Not on birth control? The CDC wants you to stop drinking. Here's what I think.
Concerned about the number of babies born with fetal alcohol spectrum disorders, the Centers for Disease Control has made quite the recommendation.
Health officials at the government agency on Feb. 2, 2016, suggested that all women of child-bearing age who are sexually active and not using birth control should ... wait for it ... avoid drinking alcohol altogether.
The CDC provided a handy infographic for health care providers, wherein they suggest that "[p]roviders can help women avoid drinking too much, including avoiding alcohol during pregnancy, in 5 steps."
Seems legit. But then step #3 is a little disconcerting (emphasis added):
"Advise a woman to stop drinking if she is trying to get pregnant or not using birth control with sex."
Yep, you read that correctly. If you're a woman who's having sex, who's capable of reproducing, and who's not using contraception, the CDC suggests your health care provider advise you to quit drinking alcohol completely.
At first, I thought maybe they just weren't being very clear. Maybe they were talking about women who are trying to become pregnant AND not using contraception. But, alas, no.
“Alcohol can permanently harm a developing baby before a woman knows she is pregnant,” principal deputy director of the CDC Anne Schuchat said, according to USA Today. “About half of all pregnancies in the United States are unplanned, and even if planned, most women won’t know they are pregnant for the first month or so, when they might still be drinking."
She continued, "The risk is real. Why take the chance?”
Let's break this down.
Late in 2015, the American Academy of Pediatrics took the definitive stance that absolutely no amount of alcohol during pregnancy is safe for a developing fetus.
For years, there's been a lot of debate about how much, if any, alcohol an expectant mother can consume before she should worry that her baby could be born with fetal alcohol spectrum disorder (FASD).
The CDC says FASD affects up to 1 in 20 U.S. schoolchildren and can result in many physical issues, such as: "low birth weight and growth; problems with heart, kidneys, and other organs; and damage to parts of the brain." Those problems can cause behavioral and intellectual disabilities, which in turn can cause problems with "school and social skills; living independently; mental health; substance use; keeping a job; and trouble with the law."
FASD is a serious condition, no question.
While some are still skeptical that even small amounts of alcohol are dangerous, the AAP published a clinical report in the November issue of Pediatrics, and the abstract contained the group's clear-cut stance:
— no amount of alcohol intake should be considered safe;
— there is no safe trimester to drink alcohol;
— all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and
— binge drinking poses dose-related risk to the developing fetus."
According to the CDC, planned pregnancies apparently make up half of all pregnancies each year in the U.S. So based on that info from the AAP, the CDC's recommendation that women who are pregnant or trying to become pregnant abstain from alcohol is logical. They included women trying to become pregnant because, according to health officials, even planned pregnancies often remain unknown until a woman is four to six weeks along.
But the way the CDC wants to address potential FASD in the other half of pregnancies — the unintended ones —is where things veer off course.
To be fair, step #2 on the info graphic for health care providers instructs them to:
"Recommend birth control if a woman is having sex (if appropriate), not planning to get pregnant, and is drinking alcohol."
But for health officials to jump from that to step #3, which is essentially saying "no more alcohol for you, the end!" is a just a tiiiiiiny bit paternalistic.
And it's problematic.
First, it's still difficult for some women to access birth control. What if instead of telling women to use birth control or give up alcohol forever — or at least until menopause — the government made absolutely certain that all women have easy, free access to birth control?
Second, why are we not more concerned with the fact that half of women who become pregnant each year do so unintentionally? That seems like the actual problem that needs addressing, not that women are going around being adults and having a glass of wine or a few cocktails in the course of, you know, living their lives.
Third, where's the recommendation and handy infographic for men about their contribution to unintended pregnancies (and potential FASD in the babies that result from those unintended pregnancies)? After all, if men were using condoms correctly 100% of the time they engaged in sex, that should reduce the number of unintended pregnancies drastically, thereby reducing the instances of FASD. Women who are not using birth control while consuming alcohol would be far more unlikely to become pregnant in the first place if their partners were using condoms.
I'd venture to guess that most people care about healthy babies.
But in the course of trying to protect potential future babies that don't yet exist, the CDC missed an opportunity to address the real problems: Women need easy, affordable (or free) access to birth control, men need to take responsibility to prevent unwanted pregnancies, and, again, why don't we care more about the number of unintended pregnancies that occur each year in the first place? The bottom line: Telling adult women they shouldn't drink alcohol isn't a solution to any of these problems.