World Health Organisation's misogynistic statement about 'women of childbearing age' is latest in history of paternalism in medicine – Marina Politis

Despite beer brewing originating as a woman's craft, with women brewing beer from the Viking to Egyptian era, the history of women and alcohol has been fraught with sexism.

Women drink beer during the 2019 Oktoberfest in Munich (Picture: Johannes Simon/Getty Images)
Women drink beer during the 2019 Oktoberfest in Munich (Picture: Johannes Simon/Getty Images)

In the 1500s, the onset of witch hunts saw symbols such as the broomstick, once insignia for alehouses, and tall pointed hats, a tool to enable customers recognise brewers in crowds, conflated with witchcraft.

An accusation of witchery resulted in inevitable ostracisation, persecution or death for women and thus, by the 1700s, female spirit production in Europe came to an end.

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In a continuation of this saga of alcohol, sexism, and gender roles, last month the World Health Organisation (WHO) made the misogynistic statement that “appropriate attention should be given to... prevention of drinking among pregnant women and women of childbearing age”.

This recommendation wasn’t simply for women who were, or wished to be, pregnant, but for all women of childbearing age. It appears that, once again, women have been reduced to vessels for reproduction, spending the decades that span menarche to menopause in a perpetual state of waiting to fall pregnant.

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In suggesting all women of childbearing age should reduce drinking to protect the health of a non-existent foetus, this also suggests that we cannot trust women to know of their theoretical pregnancy status and make their own informed choice about drinking and reproductive health. Here is a thought: it is possible that not all women of childbearing age can – or want to – have children.

Furthermore, if we want to talk about hypothetical foetuses and children, where is the conversation about men and their own alcohol consumption? The WHO itself released a report earlier this year that highlighted the significant link between harmful use of alcohol and intimate partner violence.

Beyond the societal harms of alcohol, research has previously found links between alcohol consumption and male fertility and hormone production. Alas, it appears that there are in fact two individuals responsible for the conception of a child, and we cannot continue to cast all responsibility on women.

With harmful alcohol consumption causing approximately three million deaths worldwide annually, a call to address our often unhealthy and problematic alcohol use is certainly needed.

A recent report by Public Health Scotland on the impact of minimum unit pricing on people who are dependent on alcohol suggests that the policy has reduced the availability of cheap alcohol, which is often consumed by those at greatest risk of harm from drinking. Nonetheless, there is still important work to be done with addressing the inherent harm associated with alcohol.

Thus, whilst most, if not all of us, who drink could afford to reflect on whether we should cut down on our alcohol consumption, be this for our physical, mental, or financial well-being, this rhetoric misses the mark.

This tone of messaging plays into a long history of systemic misogyny and paternalism in medicine, when it comes to women and what they decide to do with their bodies.

Women’s health must concern our own health and can no longer start and end with our reproductive ability, fertility, and potential to carry a – very much, for many of us – hypothetical foetus.

Marina Politis, a medical student, is deputy chair for welfare of the BMA UK Medical Student’s Committee. She is on Twitter @marinadpol

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