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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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The Liberal Democrats are back - and the Tories should be worried

A Liberal revival could do Theresa May real damage in the south.

There's life in the Liberal Democrats yet. The Conservative majority in Witney has been slashed, with lawyer and nominative determinism case study Robert Courts elected, but with a much reduced majority.

It's down in both absolute terms, from 25,155 to 5,702, but it's never wise to worry too much about raw numbers in by-elections. The percentages tell us a lot more, and there's considerable cause for alarm in the Tory camp as far as they are concerned: the Conservative vote down from 60 per cent to 45 per cent.

(On a side note, I wouldn’t read much of anything into the fact that Labour slipped to third. It has never been a happy hunting ground for them and their vote was squeezed less by the Liberal Democrats than you’d perhaps expect.)

And what about those Liberal Democrats, eh? They've surged from fourth place to second, a 23.5 per cent increase in their vote, a 19.3 swing from Conservative to Liberal, the biggest towards that party in two decades.

One thing is clear: the "Liberal Democrat fightback" is not just a hashtag. The party has been doing particularly well in affluent Conservative areas that voted to stay in the European Union. (It's worth noting that one seat that very much fits that profile is Theresa May's own stomping ground of Maidenhead.)

It means that if, as looks likely, Zac Goldsmith triggers a by-election over Heathrow, the Liberal Democrats will consider themselves favourites if they can find a top-tier candidate with decent local connections. They also start with their by-election machine having done very well indeed out of what you might call its “open beta” in Witney. The county council elections next year, too, should be low hanging fruit for 

As Sam Coates reports in the Times this morning, there are growing calls from MPs and ministers that May should go to the country while the going's good, calls that will only be intensified by the going-over that the PM got in Brussels last night. And now, for marginal Conservatives in the south-west especially, it's just just the pressure points of the Brexit talks that should worry them - it's that with every day between now and the next election, the Liberal Democrats may have another day to get their feet back under the table.

This originally appeared in Morning Call, my daily guide to what's going on in politics and the papers. It's free, and you can subscribe here. 

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