Nanny State

CDC to Women: Don't Drink. Or Take Antidepressants. Or Forget Your Folic Acid. Or Treat Pain.

The new guidelines on alcohol consumption for young women are silly, but the CDC has been issuing similar rules for years.



The Internet is freaking out today over a recommendation from the Centers for Disease Control and Prevention (CDC) that women of childbearing age who are not on birth control should abstain from alcohol, lest they unknowingly damage their hypothetical progeny.

USA Today reported:

"Alcohol can permanently harm a developing baby before a woman knows she is pregnant," said Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention. "About half of all pregnancies in the United States are unplanned, and even if planned, most women won't know they are pregnant for the first month or so, when they might still be drinking. The risk is real. Why take the chance?

Which makes now a good moment for a reminder that this is hardly the first time the CDC has treated women as irresponsible potential baby-porters.

A quick note: The suggestions below are scientifically sound—more so, I would guess, than the booze recs. (For more on that, check out Jacob Sullum's "Drink Up, Moms!" or Emily Oster's excellent book, Expecting Better.)

I actually did take folic acid for years before I became pregnant. (Thanks, mom!) People who are on antidepressants should talk to their doctors about all the ramifications, including on an unplanned pregnancy. 

But that doesn't change the fact that there is something profoundly creepy about a government agency officially telling women to forgo pleasurable or life-improving choices solely on the basis of their status as the theoretical mothers of the nation's children.

OK, let's get to the nanny statism!

For starters, everyone with functional ovaries should be popping folic acid like T.I. is popping bottles.

The U. S. Public Health Service and CDC recommend that all women of childbearing age consume 0.4 mg (400 micrograms) of folic acid daily to prevent two common and serious birth defectsspina bifida and anencephaly.

All women between 15 and 45 years of age should consume folic acid daily because half of U.S. pregnancies are unplanned and because these birth defects occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.

Then, of course, as CDC honcho Thomas Freidan reminded us last year in a news release titled "Opioid painkillers widely prescribed among reproductive age women," doctors of women who are in pain should reconsider treating that pain with opioids, lest they damage a hypothetical future human:

"Taking opioid medications early in pregnancy can cause birth defects and serious problems for the infant and the mother," said CDC Director Tom Frieden, M.D., M.P.H.  "Many women of reproductive age are taking these medicines and may not know they are pregnant and therefore may be unknowingly exposing their unborn child.  That's why it's critical for health care professionals to take a thorough health assessment before prescribing these medicines to women of reproductive age."

Next, think twice about those antidepressants, ladies! Because (again) you're probably pregnant right now, as a new study in the CDC's Mortality and Morbidity Weekly Report noted just this week. One of the authors told CNN:

"Early pregnancy is time that is critical for baby's development and because so many women may be taking medications without knowing they are pregnant, we wanted to get a better sense of trends of antidepressant use of all women of reproductive age," said Jennifer N. Lind, epidemiologist in the CDC's Birth Defects Branch.

To be fair: This report was presented with much more nuance than the alcohol study, with headlines like "Women need better info about pregnancy and antidepressants," perhaps because antidepressants do not stimulate the same puritanical impulses as alcohol and opiates.

Pain meds, antidepressants, and booze carry risks for everyone. Having government officials ask "Why take the chance?" about women of reproductive age in particular suggests that there are no legitimate upsides to balance the equation.