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Women and Alcohol: Let’s Talk About the Real Problem

The CDC’s recent sexist and patronizing warning about women and alcohol managed to outrage huge numbers of people and provoke some excellent responses from commentators throughout the nation. Did the statement get released just before Super Bowl Sunday — a day when drinking spikes, followed by an increase in calls to rehab centers.? What were they thinking?

As a historian, I know that the focus on alcohol and pregnancy is not new. The alcoholic beverage warning label that began appearing on bottles in 1989 starts with warning first about drinking in pregnancy and birth defects and then about driving cars and operating machinery. The language is the result of an accommodation between the alcoholic beverage industry and Congress, a deal that kept warnings off of television (following a threat by the industry to pull beer advertising from sports that might have led to a demise of sportscasts and advertising revenue). So, yes, please drink responsibly, whatever that means.

"Alcohol is dangerous" warning poster, 1985. (UNESCO/National Library of Medicine)
“Alcohol is dangerous” warning poster, 1985. (UNESCO/National Library of Medicine)

Here is what is missing from the warnings and warning labels: any distinction between alcohol use and abuse and any mention of the link between alcohol and violent crimes. Alcohol abuse is linked to homicide, rape, assault, and child and partner abuse. Intimate partner violence towards pregnant women is responsible for fetal demise, fetal injury, and low birth weight and for the deaths and injuries of thousands of women. Should we be warning women not to have intimate partners?

Let’s get real. Talking about how women ought to behave and about fetuses is a way of not talking about and acting upon the real issue: the lack of treatment for women (for everyone really) with alcohol abuse disorders. Credit the robust alcoholic beverage industry lobby and the politicians who won’t stand up to them with keeping us focused on all the wrong things. According to the National Institute on Alcohol Abuse and Alcoholism, approximately 26,000 women die each year from alcohol-related causes. Alcohol abuse is the third leading preventable cause of death in the United States.

As for the women needing treatment, a 2013 study found that only 7.3 percent of them received it. We need to stop talking about potential harm to fetuses and focus on the needs of women who are suffering, dying, or becoming severely physically and mentally disabled by their alcohol dependency. We need to fund their treatment and to erase the barriers to access — whether it is limited Medicaid funding, lack of health insurance, undocumented status, or fear of losing custody of their children.

The last point is vital. Inpatient programs for women cannot function on a male model of care. Women with children do not want to go into treatment if they have to put their children into foster care and risk losing them permanently. They need programs that let them keep their youngest children with them as well as maintain contact with and enable a guaranteed reunion with their older children.

I’m not naive. Warnings are cheap. Saving women’s lives costs money. But we have a problem with a solution. Maybe if we shift our focus from responding to sexist messages to demanding that women’s real needs be addressed we can make a difference. Or, at least, we can change the conversation and go from there.

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Kelly O

“Maybe if we shift our focus from responding to sexist messages to demanding that women’s real needs be addressed we can make a difference.” Thank you! Really, this is the key.

But at the same time, I also think people are a bit too quick to decry paternalism and condescension in these kinds of official public health warnings. When I asked my mother (a disabled single parent with only a high school education, and an alcoholic) if she drank while pregnant, she actually said to me, “Well, yes–they said a couple of glasses of wine with dinner is healthy for you!” (Who were “they” I wondered. The media?) Sometimes messages really do need to be as blunt as the CDC’s. They have consequences. It is easy for those with greater privilege, resource and education wise, to forget that. (Plus isn’t it fun to just jokingly problematize things with your academic friends?)

Cynthia Daniels

Great column, Prof. Golden! But what about the MEN? Does anyone want to recognize that alcohol use/abuse by men causes increased risks to fetal health, including miscarriage and birth defects? Why don’t we talk about alcohol and seminal fluid? We simply don’t want to tell men what to drink or warm them about the vulnerabilities of the male reproductive system. Imagine the resistance to warning labels on beer bottles that alcohol use by men increases risks to the children drunk men father…..those are the ‘real’ ‘super bowl babies’!

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