Pregnancy, Partners and Alcohol Warning Labels
In this research commentary the authors discuss the Wilkinson & Ritter’s commentary which discusses substance use harm to others (HTO) research, policy and stigmatization of vulnerable populations. Wilkinson & Ritter discuss a challenge to researchers and advocates engaged in public health alcohol policy regarding alcohol policy and its role in the uneven experience of stigma by vulnerable groups. One of the examples used concerned alcoholic beverage warning labels about [consuming alcohol] during pregnancy (warning labels) and the implication that labels could stigmatize pregnant women who consume alcohol.
The present authors believe it would be dangerous if some concluded stigmatization as a rationale for pulling back or halting progress on warning labels or information dissemination on risks of alcohol use during pregnancy. Even when motivated by the best intentions, limiting or withholding access to health information undermines self‐determination, reduces health literacy and perpetuates confusion. Public policymakers would be remiss if they failed to prioritize the most vulnerable in their efforts to increase access to easily understandable, evidence‐based health information.
That said the authors state three reasons why this challenge warrants a closer look:
- First, although Wilkinson & Ritter do not cite evidence of stigma associated with warning labels, there is one study suggesting they may lead some women to avoid prenatal care and have worse pregnancy outcomes.
- Secondly, efforts aimed at reframing prenatal alcohol exposure from a ‘women‐only’ issue to a responsibility shared by partners, families, friends and communities could bring major gains in behaviour change.
- Thirdly, in July of this year, the Australia New Zealand Food Standards Code was amended to mandate specific pregnancy warning labels for all alcoholic beverages. While backed by 150 organizations, the alcohol industry had opposed the policy.
Mandated labels must show a silhouette of a pregnant woman (standing), holding a glass (poised to [consume alcohol]) and enclosed in a red circle with a strikethrough. Alcohol consumption, however, is not bound to gender and is influenced by the alcohol use behaviors of others. The authors cite previous research which indicate a relationship between partners’ alcohol use and alcohol use during pregnancy. For example, if a male live‐in partner consumes alcohol while his female partner is pregnant, chances are higher that she will continue to use alcohol, particularly if he is a heavy or risky user. In contrast, women are more likely to follow health advice to reduce alcohol use if partners are supportive and actively involved in the pregnancy.
The authors issue an alternative challenge to the public health sector: Imagine a pregnant female silhouette and her partner standing side‐by‐side (holding hands optional), both raising their glasses as if to [consume alcohol], both contained in a circle of red with a strikethrough. What are the chances?
Regarding illicit drug use during pregnancy, the present authors agree with Wilkinson & Ritter that individualizing focus will probably add to stigmatization of vulnerable women who use illicit drugs during pregnancy. The authors state that researchers might choose, to recognize the problems but pursue a more restorative public health discourse by reframing all harmful substance use during pregnancy as a responsibility shared by parents, family, friends and communities alike.