America’s laws about alcohol during pregnancy are more about restricting reproductive rights than reducing harmful drinking

Careful what you drink.
Careful what you drink.
Image: AP Photo/Richard Drew
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British women may enjoy a glass of wine every now and then during pregnancy, but in the United States, drinking while pregnant is fraught. Forty-three US states have regulations around the practice, which range from prohibiting criminal prosecution of pregnant women who drink alcohol to mandating rehab for pregnant women who drink alcohol. The Centers for Disease Control and Prevention (CDC) pegs the number of American women at risk of alcohol-exposed pregnancy at more than 3 million, a controversial figure that includes any woman who consumes alcohol without being on birth control.

To be sure, exposing a fetus to high levels of alcohol is harmful, and can cause all sorts of disabilities. But a study published this week in the journal Alcohol and Alcoholism found an interesting correlation: States with more punitive laws about drinking during pregnancy also had restrictive abortion laws.

“No one is paying attention to [these] state-level policies,” says Sarah Roberts, a professor at the University of California who led the study. “We don’t know whether they have an effect.”

Roberts points out that, while there has been little to no research on the effects of punitive policies surrounding pregnancy and alcohol, there have been studies around attempts to curb other alcohol-related behavior, including drinking and driving. But there isn’t much overlap between states with aggressive alcohol/pregnancy regulations and states with aggressive drinking/driving regulations. Roberts says that disconnect suggests certain states are policing women under the guise of policing drinking.

The study also found that the US has been adopting more punitive alcohol/pregnancy policies of late, a trend that mirrors a recent increase in restrictive policies around reproductive rights. Currently, 21 US states have policies requiring that pregnant women who consume alcohol be reported to child services, 20 consider the women liable for child abuse, and five recommend civil commitment.

Roberts says the study’s findings “reinforce the idea that there is some other motive [behind punitive policies],” which the paper defines as “efforts to restrict women’s reproductive autonomy rather than efforts to have policies effective at reducing alcohol-related harms.”

Supporters of punitive laws against substance abuse during pregnancy don’t disagree: They are more concerned with defending the rights of the fetus than dissuading adults from consuming alcohol. “Child abuse is child abuse, whether it’s in the womb or out of it,” a representative of pro-life group Personhood USA said in 2013. Research has found that legally protecting a fetus as a child inevitably ends up crossing the line into abortion rights.

Roberts says punitive measures around drug use during pregnancy have shown how ineffective such policies can be, noting that they can even prevent women from seeking medical care for fear of getting in trouble. Her team plans to keep digging on those questions of efficacy as they relate to alcohol and pregnancy.