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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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Forget planning for no deal. The government isn't really planning for Brexit at all

The British government is simply not in a position to handle life after the EU.

No deal is better than a bad deal? That phrase has essentially vanished from Theresa May’s lips since the loss of her parliamentary majority in June, but it lives on in the minds of her boosters in the commentariat and the most committed parts of the Brexit press. In fact, they have a new meme: criticising the civil service and ministers who backed a Remain vote for “not preparing” for a no deal Brexit.

Leaving without a deal would mean, among other things, dropping out of the Open Skies agreement which allows British aeroplanes to fly to the United States and European Union. It would lead very quickly to food shortages and also mean that radioactive isotopes, used among other things for cancer treatment, wouldn’t be able to cross into the UK anymore. “Planning for no deal” actually means “making a deal”.  (Where the Brexit elite may have a point is that the consequences of no deal are sufficiently disruptive on both sides that the British government shouldn’t  worry too much about the two-year time frame set out in Article 50, as both sides have too big an incentive to always agree to extra time. I don’t think this is likely for political reasons but there is a good economic case for it.)

For the most part, you can’t really plan for no deal. There are however some things the government could prepare for. They could, for instance, start hiring additional staff for customs checks and investing in a bigger IT system to be able to handle the increased volume of work that would need to take place at the British border. It would need to begin issuing compulsory purchases to build new customs posts at ports, particularly along the 300-mile stretch of the Irish border – where Northern Ireland, outside the European Union, would immediately have a hard border with the Republic of Ireland, which would remain inside the bloc. But as Newsnight’s Christopher Cook details, the government is doing none of these things.

Now, in a way, you might say that this is a good decision on the government’s part. Frankly, these measures would only be about as useful as doing your seatbelt up before driving off the Grand Canyon. Buying up land and properties along the Irish border has the potential to cause political headaches that neither the British nor Irish governments need. However, as Cook notes, much of the government’s negotiating strategy seems to be based around convincing the EU27 that the United Kingdom might actually walk away without a deal, so not making even these inadequate plans makes a mockery of their own strategy. 

But the frothing about preparing for “no deal” ignores a far bigger problem: the government isn’t really preparing for any deal, and certainly not the one envisaged in May’s Lancaster House speech, where she set out the terms of Britain’s Brexit negotiations, or in her letter to the EU27 triggering Article 50. Just to reiterate: the government’s proposal is that the United Kingdom will leave both the single market and the customs union. Its regulations will no longer be set or enforced by the European Court of Justice or related bodies.

That means that, when Britain leaves the EU, it will need, at a minimum: to beef up the number of staff, the quality of its computer systems and the amount of physical space given over to customs checks and other assorted border work. It will need to hire its own food and standards inspectors to travel the globe checking the quality of products exported to the United Kingdom. It will need to increase the size of its own regulatory bodies.

The Foreign Office is doing some good and important work on preparing Britain’s re-entry into the World Trade Organisation as a nation with its own set of tariffs. But across the government, the level of preparation is simply not where it should be.

And all that’s assuming that May gets exactly what she wants. It’s not that the government isn’t preparing for no deal, or isn’t preparing for a bad deal. It can’t even be said to be preparing for what it believes is a great deal. 

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.