Examining Alcohol and Zika Virus Policies
The Centre for Disease Control (CDC) created a small controversy on 2 February after it released a report that recommended sexually active women should abstain from drinking alcohol. The CDC’s report intends to reduce the risk of accidental but harmful complications to pregnancies.
However, some organizations have criticized the CDC’s recommendations. For some, it unjustly prioritizes the needs of potential babies ahead of their mothers, suggesting that this report is another example of how pro-life values are influencing healthcare. For others, it paternalistically imposes certain safe or docile lifestyles onto women, robbing them of freedom to make these choices themselves. For example, Sarah Longwell from the American Beverage Institute criticized the CDC’s stance on alcohol as “puritanical,” commenting that women are fully capable of drinking safely and responsibly without a blanket prohibition.
The CDC has defended its report despite the negative reaction from the broader community. The report points to some statistics regarding female pregnancy in the United States in order to justify their policy recommendations. First, they state that almost half of US pregnancies are unplanned, and that even planned pregnancies are usually not realized until four to six weeks into the pregnancy. Secondly, over three million women between the ages of fifteen and forty-four drink, have sex, and do not use birth control. For the CDC, these statistics already point to notable concerns regarding safe sex practices in the United States.
Lastly, the CDC claims any level of alcohol use puts the fetus at risk. Some of these consequences include miscarriage, stillbirth, prematurity, fetal alcohol spectrum disorders (FASDs), and sudden infant death syndrome (SIDS). Given these risks, the report states that women should try to minimize these harms by abstaining from alcohol entirely if they are sexually active and do not use birth control.
The reasoning behind the CDC’s report is risk management for both women and children. Alongside preventing the long-term consequences on children, it also intends to minimize the potential of accidental but harmful complications to the pregnancy itself. As stated by Anne Schuchat, Principal Deputy Director of the CDC, “The risk is real. Why take the chance?”
Some commentators have linked the controversial CDC report with broader issues related to reproductive rights and women’s autonomy within the health care system. Of particular interest to these commentators are the health care policies currently being created in Central and South America as a response to the Zika virus.
The Zika virus is a mosquito-borne disease that is currently affecting large populations of Central and South America. The disease itself is relatively mild, with the most common symptoms including fever, rash, joint pain, red eyes, muscle pain, and headache. The symptoms last between a few days to a week. However, women who contracted the virus during their pregnancy have been giving birth to babies with microcephaly. These newborns have abnormally small heads and underdeveloped brains, causing lifelong complications. Microcephaly can lead to further debilities, including seizures, intellectual and motor disabilities, and developmental delays. Nearly 4,000 cases of Zika-linked microcephaly were reported in the past year.
In response to this outbreak and its effects on women, Central and South American governments issued policy statements warning women not to get pregnant. Colombia has urged women not to get pregnant within the next several months, while El Salvador suggested a two-year delay in pregnancy.
Critically, these policies created a controversial debate over abortion and other reproductive rights for women in Central and South America. Many of these countries have dominant Roman Catholic communities, and their laws are sometimes influenced by underlying values regarding the sanctity of life. As such, certain forms of abortion, birth control, and family planning are largely illegal or socially stigmatized.
These barriers to reproductive services make it difficult for women to carefully plan pregnancies while being wary of the Zika virus recommendations. Some local activists have used this outbreak as an opportunity for health care reform in order to better uphold reproductive rights for women.
Commentators are finding common ground in the issues being raised by the CDC report and the Zika virus recommendations. Importantly, both policies are being criticized for placing the responsibility on women to change their habits and lifestyles in response to perceived health care risks. These commentators concede that the risks are real and that families are being unduly affected. However, a better and more sustainable solution would be to change the underlying health care system through greater recognition of reproductive rights and through providing increased accessibility to reproductive services for women.
For the women in the US, this approach might mean focusing on a comprehensive health promotion rather than a blanket prohibition, in order to give women a more informed choice. It might also mean better access to abortion services for pregnancies that carry the risk of FASD and SIDS. Similarly in Central and South America, this approach might mean better protections against the Zika virus, such as providing mosquito nets, as well as better access to reproductive services like contraceptives and abortion.
The issue of reproductive rights entered the public arena after a set of policy recommendations raised important questions about how health care systems approach health care issues. Only time will tell, however, whether these criticisms will lead to reform.