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Advice to pregnant women about drinking alcohol may cause more harm than good

Telling women that small quantities of alcohol in pregnancy can cause irreparable damage to a developing foetus has no basis in evidence and can cause needless anxiety, academics and women’s advocates will warn at a conference: Policing Pregnancy: Who Should be a Mother? today. 

Pregnant women are currently warned that even light alcohol consumption can cause stunted growth, learning and behavioural difficulties, and increase the risk of premature birth.

However, low levels of alcohol consumption during pregnancy have not been shown to cause this kind of harm. While consistently heavy drinking during pregnancy can result in foetal alcohol syndrome, there is also no robust evidence that isolated episodes of binge drinking cause long term damage: this means that women who have drunk in this way before confirming a pregnancy – as many women in the UK have done – are unlikely to have caused their baby harm.

Last year the UK Chief Medical Officers altered guidelines on drinking in pregnancy, which had previously advised pregnant women to avoid alcohol but noted that if they did choose to drink, they should not drink more that 1 or 2 units of alcohol once or twice a week. This changed to simply advising women to avoid alcohol altogether for the duration of their pregnancy.

This was not as a result of changes in the evidence base, but in part because there were concerns that the previous guidance “may have been read as implying a recommendation to drink alcohol at low levels during pregnancy, which was not the intention” and the need “for clarity and simplicity in providing helpful advice for women”.

Speakers and delegates at the conference, being held at Canterbury Christ Church University (CCCU), will explore what this approach implies about women’s ability to make their own decisions on the basis of the available evidence, and what the implications are for reproductive choice and maternal wellbeing when information is not based on good evidence.  The conference, a collaboration between British Pregnancy Advisory Service (BPAS), the Centre for Parenting Culture Studies (CPCS), Birthrights, and Engaging Sociology at CCCU, will explore how risk and benefit is communicated to women of childbearing age today in regard to pregnancy – from how they behave before conception, their BMI during pregnancy, to how they feed their newborn baby.

Ellie Lee, Director of the Centre for Parenting Culture Studies at the University of Kent said:

“Official advice about drinking in pregnancy has gone down an overtly precautionary route. Evidence that suggests the odd drink, or even more than that, has no impact on child outcomes is interpreted as ‘insufficiently robust’ and any level of drinking is now associated with ‘possible harm’. As proving ‘complete safety’ is entirely impossible where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign. These are the issues that need to be made the focus for discussion.”

Clare Murphy. Director of External Affairs at the British Pregnancy Advisory Service, said:

“We need to think hard about how risk is communicated to women on issues relating to pregnancy.  There can be real consequences to overstating evidence, or implying certainty when there isn’t any. Doing so can cause women needless anxiety and alarm – sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm. But just as importantly,  it assumes women cannot be trusted to understand risk, and when it comes to alcohol, the difference between low and heavy consumption.  Women don’t stop being people with the capacity and the right to make their own informed choices just because they are pregnant.” 

Sessions at the conference include:

  • 'Ideal pregnancies' and the new family planning - including the role of the 1967 Abortion Act in establishing the 'problem' pregnancy
  • Bad Bodies, Bad Choi‎ces - exploring the evidence and rationale underpinning pre-conception and pregnancy advice today
  • Breastfeeding, guilt, and ideals of good motherhood - examining ‎the increasing trend towards advice that formula milk is harmful - as opposed to breastfeeding beneficial - and how the current approach to infant feeding promotion may negatively affect maternal well-being.

Jennie Bristow, Senior Lecturer in Sociology at Canterbury Christ Church University, said:

“There is so much advice to pregnant women about how they should behave – but we need to talk about the negative effects of some of this advice. Does it simply make for healthier pregnancies, or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women, and the conference aims to discuss how we might find a better balance.”

Rebecca Schiller, Chief Executive of Birthrights, said:

"From supposedly mandatory referrals to obesity clinics, to non-evidence based restrictions on the use of birth pools, birth centres and homebirth teams, women can find their bodies scrutinised, their lifestyles policed and their options limited in pregnancy and childbirth. Birthrights believes all women have the right to unbiased, non-judgemental support as they become mothers and we look forward to exploring this and more at the Policing Pregnancy conference. "

ENDS

For more information please contact the bpas press office on 07788 725185 or press@bpas.org

Notes to Editors:

The full programme for Policing Pregnancy: Who Should be a Mother? can be found here.

Biographies and abstracts can be found here.

About bpas

bpas is a charity which sees more than 70,000 women a year and provides reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception, at clinics across the UK. It supports and advocates for reproductive choice. More information can be found at bpas.org