To think that recording pregnant women's drinking is pointless as well as invasive?

[Hardbackwriter]

If I've understood correctly, NICE have proposed that the mother's consumption of alcohol should be recorded on a child's medical record, to help with any future diagnosis of fetal alcohol syndrome. The British Pregnancy Advisory Service (quoted in this article: www.theguardian.com/lifeandstyle/2020/sep/16/plans-to-record-pregnant-womens-alcohol-consumption-in-england-criticised) have pointed that this breaches data protection rules, and that "Women do not lose their right to medical confidentiality simply because they are pregnant".

I have sympathy with this view, but I also just fundamentally think that it's quite pointless to record this information as it's surely self-reported? Women who have been drinking heavily are unlikely to admit to it, surely (and maybe even less so if it's going to go on their child's medical record for all time)? Are you not going to miss a lot of cases of FAS if you're ruling them out if the child's record said the mother swore she didn't drink, or did so only moderately? I assume there's a lot of under-reporting already - I've seen people on MN insist they know someone whose child has FAS 'even though she only had a couple of drinks in the whole pregnancy'; I'm guessing in the vast majority of cases the mother is drastically underplaying what she drank. Maybe she's even convinced herself.

I just can't see the point of this, and worry that it'll put off someone who could benefit from help with alcohol dependency in pregnancy seeking help if they know it'll go on the child's record. AIBU?

[cologne4711]

It's all completely outrageous and just another stick to beat pregnant women with. We already have people policing them eg not selling them a bottle of wine in a supermarket or a glass of wine in a pub.

It is nobody else's business. Women are not just an incubator.

In any event, most women drink in the early stages of pregnancy before they know they are pregnant, so virtually everyone would be recording it and what use is that?

[Sexnotgender]

We don’t lose our rights just because we’re pregnant. We’re not some incubator to be judged.

They can fuck right off.

I’m pregnant and not touched a drop since I found out but honestly this is just bullshit and another stick to beat women with.

Also GDPR.

[Llamapolice]

Totally pointless, and only likely to increase anxiety amongst women who drank before they found out they were pregnant. If anything it will lead problematic drinkers to avoid seeking help because of fear of judgement/repercussions.

I'm actually really angry because there are many things that could be done better in the field of antenatal care - just spend some time on the pregnancy boards here - but instead they're investing their scant resources on this waste of time.

[Hardbackwriter]

Realistically, it'll also be certain kinds of women that are interrogated over it - in my booking-in appointment for my current pregnancy the midwife just said 'take it you've not been drinking alcohol?' and I said no - I strongly suspect that this is because I'm middle-class, in my 30s, had described a long and difficult history of trying to have a baby, etc. In both this and my pregnancy with my DS I said that I was a non-smoker and that was just recorded; my SIL - in the same area, but 22 with an unplanned baby - was made to blow in one of those machines.

[Pearsapiece]

I haven't had a drink in either my first or this pregnancy however I have purchased alcohol in the supermarket for dh or as gifts. I can't imagine what I would do if someone refused to serve me based on my pregnancy. I'd he so furious.
Back to the actual point, pregnant women are entitled to just as much privacy as anyone else. We are our own people as well as growing a baby. It's just going to out women who maybe did drink through pregnancy off seeking help for their child for fear of being judged. That, in turn, passes the detriment of this rule onto the child.

[Hardbackwriter]

By the way, the NICE consultation on this is open to individual comments, if people want to do so: www.nice.org.uk/guidance/indevelopment/gid-qs10139/consultation/html-content-3

[5amonSunday]

Surely FASD would be apparent enough that if suspected clinicians would just ask the question.

It's a deliberate intrusive act designed to put women off.

[unmarkedbythat]

Wow, the difference between the conversation about this on here and the one I am in on a politics sub on reddit! (The one here is much, much better for my sanity ftr).

It's a poorly thought out policy which seems to be more about policing and surveillance than support and outcomes, to me.

[SnuggyBuggy]

To be fair in my area everyone blows into that machine. I'm not sure this is a good idea. As people have said a lot of people are going to be in denial and round down how much they've been drinking.

[FoxtrotSkarloey]

Sorry I haven't read the links, but as pp have said, if this is based on self reporting, it will be hit and miss anyway. It's shameful if they think this can and should be mandatory.

HOWEVER as I understand it, there's of course little data of this nature and what seems to be the case is that women who drank just a tiny bit can have children with strong FAS impacts and some women drink quite a bit yet have perfectly healthy children. Therefore ANYTHING which increases data and understanding in this area should be a good thing, but it should be voluntary and absolutely shouldn't be another method to add more pressure to pregnant women.

[Abraid2]

Women with drink problems will just lie. Women who drank now knowing they were pregnant will feel awful. Women who could enjoy half a glass of champagne at a wedding or on Christmas Day with no risk of harming the baby will be scared off.

It makes me mad.

[Hardbackwriter]

Surely FASD would be apparent enough that if suspected clinicians would just ask the question.

The rationale is, I think, that the birth mother won't always be there (e.g. cases of adoption) to ask - but I still just don't think that they'll end up with records that are reliable enough that it'll actually help, and it comes at the cost of invading women's privacy and potentially putting them off seeking help if they can't do so in confidence.

[PurplePansy05]

The Guardian link doesn't work for me for some reason so sorry if I've missed something.

I saw the headlines about this this morning and they've made me feel uncomfortable. I lost three babies in pregnancy, never drank any alcohol (only some in TWW before testing in two out of the three). I am sufficiently concerned about getting pregnant again without having someone looking over my shoulder. I barely drink when not pregnant anyway and don't intend to in pregnancy but why do we need to be monitored and recorded in that regard? It's all very Orwellian and I don't like the idea.

The one positive, IF this is how they'd use the data would be that maybe we'd have a clearer picture on the amount of alcohol that is risky and what the risks truly are. However, my instinct is that these links will never be fully established because everyone's bodies work differently and pregnancy is an intricate state impacted by a multitude of factors or a combination thereof. So is this really needed? Ultimately surely it's the mother's choice and I see there will be scope for mother-bashing just because she's had a small amount. I don't support drinking in pregnancy but I also respect everyone's health choices. What next, we'll have to report every time we have a burger cause we may end up with a heart attack or high cholesterol?

[Abraid2]

Sorry, by lie, I don’t mean anything pejorative, just that they will be scared to admit to it.

[Hardbackwriter]

HOWEVER as I understand it, there's of course little data of this nature and what seems to be the case is that women who drank just a tiny bit can have children with strong FAS impacts and some women drink quite a bit yet have perfectly healthy children.

In nearly all cases this will be that women who said they drank just a tiny bit had children with FAS. I don't see how you will ever have anything other than self-reported data on this, alcohol isn't like some drugs where you can test and see if someone has used in the last, say, month - unless you're breathalysing women daily you don't have any objective measure.

[Fredthefrog]

I think it is a stupid. People will just say no or not answer. That is what I would do. It is not a way to find out which children will develop FAS and support them/their family.

[Chicchicchicchiclana]

Just how common is FAS?

This proposal absolutely sickens me. Millions of women will have drunk alcohol (often quite a lot of alcohol, going by the conception rates around Christmas, New Year and when people are on holiday!) before they even know they are pregnant. The vast, vast majority will stop or strictly limit what they drink once they know they are expecting. Does any sane person for one second think this proposal will stop the women who would have carried on drinking throughout and put their child at risk of FAS? Will it fuck as like!

I am fuming even though I'm no longer invested at all as long past child bearing years. But it's just yet another way to pile guilt on to women and is crazy and nonsensical and enraging! .

[Hardbackwriter]

@Abraid2

Sorry, by lie, I don’t mean anything pejorative, just that they will be scared to admit to it.

Or just in a bit of denial about it themselves? If you'd asked me when I was 23 (when I wasn't pregnant, by the way!) what I drunk I'd have said 'oh, I have a couple of drinks a couple of times a week' which wouldn't have been a lie as such, but would have been a bit of an optimistic recounting as I'd have thought 'well, that's in a normal week - though I do have quite a few, erm, heavier weeks'... And I didn't have any particular reason to feel ashamed or defensive about my drinking. If you ask a pregnant woman, who is going to know of the huge stigma attached, the psychological tendency to undercount to make herself feel better is going to be strong.

[PurplePansy05]

I would put a bet on that if these rules come into force they'll be challenged in courts at the first opportunity, there'll be a test case based on the right to privacy and potentially data protection laws, and this will be the end of this malarkey. Quite rightly so.

[ellentree]

They make some women blow to check alcohol consumption?! I would do the CO check but not an alcohol test.

I had the odd drink when pregnant, maybe 10 small glasses total, but notes say no alcohol as when they asked me at booking in I hadn't had any alcohol to drink at that point.

[BeingATwatItsABingThing]

I don’t drink at all ever but I do buy alcohol in shops (usually as a gift or for DH). If someone took it upon themselves to tell me I couldn’t have it, I’d be furious.

Recording this data will be pointless because, as others have said, people will lie. I have quite strong feelings about alcohol during pregnancy (I’m a ‘not even a small glass at a wedding’ person) but I can not control what others do.

[Hardbackwriter]

@ellentree

They make some women blow to check alcohol consumption?! I would do the CO check but not an alcohol test.

I had the odd drink when pregnant, maybe 10 small glasses total, but notes say no alcohol as when they asked me at booking in I hadn't had any alcohol to drink at that point.

Oh, no, sorry, I think I created confusion here - I was saying that the use of the CO machines seems often to be based on the midwife's assessment of if you're the 'type' to smoke in pregnancy (having spoken to friends I don't think my/SIL example is unique, though obviously I can't point to statistics on this!) and that how zealous they were about interrogating on alcohol use would likely be similar. There would be no point breathalysing women at antenatal appointments - all it could show you is whether or not they'd been drinking that day or, at a push and if it was heavy, the night before.

[IAteAlltheAvocadoPears]

@Sexnotgender

We don’t lose our rights just because we’re pregnant. We’re not some incubator to be judged.

They can fuck right off.

I’m pregnant and not touched a drop since I found out but honestly this is just bullshit and another stick to beat women with.

Also GDPR.

This. We know the risks already

[IAteAlltheAvocadoPears]

If someone is drinking so heavy their child may have FAS then they have an issue with alcoholism which needs help. How many mothers to be all be honest Nd get the help they need?

[jellyfishdoodoodoo]

Just seems like more excuses to treat pregnant women like children who are ‘allowed’ and ‘not allowed’ to do certain things, lose rights to privacy and must see HCPs as superior beings with authority over them.