The CDC Missed the Cask on This One

Earlier today, the Centre for Disease Control issued a statement; women of child-bearing age who are not currently using birth control should completely abstain from drinking. The presumption is that these women are sexually active and therefore “at risk” of becoming pregnant.This position is certainly ruffling some feathers, so it is important to look at the full statement and determine exactly what is happening and if it is evidence based.

Image courtesy of Ken Hawkins

The statement stipulates that, since no amount of alcohol is known to be safe, and since there are approximately 3 million American women who are sexually active, not using birth control, who also consume alcohol, at any given time, that the risk of Fetal Alcohol Spectrum Disorders (FASDs) is just too great. These women need to abstain completely from alcohol consumption.  Here are their recommendations,

• Talk with their health care provider about their plans for pregnancy, their alcohol use, and ways to prevent pregnancy if they are not planning to get pregnant.
• Stop drinking alcohol if they are trying to get pregnant or could get pregnant.
• Ask their partner, family, and friends to support their choice not to drink during pregnancy or while trying to get pregnant.
• Ask their health care provider or another trusted person about resources for help if they cannot stop drinking on their own.

In Canada, the most commonly cited statistic for FASDs is 0.3% to 1% of live births will eventually have a diagnosis of Fetal Alcohol Spectrum Disorder. The Canadian Northwest FASDs Research Network issued a consensus statement in February 2010. The most recent CDC position is in direct opposition to the consensus statements that already exist.

The CDC position is dictorial, and oppressive. It does not take into account many factors, including women’s desires and their needs to be more than just a reproductive baby factory. The Canadian consensus statement acknowledges that the women who are at-risk of alcohol and substance abuse during pregnancy need to be nurtured and have their health promoted rather than dictated.

Furthermore, the CDC’s own statistics estimate the prevalence of FASDs to be 0.5-2.5 births per 1000 births. That is less than their reported statistics for infants exposed to motor vehicle accidents in utero, less than the natural incidence of birth defects, and a fraction of the risk of preterm birth.

A review of scientific studies does not hold up to the extremism of the CDC’s statement.

This review of multiple studies suggests that, while we do not know the threshold of safety, no studies indicate harm if the pregnant person consumes 1-3 drinks per week. This suggests that consumption of alcohol prior to conception will have no bearing on pregnancy outcomes.

We are not doctors, we cannot tell you what is right for you.

You need to discuss alcohol consumption with your medical care provider.

However, the CDC statement is extreme. It is paternalistic and oppressive to women from the age of 15-45. It places undue stress and responsibility on women who do not necessarily plan on being pregnant. It also suggests that women are nothing more than baby-making machines, with no life or desires outside of their reproductive choices. It fails to recognize that some unplanned pregnancies are due to failed birth control rather than lack of birth control.

Only you and your care provider can determine if your alcohol consumption is safe and healthy. This self-assessment can help you to determine if you should speak with your physician about your alcohol intake. If you are concerned about your intake, you can reach out for help.

But, if you are not pregnant, even if you are trying, you are probably safe to have that glass of wine.