[cleaver]

My understanding of the reason for total abstinence is while there may be a shoulder in the graph (eg. more than 5 drinks a week) beyond which FAS begins to take effect, nobody knows where that point is. It's not exactly the sort of thing you want to run a controlled test for.

It would be great if we could tell expecting mothers: "have two drinks a week, you'll be fine." We don't know, so "don't drink at all" is a reasonable statement.

[rayiner]

The studies have not proven that there is a level of alcohol consumption below which there are no negative effects, but they fail to demonstrate long-term negative effects from low levels of alcohol consumption.

Now, absence of proof is not proof of absence, but in what other contexts do we tell people: the studies don't show harmful effects at low levels, but you shouldn't do it anyway because the studies haven't proven there aren't harmful effects at low levels? That's not how we generally do things. We only say "no" when we have actual evidence that some activity is harmful.

The reason we do it is not because science demonstrates there is a danger. We do it because we as a society love to control women, their behavior and their bodies, and pregnancy offers a great opportunity to exert that control.

[yummyfajitas]

We only say "no" when we have actual evidence that some activity is harmful....We do it because we as a society love to control women, their behavior and their bodies, and pregnancy offers a great opportunity to exert that control.

This latter theory is a bit silly.

In fact, we say "no" to all sorts of things regardless of evidence that the activity is harmful. Examples include modafinil, steroids and various other brain and body enhancers. More commonplace examples include salt, fat, carbs, second hand smoke, marijuana, gluten and foods not present in the cave man era.

[rayiner]

I'm not familiar with the side effects of steroids, etc, but nobody tells pregnant women that they shouldn't eat any salt, any fat, any carbs, etc. Nobody freaked out at a restaurant when my wife ordered a nice ribeye or a piece of chocolate cake.

[yummyfajitas]

You miss the point. Without evidence, "they" tell everyone (pregnant or not, male or female) to avoid all sorts of things for imagined or minor harms.

And if you decided to light up and expose others to harmless secondhand smoke, "they" certainly would freak out.

[pyre]

  | We do it because we as a society love to
  | control women

This is a ridiculous claim. If anything erring on the side of caution and telling pregnant women not to drink alcohol falls under the "Think of the Children" banner. It's an effort to prevent babies from being born with issues, rather than some need to tell women to 'get back in the kitchen.'

[rayiner]

So my wife was a summer associate at a law firm while she was pregnant. The difference between having a drink with dinner and not drinking at all was the difference between being a regular summer associate, interviewing for a job, and "the pregnant one."

In our society, where drinking is an important social rite, not drinking makes you "the other" and we're tremendously eager to force women into that position based on little to no evidence that it actually has any impact on children at low levels. Even the justifications that are possible ("doctors say not to do it at all because women might drink too much") treat women like children instead of adults who are capable of evaluating truthful information from their doctors and reaching reasoned conclusions about their behavior.

[pdonis]

In our society, where drinking is an important social rite, not drinking makes you "the other"

IMO, the appropriate response to that is to fix our society's attitudes about drinking as a social rite, not to use it as an excuse for women to risk harm to their children.

That said, if the woman's job is what's going to support the child, that does add an element to the risk-benefit calculation.

[rayiner]

You're begging the question. There is no evidence of harm to children from light drinking during pregnancy. So you really have to question the motives of a policy that dictates women to engage in a behavior that excludes them socially for an imagined benefit to children.

Its one step above segregating women into sanitation tents during menstration. A policy completely disproportional to the underlying problem whose intent is social exclusion as much as anything else.

[pdonis]

There is no evidence of harm to children from light drinking during pregnancy.

What's the limit of "light drinking"? Nobody knows for sure. If the woman were making a decision about her own risk, that's one thing; but she's making a decision about the risk to her child. That makes a big difference; when you're imposing a risk on someone else, the standard should not be "is there evidence of harm", but "is the risk avoidable". The risk of drinking is avoidable, so it should be avoided.

So you really have to question the motives of a policy that dictates women to engage in a behavior that excludes them socially for an imagined benefit to children.

I question the motives of people who claim drinking is so socially necessary that it's OK to socially exclude people who don't drink, and OK to exert social pressure on women to drink while pregnant even if it might harm their child.

But that's really a red herring, because you're misrepresenting the policy--at least, the policy I've been advocating in this thread. I'm not saying anyone should force women to not drink during pregnancy; I'm just saying that, IMO, whatever imagined benefits there are to drinking are not worth the risk to the child.

[pyre]

  > There is no evidence of harm to
  > children from light drinking
  > during pregnancy

To my knowledge, there are is no evidence that taking ibuprofen during pregnancy harms the child. Should a woman then ignore the medical recommendations that she not take it?

[pyre]

  > Even the justifications that are possible
  > treat women like children

There are plenty of cases where social convention and/or the law treat adults like children. This, to me, seems like something that only happens to be aimed at women because they are the only ones that get pregnant. This doesn't seem like a social convention that is targeted explicitly at women because people believe that women have no self-control, and would do keg-stands while pregnant if we didn't hold them to task.

[saraid216]

Heh.

You don't think "Think of the Children" is part of the "Women need to be controlled" category? This is also where we get the notion that there is a magical mystical maternal mojo.

Women are resources, not players.

[pyre]

  > You don't think "Think of the Children" is
  > part of the "Women need to be controlled"
  > category?

Here are a few "Think of the Children" scenarios:

- Preventing child pornography

- Preventing child abuse

- Preventing children from hearing 'bad words'

- Stopping children from gaining access to violent video games

I fail to see how any of these is about 'controlling women.' I don't see how being generally concerned with the well-being of children (even if it's misguided) has anything to do with controlling women[1].

  > This is also where we get the notion that there is a
  > magical mystical maternal mojo.

How do we get this from "Think of the Children" + "Women Need to be Controlled?"

[1] I realize that some people's solutions to Think of the Children problems might involve 'controlling women,' but I fail to see how the entire "Think of the Children" category is a sub-category of "Women Need to be Controlled."

[saraid216]

> I fail to see how any of these is about 'controlling women.'

Because you're looking at it in terms of public policy and law making (which is appropriate; "Think of the Children" is precisely such a public face). How do these scenarios play out in a domestic environment?

> How do we get this from "Think of the Children" + "Women Need to be Controlled?"

Because fathers are not expected to have such a strong connection to their children. The chain of command is "Man -> Mother -> Child". A woman's first and foremost responsibility, in this way of thinking, is the well-being of the child. Only when she can't handle it does she appeal to the man. The obedience of the child derives directly from the obedience of its mother.

Thus, the man's job in parenting is to provide from afar. He does not sully his hands by dealing with silly emotional issues; he brings bread home and punishes any misbehavior that isn't dealt with by the mother.

In this model of the world, the mother is useful only as an intermediary to handle messy things like diaper-changing and doctor visits and crying. She is the hammer that pounds down the nail. This particular role and objectification must be justified. That justification is that there is a Super Special Bond of Specialness that makes her uniquely qualified so that no one else could usurp her place.

Honestly, there is so much cultural detritus to point out as context that, if I made dealing with sexism my life's work, I could probably put together a book or two on the subject.

[sopooneo]

It could also be a matter of public health advocates being savvy about how their messages are received. If we say it's probably safe to drink d drinks per week, then some percentage p of the population will assume it's okay to drink x*d drinks per week and may harm their babies.

Also, simple rules are easy to state and simple to follow. The words "never" and "always" are very clear and leave no room for misinterpretation.

However, if any of my speculation is correct, and public health messages are tuned to account for their real world affect, than perhaps there is a risk that they will loose credibility.

[mhb]

Saying "never" without a reasonable basis is a great way to lose credibility.

[mpyne]

Sure, but "it would require a Ph.D. $3000 to estimate the amount you can safely drink over the course of a pregnancy, so the only accurate amount I can recommend that we know won't cause issues is 0" might actually be a reasonable basis.

[mhb]

An abstruse way of saying "I don't know what you should do" is likely not particularly credibility-enhancing either.

[mpyne]

Read it from the eyes of the patient. If they hear their doctor tell them that they have no clue, the patient is going to hear it as "I don't feel like dealing with you right now, go away", especially on a topic so extensively researched and debated. In this case they are the doctor, they should at least have a professional opinion, even if that opinion is "there's probably a safe level, but I have no way to figure it out".

[Karunamon]

Absent the proper research, it seems to me like avoiding any possible risk would be the wise course of action.

[rdtsc]

> but in what other contexts do we tell people: the studies don't show harmful effects at low levels, but you shouldn't do it anyway because the studies haven't proven there aren't harmful effects at low levels?

Erm...in health and safety related contexts. At least in countries that care about those things. When it comes to someone's life isn't that hard to assume that if something is considered it could even be dangerous or not enough is known to advise staying away from it, rather than way and find out until experiments have shown otherwise.

Seems like a no brainier to me. To put it another way, if you are a parent, do you want your child or wife to participate in a study where she told to go ahead and drink 15 glasses of wine while pregnant so 20 year from then they can publish a paper on it.

To put it yet another way, each person has only one life and if they are told it is ok to consume a substance because there is not evidence it is harmful but then oops it turns out it is, they don't get a do over. It is not like buying a car someone saying, wash it with this new acid substance and it rusts and has to be replaced. You can replace a car, you can't replace your body.

Moreover. It is considered unlikely that alcohol will help in the pregnancy case. It seems at best it won't have any effect and at worst it will have a detrimental effect. Again, seems like a pretty good reason for the advice to stay away from it for 9 months.

> We do it because we as a society love to control women, their behavior and their bodies, and pregnancy offers a great opportunity to exert that control.

See now I don't know if you are serious or sarcastic. That is a pretty ridiculous argument. Sure go ahead and tell your wife, friends and family to drink so they can liberate themselves from the shackles of the Western Anglo-Saxon While Male Dominated Society

[mpyne]

> but in what other contexts do we tell people: the studies don't show harmful effects at low levels, but you shouldn't do it anyway because the studies haven't proven there aren't harmful effects at low levels.

A specific 'health and safety' context where this exact issue comes up is actually with ionizing radiation (such as from nuclear reactors).

Humans (like most animals) actually have a remarkable ability to overcome low levels of radiation damage, by means such as genetic repair, programmed apotosis (essentially ASSERT()s in your own genetic code), and even roving patrols by your immune system that catch pre-cancerous cells.

The problem is that it is difficult to determine whether there is a real low-dose threshold, below which people do not suffer appreciable increase in health risk from radiation. Also, whether that threshold depends on the person, depends on prior exposure, depends on type of dose received, a combination of the above, etc.

The evidence leans heavily to there being a threshold much higher than the levels of radiation we'd ever encounter in day-to-day life (and possibly even there being a beneficial effect to low levels of radiation).

But our radiation health physicists (and UN health organizations) have tended to take a very conservative view and simply recommend that people minimize radiation exposure, at least until there is enough evidence to make very clear what a safe threshold level is.

[sk5t]

> Erm...in health and safety related contexts.

Exactly. The rule is not "put on your seatbelt except when you don't plan to exceed 10mph and there are no obvious nearby hazards, or if the windows are open and you're near a body of water," the rule is "always wear a seat belt."

If American society would tolerate it, surely we'd have anti-drunk driving laws that allowed no higher BAC than naturally occurs due to metabolism.

[cwp]

Perhaps... but as a society, we also love to freak out about danger to children. The younger the child and the less-well-defined the risk, the better. FAS presses all the right buttons.

[pdonis]

in what other contexts do we tell people: the studies don't show harmful effects at low levels, but you shouldn't do it anyway because the studies haven't proven there aren't harmful effects at low levels?

In contexts where the effects aren't suffered by the person making the choice, but by someone else that's at their mercy--in this case, the child. Making decisions about one's own risk is very different from making decisions about someone else's; the latter involves a much greater responsibility to avoid possible harm.