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Smallish Magazine - How much is too much?

Smallish Magazine - How much is too much?

By Beverley Turner

I have a confession to make: I host antenatal classes in a pub. I know, it sounds a bit weird, rather like holding Weight Watchers meetings in the warm and wafty surrounds of  a bakery, or forcing Russell Brand to pay attention to a midwife while semi-naked women lap-dance around him. But it works. It works because most women are generally able to resist the temptation of  drinking in pregnancy and many women inherently balk at a hint of  beer on their semi-queasy lips (and besides, dads do like to sip on a pint while talking about placentas).

Which is why I get a bit uppity when medical types start finger-wagging at all women about bumps and booze. The latest telling off  came from Professor Sir Al Aynsley-Green, president of  the British Medical Association, who said that government guidelines to women on drinking alcohol in pregnancy were “confusing”, “contradictory” and “inconsistent”, and should be changed to one simple recommendation: pregnant women should not drink alcohol. “It has to be concluded,” he said, “that there is no ‘safe’ limit for alcohol consumption during pregnancy.” Presumably he then patted the bottom of  the girl handing him his coffee and asked his female colleagues not to worry their pretty little heads about this complicated issue.

Dictating that no pregnant woman should ever be glimpsed enjoying a glass of  champagne at a wedding is patronizing nonsense; it’s a demonizing instruction based on a one-size-fits-all perspective that doesn’t even attempt to be grounded in actual medical evidence – which should, after all, be the very basis for any BMA guidelines. It’s impossible to imagine a scenario in which men would accept being talked down to in that way by folk in white coats.

But there have always been some who believe “Tota mulier in utero” or “Woman is a womb”, as Simone de Beauvoir wrote in her influential 1949 book, The Second Sex. Last year I breathed a sigh of  relief  when a council in the north west of  England lost a legal case that they had brought against an alcoholic mother whose daughter was born with Foetal Alcohol Syndrome and required care from her local authority. The council’s lawyer, Neil Sugarman, said the action was “simply about proving that if  there was recklessness and it resulted in damage, the child is then entitled to an award which will improve their lives”. The “recklessness” part chilled me as that assessment is always subjective. We all have different parameters of risk.

As banning pregnant women from drinking creeps dangerously close, it opens the door to all sorts of  monitoring and potentially criminalising of  women’s behaviour in pregnancy: the over-eater who risks diabetes; the malnourished anorexic; the CEO who works long hours and whose baby is low birth-weight; the weekend hiker who may slip and injure her unborn child. Taken to its logical conclusion, abortion itself  becomes illegal as the rights of  the unborn child are raised above all else.

However – and it is a huge however – it is spectacularly short-sighted to drink regularly in pregnancy. A lifetime of  watching a child struggle at school because of  drinking too much in pregnancy must be the ultimate purgatory for any mum. In the UK almost 7,000 babies a year are born with signs of  developmental damage due to alcohol in utero. Yes, we are better at identifying the signs now, but  do agree with Professor Green that the guidelines are confusing. NICE say that no alcohol should be consumed for the first twelve weeks (here, here) but then one to two units once or twice a week from thereafter should cause no risk of  major complications. The problem is that a unit is tiny: a 125ml glass of white wine which probably bears no resemblance to the goblets we pour ourselves at home after a long day.

The fact is that the biggest shift in drinking habits in the last 30 years lies in female hands. A glass of  rosé at an afternoon summer play date has become the norm. Can you imagine the eyebrows that would have been raised if our own mothers had poured a nightly G’n’T to take the edge off  bath-time? There is a definite softening of boundaries around kids and booze born of relaxed licensing laws, a move towards a more ‘European’ drinking culture and the fact that we’re all just a bit stressed out. Remember, this isn’t the preserve of Channel 4’s Benefits Street; it’s the mums who shop at Waitrose and The White Company. Alcohol Concern tell us that adults living in households in the highest income quintile are twice as likely to drink heavily as those in the lowest.

So for lots of  us one of  the delights of finally meeting our babies is the joy of  a guilt-free glass of  fizz to celebrate, except of course, that if you’re breastfeeding your final liberation must wait. One of  the most frequently asked questions in our breastfeeding class is “When can I drink?” (and this isn’t because I attract a particularly jolly sort of  mother-to-be. I don’t think…). It’s a tricky one to answer as everybody metabolises alcohol at different rates due to body weight, food consumed and tipple of  choice. Official advice states that one 125ml unit of  wine will normally leave the breastfeeding body after two hours. But a new gadget which is shifting a million units a week in the USA offers a brilliant solution. ‘Milkscreen’ answers the peculiarly American question, “Do I need to pump and dump?” In other words, new mums can now express some milk, check it for signs of  vodka with a dipstick and make an informed choice of  whether it’s a good idea to feed their baby. If  not, they pump and dump and wait until their milk runs as pure as nature intended. Each testing stick costs about £2, which is a small price to pay if you’re carefully guarding your child’s health while letting your own hair down from time to time. It’s genius.

Unfortunately, science has found no way to offer such informed choice while baby is still on board – and it probably never will. Until then, we have to accept that swapping gin and tonic for lime and soda on a hot summer’s evening is just a tiny part of  adjusting to all the massive sacrifices that come with being a mum. We probably do need to get smarter about how much is too much. But we don’t need doctors to treat us like babies. We’re already doing a pretty good job of  looking after those ourselves.

  • Post author
    Beverley Turner