The nation's leading public health institute has a message for millions of American women: If you want to have sex, stop boozing, because you might get pregnant.
On Tuesday, the Centers for Disease Control and Prevention issued a statement aimed at reducing the incidence of fetal alcohol spectrum disorders, which "can cause lasting physical, behavioral and intellectual disabilities" and can result from alcohol consumption during pregnancy. With that goal in mind, the CDC noted:
An estimated 3.3 million women between the ages of 15 and 44 years are at risk of exposing their developing baby to alcohol because they are drinking, sexually active, and not using birth control to prevent pregnancy, according to the latest CDC Vital Signs report released today. The report also found that 3 in 4 women who want to get pregnant as soon as possible do not stop drinking alcohol when they stop using birth control.
The press release goes on to make the thinly veiled suggestion that any woman who might expose even a hypothetical fetus to FASDs should abstain from drinking entirely.
"Alcohol can permanently harm a developing baby before a woman knows she is pregnant," Dr. Anne Schuchat, CDC principal deputy director, said. "About half of all pregnancies in the United States are unplanned, and even if planned, most women won't know they are pregnant for the first month or so, when they might still be drinking. The risk is real. Why take the chance?"
So, basically, if you are a woman who has ever had unprotected sex and you have a uterus that could potentially be inhabited, you have two options: Either shut your legs or stick to club soda.
Of course, as the 31% of women who rely on the pullout method (or the likely much larger group of people having totally unprotected sex who just don't want to admit it) could tell you, the CDC's suggestion is fairly unrealistic, in that it ignores the reality of how women are actually having sex. In addition to policing women's bodies and shaming them for their choices, the recommendation utterly ignores the reasons why women might not be using contraception.
Often, those reasons are entirely out of women's control. Contraceptive access remains severely limited for millions of American women for myriad reasons, from a lack of insurance coverage to the cost of doctors' appointments to persistent pharmacy refusals to provide birth control. Some women can't get to the pharmacy before it closes to get their contraception; others are shamed when they go to pick it up.
There are plenty of ways contraception could be more accessible nationwide, like allowing pharmacists to prescribe hormonal birth control, or making it available over-the-counter without a prescription but with full insurance coverage, or not continually attacking organizations that provide it for free, like Planned Parenthood. Unfortunately, we don't live in a world where those things are likely to happen.
Instead, we live in a world where a majority of U.S. states don't require comprehensive sexual health education in public schools and young people are taught virtually nothing about safe sex. A world where the CDC wouldn't think to issue a corresponding press release reminding men who haven't had vasectomies to use a condom if they want to prevent FASDs, because women are expected to take sole responsibility for avoiding pregnancy (as well as the complications that can come with it). A world where women's behavior, particularly their alcohol consumption, is routinely implicated as the cause of other problems — we already tell women not to hit the bottle so hard if they don't want to be sexually assaulted.
The CDC's statement wasn't issued in a vacuum, but rather in a time and place where women's ability to control their own bodies and reproductive health is rapidly eroding. Indeed, while there are many realities about women's sex lives the CDC recommendation overlooks, the statement's implicit assumption that women can't terminate unintentional pregnancies isn't totally off-base. In fact, it rather accurately reflects the current state of affairs for thousands of American women, for whom access to abortion has been severely impeded by state-level regulations — for whom getting pregnant does, indeed, mean staying pregnant, or risking their lives to avoid it.
And yet, instead of acknowledging the way abortion restrictions have all but eliminated the right to terminate a pregnancy, or advocating for expanded access to contraception or implicating the abysmal state of sex education in the U.S., the CDC has taken an easier approach to prevention: Blame and shame women.
It's not without historical precedent. It's also not likely to work. Maybe we should pour one out for the idea.