Annabel Denham

Pregnant women don’t need nannying

Pregnant women don't need nannying
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Some bright spark at the National Institute for Healthcare Excellence wants all alcohol intake by expectant mothers to be recorded, regardless of whether they consent. This would reveal whether a mother had consumed a single drink during the first week of pregnancy – a time when they may not even have realised they were expecting.

There is no consistent system in place to monitor drinking among pregnant women which, according to NICE, is a problem. Midwives ask about alcohol but it is not mandatory to record the information; NICE wants women at antenatal appointments to be grilled on the pattern and frequency of their drinking and the numbers and type of beverage. This information would be noted in maternity records and later transferred to the baby’s health records after birth.

Quite rightly, people are up in arms over the notion that women should lose their right to medical confidentiality simply because they are pregnant – not to mention the fundamental question of how this measure could possibly be enacted. (Should all women of child-bearing age keep a permanent log their alcohol intake, on the off chance they hop into bed with a handsome stranger and wind up with child?)

Charities and pregnancy organisations have also condemned the move. The trouble is, outrage has historically been no match for steadfast nanny statists determined to see a micro-managing, finger-wagging policy over the line.

Proponents even acknowledge that this could breach GDPR: the law states that health records can be shared only on very limited grounds. But they assert that the risk of foetal alcohol spectrum disorder (FASD) – a range of physical and mental conditions caused by drinking in pregnancy – to an unborn child means the mother’s right to privacy should be 'secondary'.

Further, while the British Pregnancy Advisory Service and legal experts have raised a red flag, GDPR often falls short when it really counts. The paternalists can usually argue away their case on some overriding public interest basis. After all, individuals cannot be trusted to make their own lifestyle choices, and if left to make up their own minds, will engage in risky behaviour. Isn’t that why the Prime Minister introduced a raft of ill-conceived, unworkable policies to tackle obesity in the summer?

We probably should have seen this coming. Our society is set on infantilising pregnant women and FASD has long been a template on which it can communicate unsolicited advice around maternal responsibilities. The result has been to trap many pregnant women in a cycle of heightened anxiety, stress, and guilt: one in ten suffers from post-partum depression.

A fundamental issue with FASD is the dearth of up-to-date, reliable evidence – but this is a by-product of successful education campaigns around the risks of drinking to a foetus. Expectant mothers may indulge in the occasional drink but that doesn’t mean they’re willing to act as guinea pigs in a trial seeking to put the theory to the test that alcohol consumption could harm an unborn child. We know that heavy drinking can increase the risk of FASD, but the impact of a tipple on a zygote is unclear. 

Public Health England may be on the way out but insidious campaigns or measures designed to pressure women into abstinence, breastfeeding or pain-free deliveries are here to stay. Not even an infringement of data privacy rights will scratch the itch. If alcohol intake must be recorded, why not blue cheese or raw meat, which may increase the risk of listeria poisoning?

Why not force women to put their cats up for adoption before they even know they’re pregnant, given litter boxes can carry the infection toxoplasmosis? And heaven forbid a woman of child-bearing age (a three to four decade window) take up impact sports. Hang up the riding boots and ski poles, baby portal, the nannies are coming for you!

And they’ll be further galvanised when this bizarre proposal turns out to be a damp squib. I don’t know a single pregnant woman who hasn’t downplayed her alcohol consumption to health professionals – and I include myself in that esteemed group. The interaction between expectant mother and midwife is already so amorphous, so impersonal, that full and frank discussions are usually elusive; this proposal will serve to weaken the relationship further. Women will be less inclined to honesty if they fear a confession could later be used against them.

Rather than abandon the idea, however, we’ll probably see mission creep: more legislation, more nanny statism, and all at a time when the public could really do with their civil liberties back.