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Patriarchy Alive and Well: CDC Releases New Guidelines for Alcohol & Pregnancy

Earlier this week the United States Center for Disease Control (the CDC) released yet more guidelines for women of “reproductive age.” These guidelines take what could be seen as a draconian, or perhaps more bluntly, a misogynous stance of recommending that all women of reproductive age who do not use contraception avoid alcohol altogether. For women, drinking alcohol, as the CDC materials detail, results in “unintended pregnancy, fertility issues, sexually transmitted diseases, cancer, and violence and injury.” This guideline follows on the heels of recent recommendations that women in South and Central America abstain from getting pregnant for the next two years, or until the medical field can understand and control the Zika virus that can cause severe brain damage to fetuses. Here, women are identified solely by their potential for pregnancy (women of reproductive age) casting “all female identified bodies as potentially pregnant,” [i] regardless of the will or agency of the female. Women alone should avoid pregnancy, alcohol and heterosexual sexual intercourse. There are no strict guidelines curtailing men’s sexual sovereignty or alcohol consumption. The role of men in pregnancy is erased as is the damaging impact of alcohol on sperm quality. [ii] Women alone are responsible for their pregnancies and for the health of a fetus. They alone have the responsibility for avoiding pregnancy.

First let me state an obvious fact: not all women of reproductive age can or choose to reproduce. Second, not all women of reproductive age engage in heterosexual sex. Furthermore, to suggest that using contraception be a requirement for women’s alcohol consumption, and sobriety a requirement for allowing women to engage in heterosexual intercourse, is to position women as chattel.

As I’ve written elsewhere, [iii] the culture in general does seem to be obsessed with what Donna Haraway called the ‘public fetus.’ This liminal and at times fantasy body seems to function as an irresistible object for infinite projections and the potential to embody them.

Such a public fetus serves an invaluable function in a U.S. culture that, as Lynne Layton and others have observed, has collapsed spaces for reflection and meaning making, resulting in a dependence on pre-packaged snippets of experience and the collective use of fetish objects. The fetus can be used to create a fantasy of wholeness in the face of overwhelming and intolerable anxiety and the resulting inability to have faith in a progressive future. The fetus as a fetish object can function in special ways, as the image of a fetus can be a fetish of citizenship, a projection of the “virtuous private citizen…for whom there is not a good-enough world.” [iv] Here the fetus becomes the fetish object that can be protected without compromising our fantasies of independence or self-sufficiency. We can relate to it without becoming weak as the fantasy fetus can contain the relational vulnerability. A fetus’ value is, of course, in its embodiment of potentiality and futurity: as a fetus, it can become anything. It is a perfect, limitless neoliberal object. Indeed, as the culture continually reminds us, the only thing standing in the way of a fetus’ limitless potential is the behavior of the maternal body. Here is a classic case of splitting and containment: the vulnerabilities of the culture are split off into the fetus while the dangers and threats are split off into the maternal. The fact that domestic violence, most often men’s violence against women, is a leading cause of birth defects, is a pesky reality that, evidently, can be explained away as a potential result of maternal drinking (i.e. the above mentioned CDC guidelines that indicate alcohol consumption by a woman can result in injury and violence. The perpetrator of the violence and injury is erased. A woman is injured because she drank alcohol). The best defense for the health of the fetus is surveillance of the maternal and potentially-maternal. This surveillance disproportionately impacts poor women and women of color.

Citing concerns for potential fetuses, 31 states have passed laws that could keep women (pregnant or not) from accessing drug treatment programs and drugs for conditions such as blood clots, epilepsy and depression, to name only a few. Twelve states have provisions directly stating pregnant women must be kept on life-support, regardless of their directives. In these states there is no legal requirement to let women know about exclusions in their living wills, nor is there an understanding of who pays for the required life-support or delivery costs since insurance policies do not usually cover clinically deceased policy holders (people for whom blood circulation and breathing have ceased). [v]

Since the 2004 passage of the Unborn Victims of Violence Act, 38 states have extended the range of this Act to feticide. – violence that kills the fetus but not the mother. Although the Act was passed with the provision it not be used to prosecute pregnant women, a report issued by National Advocates for Pregnant Women [vi] surveying criminal cases involving pregnant women found that 77% of these cases did not even mention the father or other men, focusing instead on criminalizing the behaviors of the mother. In these criminal and/or civil cases (which occurred in 44 states throughout the country), women were arrested, detained, and deprived of their civil rights based solely on the fact that they were pregnant. The majority of cases were economically disadvantaged African American women who were arrested or/and reported to state authorities by hospital and other medical staff when they attempted to gain access to drug treatment programs upon realizing they were pregnant. Instead of treatment, they were subject to felony charges and oftentimes imprisoned based on the ruling that the fetus be deemed a ward of the state. And demonstrating that the fetus really is merely a fetish object, this concern for fetal health ended at imprisoning the maternal body. In the majority of cases the women received no prenatal care while being held in prison.

In a culture shaped temporally by notions of what can be called heteronormative “reprofuturity,”[vii] the public fetus slips in easily as the fetish object in relation to which we can feel whole and disavow death and anxiety by creating an embodied representation of a hopeful future. And as our anxieties about climate change, spreading viruses, economic instability, and global violence build, the need for/and use of such fetish objects will most likely mount, as we become more dependent on this method of manufacturing futurity. But as “the fetus emerges as a fantasized beacon of hope, containing vulnerability by organizing risk and locating it squarely and safely within the other – the maternal/women’s body,”[viii] we engage in a dangerous form of regulating our affect by playing with and manipulating bodies and times. Women, in particular women of color, women from the southern hemisphere, and economically disadvantaged women, pay the price of disavowals, and a privileged white masculinity once again emerges evacuated of vulnerability or accountability. It is a chilling pattern that jeopardizes all bodies through time.

[i] Gentile, K. (2013). Biopolitics, trauma and the public fetus: An analysis of preconception care. Subjectivity, 6 (2): 153-172.

[ii] See Daniels, C. R. (2006). Exposing Men: The Science and Politics of Male Reproduction. New York: Oxford University Press.

[iii] Gentile, K. (2016). The business of being made: The temporalities of reproductive technologies, in psychoanalysis and culture. London/New York: Routledge.

[iv] Berlant, L. (2010). Cruel optimism. In The Affect Theory Reader, ed. M. Gregg & G.J. Seigworth. Durham, NC: Duke University Press, pp. 93-117.

[v] Taylor, K. & Paltrow, L. (2014). Marlise Munoz case shines light on dehumanizing ‘Pregnancy Exclusion’ laws. RH Reality Check: Reproductive & Sexual Health and Justice News, Analysis & Commentary. Downloaded January 16, 2014.

[vi] Paltrow, L. (2013). Roe v Wade and the new Jane Crow: Reproductive rights in the age of mass incarceration. American Journal of Public Health, 103 (1): 17-21.

[vii] See for instance Edelman, L. (2004). No Future: Queer Theory and the Death Drive. Durham, NC: Duke University Press.

[viii] Gentile, K. (2014). Exploring the troubling temporalities produced by fetal personhood. Psychoanalysis, Culture & Society, 19 (3): 1-18. P. 293

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