The test case of a child born with foetal alcohol syndrome is currently the focus of much debate. Later this month, the Court of Appeal will decide whether the child is entitled to compensation from her mother for excessive drinking during pregnancy. If successful, commentators say the case could set a precedent for other, similar cases.
I do not know enough about the case to make comment, but what concerns me about a precedent being set is the potential to criminalise pregnant women for a variety of things they do or do not do that may harm their unborn baby.
Pregnancy should be a beautiful time, but it can already be a fearful and worrying time for many expectant mums. There is so much advice on offer during pregnancy (from well-intentioned family and friends, the internet as well as health professionals) it can often feel overwhelming. You so desperately want to do the right thing.
From the moment we know we are pregnant – and sometimes even before, when we are trying to conceive – we make changes to our behaviour and lifestyle to give our little beans the best possible chance to grow into a healthy, bouncing baby. We constantly ask ourselves whether we are doing the right thing, eating and drinking the right things, too much or too little exercise – the list is endless.
Ultimately, we all know that too much alcohol, taking drugs and smoking is bad for us, male or female and whether or not you are pregnant. The real issue here is criminalising behaviour that may present a risk to an unborn baby.
If a precedent is set, where is the line drawn? Would women who drank alcohol before discovering they are pregnant be prosecuted? Pregnant women who are under or overweight; gain too much weight during pregnancy; drink caffeine; eat; unhealthy foods; fail to take folic acid; continue to indulge in brie, pate, and homemade ice cream? All these activities have the potential to harm an unborn baby.
Then we have the impact of stress to consider. When we are stressed, our body secretes a hormone called cortisol. Cortisol can be helpful in the short term to help us deal with a stressful situation, but long term it can cause harm – and it has the potential to harm the unborn babies of stressed-out pregnant women, too. I say this not to cause pregnant women additional anxiety, but to make the point that life can be stressful anyway; pregnancy has its own set of stresses (especially if you have other children and work, too) – heap on to that guilt, uncertainty and mixed messages about what expectant mums should and should not do and you have a recipe for harm.
Thinking more about guilt for a moment, we also have to consider the feelings of mothers who experience loss, at any stage of pregnancy. Guilt comes hand-in-hand with motherhood. Many baby losses cannot be attributed to any particular cause, but that does not stop bereaved mummies torturing themselves with “if only…”. My son Hugo was born at 24 weeks because I had the rare, life-threatening pregnancy complications pre-eclampsia and HELLP syndrome; Hugo lived for 35 days. There is nothing that could have been done differently, and nothing that could have prevented my illness or Hugo’s death. Criminalising behaviour that may harm an unborn baby has the potential to intensify these mothers’ grief, sadness, and self-flagellation.
The possibility of prosecuting a mother for activities during pregnancy reminds me of a book called Intrusion, by Ian Macleod. Set in Britain in a dystopian near-future, all women of childbearing age are forbidden from working in case their bodies absorb decades-old cigarette smoke from their workplace. They must also wear monitor rings, which record and report to the authorities any contact with noxious circumstances. In addition, they are not permitted to purchase alcohol unless they can prove they are not pregnant. This and a wide range of other intrusive laws in the book have been set by the government for the people’s ‘own good.’
Yes, this is fiction, but we need to balance protecting unborn babies with freedom, and choice.
People – men, women and pregnant women should feel free to make their own choices.
Of course, the issue at stake here is not just what we choose to do to our own bodies, but the impact on what pregnant women choose to do may have on an unborn baby.
What pregnant women need is clear, concise and easy-to-access information about what to do and what not to do in pregnancy for the benefit of both them and their unborn baby. The information needs to be, as far as current evidence and research allows, categorical and not giving mixed messages. For example, NHS advice says that alcohol should be avoided entirely when trying to conceive and while pregnant, and the next paragraph advises: “If they do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than one or two units once or twice a week, and should not get drunk.” So, is alcohol in pregnancy ok in small doses or not?
Pregnant women who have substance abuse problems – or any other physical, emotional or mental issues need appropriate assistance.
All pregnant women need support and guidance, not have extra guilt heaped upon them, or be the subject of admonishment and vilification.