That’s the attack line that Labour will throw at Theresa May in the wake of her £1bn deal with the DUP to keep her party in office.

It’s worth noting that while £1bn is a big deal in terms of Northern Ireland’s budget – just a touch under £10bn in 2016/17 – as far as the total expenditure of the British government goes, it’s peanuts.

The British government spent £778bn last year – we’re talking about spending an amount of money in Northern Ireland over the course of two years that the NHS loses in pen theft over the course of one in England. To match the increase in relative terms, you’d be looking at a £35bn increase in spending.

But, of course, political arguments are about gut instinct rather than actual numbers. The perception that the streets of Antrim are being paved by gold while the public realm in England, Scotland and Wales falls into disrepair is a real danger to the Conservatives.

But the good news for them is that last year Philip Hammond tweaked his targets to give himself greater headroom in case of a Brexit shock. Now the Tories have experienced a shock of a different kind – a Corbyn shock. That shock was partly due to the Labour leader’s good campaign and May’s bad campaign, but it was also powered by anger at cuts to schools and anger among NHS workers at Jeremy Hunt’s stewardship of the NHS. Conservative MPs have already made it clear to May that the party must not go to the country again while defending cuts to school spending.

Hammond can get to slightly under that £35bn and still stick to his targets. That will mean that the DUP still get to rave about their higher-than-average increase, while avoiding another election in which cuts to schools are front-and-centre. But whether that deprives Labour of their “cuts for you, but not for them” attack line is another question entirely. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to domestic and global politics.

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