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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 “lunatic” incident showed us the real Owen Smith: and it ain't pretty

Forget the slur - what really matters is what it says about his empty promises, says David Wearing. 

Owen Smith has embarrassed himself again. Having previously called for Labour to “smash” Theresa May “back on her heels”, advocated negotiations with ISIS, and described himself as “normal” with “a wife and three children” while competing with a gay woman to stand for the Labour leadership, you might expect him to have learnt the value of expressing himself more carefully. But no. Not a bit of it.

At a rally on Tuesday evening, Smith described Jeremy Corbyn as a “lunatic” with no “coherent narrative about what’s wrong with Britain”. It’s an interesting choice of words from someone who needs to win over tens of thousands of Corbyn’s supporters if he is to avoid a crushing defeat in this summer’s Labour leadership election. Indeed, we may look back on this as the final nail in the coffin of Smith’s campaign.

Let’s be honest. Most of us at some stage have used casual language like this (“lunatic”, “insane”), to describe those whose rationality we don’t share or understand. I’ll admit to having done so myself. But it is wrong. It perpetuates a stigma around mental illness and damages peoples’ chances of getting the care and support they need from society. We should all cut it out, especially those of us who aspire to high public office.

Beyond this, however, Smith has driven a coach and horses through the central premise of his own campaign. Throughout the summer he has presented himself as substantively agreeing with Corbyn on almost all domestic and economic issues, and only seeking to pursue that agenda more effectively and professionally. He has set out a range of policies - including a £200bn “British New Deal”, workplace rights and more redistributive taxation - that constitute an overt appeal to the social democratic, progressive values of the hundreds of thousands who joined the party to support Corbyn and secure a clean break with the neoliberalism of New Labour.

But it is simply not credible to simultaneously say “I agree with Jeremy” and that Jeremy is a “lunatic”. No one uses the word "lunatic" to describe someone whose politics they basically share. No one says “your diagnosis of the country’s ills is incoherent, and that’s the substantive agenda I want to take forward”. Smith’s remarks indicate that, deep down, he shares the incredulity expressed by so many of his colleagues that anyone would want to abandon the Thatcher-Blair-Cameron “centre ground” of deregulation, privatisation, corporate-empowerment and widening inequality. After all, Corbyn’s narrative only appears incoherent to those who regard the post-1979 status quo as self-evidently the best of all possible worlds - give or take a few policy tweaks - rather than the very essence of “what’s wrong with Britain”.

This incident will confirm the suspicion of many Labour members that, if he did win the leadership, Smith would dilute or ditch most of the policies he has used to try and win their votes. Those fears are well founded. Take as one illustrative example the issue of immigration, where Smith has shown one face to the party while suggesting that he would show quite another to the country, as party leader.

At leadership hustings, Smith presents an enlightened, pro-immigration, anti-xenophobic stance, but in a Newsnight interview last month we saw something rather different.  When asked if there were “too many immigrants” in the UK, he replied that “it depends where you are”, giving official comfort to the post-Brexit “pack your bags” brigade. He asserted that EU migration “definitely caused downward pressure on wages” despite academic studies having repeatedly shown that this is false, and that EU migration is of clear overall benefit to the economy.

Then, calling for an “honest” discussion on immigration, Smith noted that his wife is a school teacher and that schools in their local area are under pressure from “significant numbers into South Wales of people fleeing the Middle East”. In fact, a grand total of 78 people have been resettled in the whole of Wales under the Syrian Vulnerable Persons Resettlement Scheme. In the local authority encompassing Smith’s constituency of Pontypridd, the total number is zero.

This suggests, not someone who shares members’ values, but one who probably regards the leader’s pro-immigration stance as “lunatic”, and would prefer a return to the days when Labour erected the notorious Yarl’s Wood detention camp, rejected the vast majority of asylum applications from Saddam Hussein’s Iraq, and when Tom Watson put out an election leaflet reading “Labour is on your side, the Lib Dems are on the side of failed asylum seekers”.

Smith’s problem is that his mask keeps slipping. And every time it does, the choice before Labour members comes into sharper focus. On the one hand, they have a man who lacks many of the managerial and communication skills for party leadership, but who shares their values and who they can trust to fight for their agenda until a credible successor can be found. Against him stands a man they may not be able to trust, who may not share their values, and whose claims of professional competence grow more threadbare by the day. It’s a poor choice to be faced with, but Smith is at least making it easier for them.