Last week, the Centers for Disease Control (CDC) issued a recommendation that women of childbearing age should abstain from alcohol consumption unless they are on some form of contraception.
This is ethically problematic for several reasons, the first being the blatant and outright paternalism and mistrust of women.
The CDC Vital Signs report estimates that “3.3 million women between the ages of 15 and 44 are at risk of exposing their developing baby to alcohol because they are drinking, sexually active, and not using birth control to prevent pregnancy.” While the CDC’s intentions are good – attempting to curb incidents of fetal alcohol spectrum disorders – advocating a policy that does not respect women’s autonomy when it comes to making decisions regarding consumption of alcohol and use of contraception is troubling.
These recommendations dictate that if a woman “could get pregnant” and drinks alcohol while not on some form of contraception, she is potentially harming a “developing baby.” In other words, in addition to having to take into consideration the wellbeing of a fetus when we are actually pregnant, we are now expected to also prioritize the health of a non-existent hypothetical fetus that may exist if we are between the ages of 15 and 44.
These guidelines also overlook the fact that habitual alcohol usage could also impact semen quality in men. Following the CDC’s logic, does this mean that all fertile men should also abstain from alcohol so as not to harm any potential future children created using subpar sperm?
The CDC provides an infographic that informs us that “drinking too much can have many risks for women,” including the category of “any woman” (i.e. those who are not currently pregnant). These risks of drinking too much for “any woman” include risk of injuries and violence, as well as contracting sexually transmitted infections (STI), or an unintended pregnancy. What the infographic neglects to mention, however, is that some sort of sexual contact is necessary in order to contract an STI or become pregnant; that step is conveniently omitted. Furthermore, by stating that drinking too much could result in “injuries/violence,” the CDC is essentially reinforcing the notion that the onus is on the woman not to put herself in situations that might result in her rape or assault.
Lastly, suggesting that all people with childbearing capacity who wish to drink should also be on some sort of birth control is problematic. These recommendations may pose ethical dilemmas for individuals who are not opposed to drinking alcohol, but may have moral or religious objections to using contraception. Moreover, this may also pose a problem for those with limited access to contraceptives.
While the CDC is right to address the serious issue of fetal alcohol spectrum disorders, the recommendations would likely be better received if targeted specifically at pregnant people, rather than through a morally questionable modern-day Prohibition for entire generations of women.
Dr. Elizabeth Yuko is a bioethicist and program administrator for the HIV and Drug Abuse Prevention Research Ethics Training Institute. A previous version of this article was published in The Establishment and Ms. Magazine.