Baby wants a double vodka

Saturday, July 20th, 2013

Pregnant women who use methadone are likely to under-report their alcohol and drug use, a piece of research published this month has found. The admittedly small sample of fifty-six opioid-dependent women, prescribed methadone as a substitute for heroin, were found to continue taking illicit drugs and alcohol during their pregnancy, as discovered by testing mothers’ and babies’ urine, and meconium (first stools). The study showed that 91% of women taking part in the study had used illicit drugs – 73% had continued taking opiates, and 70% had used benzodiazepines (which are thought to be linked to birth defects). 47% of the babies had also been exposed to alcohol use at levels of at least 2 units a day or 5 units at once, despite only 5% of the women disclosing this level of alcohol use. The most common combination (drug workers won’t be surprised to hear) was heroin, cannabis and alcohol.

Now this is clearly a highly-contentious area to discuss. On one side of the debate, there are people who acknowledge that women become pregnant for a variety of reasons, not necessarily through choice, and that the lifestyle that comes with heroin addiction may not be the most happy or meaningful existence, or borne from the most stable of upbringings. Once pregnant, drug users typically face extreme feelings of guilt – feelings which they have historically used drugs and alcohol to manage. And then the judgements and processes they are subjected to during pregnancy – safeguarding procedures and meetings, constant monitoring, reports written weekly about them and their parenting capacity, every bad decision they have ever made dragged up and pored over – make pregnancy not a joyful but a very stressful experience.

And then, on the other side of the debate, there are the tabloid readers – and there is so much meat on this bone for them to chew. First of all, of course, all drug users should die. They sacrificed their right to be on this planet the first time they smoked a spliff. Then – it gets worse – they are mothers. Should a woman not cease to exist in her own right the instant she conceives? She is, after all, a vessel. She should be pure and demure and fit all the glowing, maternal images we associate with motherhood. So the lifetime of misery, abuse, ill-treatment and self-deprecation should end the second that sperm hits that egg.

Now, don’t get me wrong, I find it very hard not to judge drug-using mothers-to-be. The unborn child is helpless and dependent on her to meet its every need, and it is heart-wrenching to think that it is disadvantaged before it has even left her womb. I do read the riot-act to these women, making it very clear that they are putting their baby’s welfare at risk, and increasing the chance that, once born, their baby will suffer painful and distressing withdrawal symptoms. What a sad and sorry start to life.

However, one thing is for sure – guilt does not perpetuate healthy behaviour. The fact these women are under-reporting their substance use is a sure sign that they already know all of this. You can bet your bottom dollar that they are beating themselves up more than anyone else ever could. And it is the discrepancy between what is expected of them and what they believe themselves to be capable of that makes burying one’s head in the sand the most realistic option.

I would imagine that most women who have had children would find this research both sickening and saddening. Whilst the idea of doing anything that may put their babies at risk may repulse them, I bet most of them have also felt judged, squeezed by other people’s expectations, desperate not to stand outside the prescriptive maternal mould that is dictated to them. Surely there is no worse judgement than being a bad mother. And not breast-feeding…?!

In the late stages of her pregnancy, I took a good friend of mine out for a drink. She was a single mum with two other kids at home, and she was desperate, for one last time before her baby was born, to just be herself for a night. She hadn’t drunk at all throughout her pregnancy, but on this occasion, I bought her a bottle of Corona, and she savoured it as we sat talking for an hour. We were in Wetherspoon’s – not an establishment known for its distinguished clientele with high moral values – but you should have seen the looks she got that evening. People gathered to bitch and point; judgements were formed, comments were made. At the time, she was drinking within the acceptable limits in pregnancy (guidance has since changed to ‘no alcohol during pregnancy’, although I believe this was mainly due to the fact that people struggle to quantify a unit), and she certainly wasn’t putting her late-stage pregnancy at any risk by her action. But as she sat there, gorgeous and bulbous, trying to enjoy her one night of being a person before months of being a multi-tasking milk machine, she was deemed by the other drinkers gathered that evening as the scourge of the earth.

So I suppose, in conclusion, I just want to say – this piece of research is sad. It is sad for the babies, it is sad for the mothers, it is sad for society. But maybe, maybe, if we saw pregnant women as people first and mothers second, the gap between expectation and reality might not be so great, and the image of the happy, stable, glowing mum-to-be might change into something more achievable for all pregnant women.

4 comments on “Baby wants a double vodka

  1. lulu says:

    I think there should be free and sometimes enforced sterilisation for long term drug and alcohol addicts. I don’t think they are falling pregnant intentionally and are not able to manage birth control. They are not able to look after themselves never mind a baby and I feel it’s not safeguarding them if we stand back and just watch them have baby after baby.

    • It’s a controversial opinion, and not one that sits comfortably with me – but I have to admit I have started to question, over the years, where the rights of the mother ends and where the rights of the baby begins. Should women who refuse to stop using drugs be detained to ensure the baby is not injured by drug use during pregnancy? Why does the baby have no rights to protection until the day it is born?

      I have to say, though, that while I would certainly encourage women who want to continue using drugs to have some long-term contraception (and the service I work for advocates for and provides this), I think forced sterilisation is a step too far. People do change their lifestyles, and for some women, becoming pregnant is the life-changer that gives them a reason to value themselves and stop using.

      I fully understand your perspective though – and have previously discussed, tongue-in-cheek, whether payment-for-stererlisation programmes in the US might be a more moral option than multiple pregnancies and subsequent removals.

      It’s a tricky one! Thanks for your opinion.

  2. Lynne says:

    It’s very true – the way society judges pregnant women is awful – like you say the odd unit of alcohol is never going to harm an unborn. Throughout the life of the child, parents, but particularly mothers are judged from then on – how the child is fed, how it is transported, how it is dressed, how long it stays up and even what it is called – pregnancy is the start but it doesn’t stop there. I know a couple of women who went riding when pregnant and they used to whisper it to me like they’d been the worse mothers on the earth. I think the truth is no matter what the mother is taking the unborn is always going to be at a disadvantage – we both know drug using parents are going to be lacking either through emotional warmth or financial problems but a lot more babies are also going to be born into worse situations.

    • Absolutely – there are plenty of people who don’t use drugs that are wholly unfit to be parents. I agree though, that what needs to change is the pressure we put on parents, and particularly mothers, to be ‘perfect’, or to conform to a constrictive stereotype. What is fashionable in the parenting role now would have been deemed cruel when we were growing up – imagine not being allowed to go out to play in case some wandering pervert snatched you! Thirty years ago that would have been considered over-cautious and restrictive – now if you let your child play out at four years old, you would be neglectful. In the same way, pregnant women would have drunk as they saw fit back then – now they are deemed unfit to be mothers for having one unit. And if a woman smoked cannabis during pregnancy – despite this having no known detriments to unborn children (other than those associated with cigarette smoke) – Social Care would want to know. There is a lot of hypocrisy around maternity, and the drug-using mother debate, I feel, highlights this.

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