Abstract
Recent research has found that most U.S. state policies related to alcohol use during pregnancy adversely impact health. Other studies indicate that state policymaking around substance use in pregnancy—especially in the U.S.—appears to be influenced by an anti-abortion agenda rather than by public health motivations. This commentary explores the ways that scientists’ aversion to abortion appear to influence science and thus policymaking around alcohol and pregnancy. The three main ways abortion aversion shows up in the literature related to alcohol use during pregnancy include: (1) a shift from the recommendation of abortion for “severely chronic alcoholic women” to the non-acknowledgment of abortion as an outcome of an alcohol-exposed pregnancy; (2) the concern that recommendations of abstinence from alcohol use during pregnancy lead to terminations of otherwise wanted pregnancies; and (3) the presumption of abortion as a negative pregnancy outcome. Thus, abortion aversion appears to influence the science related to alcohol use during pregnancy, and thus policymaking—to the detriment of developing and adopting policies that reduce the harms from alcohol during pregnancy.
Highlights
Alcohol is a known teratogen that causes fetal alcohol syndrome (FAS) and a range of other harms to fetuses [1,2,3,4,5]
At worst, using methods that allow for causal inference, this study found that multiple state alcohol/pregnancy policies lead to increases in low birth weight and preterm birth, and decreases in prenatal care use [17]—leading to thousands of babies born with low birth weight, or preterm each year, due to the policies [18]
This commentary describes each aspect of abortion aversion and argues that abortion aversion appears to influence science related to alcohol use during pregnancy, and policymaking—to the detriment of developing and adopting policies that reduce harms from alcohol during pregnancy
Summary
Alcohol is a known teratogen that causes fetal alcohol syndrome (FAS) and a range of other harms to fetuses [1,2,3,4,5]. The Merriam–Webster dictionary defines aversion as a feeling of repugnance toward something, with a desire to avoid or turn away from it, and as a tendency to extinguish a behavior or to avoid a thing or situation [28] In this commentary, using this definition of aversion as a guide, I trace three main ways aversion to abortion appears to influence scientific questions asked and perhaps policy options scholars and other health professionals imagine related to alcohol (and drug) use during pregnancy. The three main ways that abortion aversion shows up in this literature include: “Shift from recommendation of abortion to non-acknowledgement of abortion as an outcome of alcohol or drug-exposed pregnancy,” “Concern that abstinence messages lead to terminations of otherwise wanted pregnancies,” and “Presumption of abortion as negative pregnancy outcome.” This commentary describes each aspect of abortion aversion and argues that abortion aversion appears to influence science related to alcohol use during pregnancy, and policymaking—to the detriment of developing and adopting policies that reduce harms from alcohol during pregnancy. Shift from Recommendation of Abortion to Non-Acknowledgement of Abortion as an Outcome of Alcohol-Exposed Pregnancy
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