Earlier this year Brandy Zadrozny interviewed me for a Daily Beast story about the new CDC guidelines for alcohol consumption by women. It caused an outcry because it advised all women who could potentially become pregnant to completely abstain from alcohol as a way to prevent fetal alcohol spectrum disorders.

Responses across the blogosphere included several objections, including the fact that research shows that alcohol alone is not sufficient to cause fetal harm (enter poverty as a major confounding factor) and paternal drinking prior to conception is believed to contribute to incidence of these disorders, too, despite no advice to men of fertile age to refrain from any alcoholic consumption.

Interesting points, but an argument made by Renée Ann Cramer in Pregnant with the Stars gave what I thought was some interesting historical perspective.

Until feminists fought to make it otherwise, she explains, it was perfectly legal in America to refuse to allow women access to certain jobs because they might get pregnant. If the working conditions were too challenging or involved exposure to dangerous chemicals, women were considered unfit for the work by virtue of their always-potentially-pregnant status. And if they did this work and harm did come to a child, it was considered a failure of the state to adequately protect her.

Feminists fought to make this “protectionism” illegal, demanding that women themselves have the right to decide, alongside men, if they wanted to take occupational risks. And they largely won this fight.

In turn, though, women themselves came under scrutiny. They were no longer excluded from certain jobs, but if they chose to do them, it was reasonable to judge them harshly for doing so. Cramer calls this the “responsibilization” of pregnancy. Now that women had the right to handle their pregnancy (or pre-pregnancy) however they wished, they (and not the state) would be held responsible for doing so in ways that society approved or disapproved.

This is what the CDC guidelines are doing. It’s not legal to “protect” women from harming her not-yet-existing fetus by refusing to serve her alcohol. Women have the same rights as men. But with rights comes responsibilization and if women don’t make the choices endorsed by their communities, the health industry, and even the federal government, they can expect to be surveilled, judged, and possibly bullied into doing so.

Cross-posted at Pacific Standard.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

Monday marked the 50th anniversary of the intervention of the birth control pill. There is no doubt that the pill has had a huge influence on sexual attitudes, sexual activity, and how much control women had over their own fertility. The pill, although it may not be the right choice for everyone, should be celebrated for these reasons. But there is something else to consider here: how did the invention of the pill shape the way that women (and the medical community for that matter) view periods?

When you think of the pill, the first image that comes to mind is that iconic little container of pink and white pills that represents one menstrual “cycle.”

In Malcolm Gladwell’s fantastic article, John Rock’s Error, Gladwell explains how the invention of the pill was heavily influenced by the Catholic Church. One of the creators of the pill, a devout Catholic, wanted it to be viewed as “natural” since it used chemicals that naturally occur in the body to prevent pregnancy. It was necessary, then, for women to continue to have their period regularly to show that the pill did not interfere with a woman’s menstrual rhythm.

But, speaking from an evolutionary standpoint, there is nothing natural about having a menstrual period every month because it is not natural to limit fertility. Our female ancestors spent a good portion of their reproductive years pregnant and not having a period. And, in fact, having a period every month can be dangerous. Every time a woman has a period, tissue lining sheds and new cells must grow to replace it. And every time there is cell regrowth there is a new chance for mutations to occur. This leads to an increased risk of cancer and cysts.

It may be healthier (and more natural), then, for women to suppress menstruation (the way pregnancy used to). But because the idea of a natural rhythm is now synonymous with monthly periods, introducing pills with alternative cycles has proven difficult. Pills that allow for four periods a year (like Seasonale, Seasonique, and Yaz) have come on the market. But instead of discussing the medical benefits of fewer periods, they are marketed in a woman-on-the-go sort of way, as a way for women to “take back” their lives by avoiding an inconvenience.

Marketing the pill in this fashion has created push back by women who think this method this pill is all about suppressing “natural” womanhood, but it is a falsely constructed version of womanhood to begin with.

Sources: NY Times, LA Times, Planned Parenthood, WebMD, No Period, and Annals of Medicine. Originally posted in 2010.

Lauren McGuire interned for Sociological Images in 2010. See more posts from Lauren on social psychology and policing by race and the evolution of Cosmopolitan magazine.

“Future research is needed to identify the process,” write the authors, but it appears that pregnant women have some control over when they give birth. A study of birth incidence on Halloween and Valentine’s Day, by public health scholar Becca Levy and colleagues, showed that spontaneous births dipped on the former and rose on the latter.

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The authors suggest that this contributes to growing evidence that culture influences birth timing. Women’s bodies resist giving birth on a day associated with fright and death, but give into birth on a day associated with love. The authors recommend extra staffing on obstetric wards on Valentine’s Day and sending a few more doctors and nurses into the streets on Halloween.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

Flashback Friday.

The term “fetal alcohol syndrome” (FAS) refers to a group of problems that include mental retardation,  growth problems, abnormal facial features, and other birth defects.  The disorder affects children whose mothers drank large amounts of alcohol during pregnancy.

Right?

Well, not exactly.

It turns out that only about 5% of alcoholic women give birth to babies who are later diagnosed with FAS. This means that many mothers drink excessively, and many more drink somewhat (at least 16 percent of mothers drink during pregnancy), and yet many, many children born to these women show no diagnosable signs of FAS. Twin studies, further, have shown that sometimes one fraternal twin is diagnosed with FAS, but the other twin, who shared the same uterine environment, is fine.

So, drinking during pregnancy does not appear to be a sufficient cause of FAS, even if it is a necessary cause (by definition?). In her book, Conceiving Risk, Bearing Responsibility, sociologist and public health scholar Elizabeth M. Armstrong explains that FAS is not just related to alcohol intake, but is “highly correlated with smoking, poverty, malnutrition, high parity [i.e., having lots of children], and advanced maternal age” (p. 6). Further, there appears to be a genetic component. Some fetuses may be more vulnerable than others due to different ways that bodies breakdown ethanol, a characteristic that may be inherited. (This may also explain why one fraternal twin is affected, but not the other.)

To sum, drinking alcohol during pregnancy appears to contribute to FAS, but it by no means causes FAS.

And yet… almost all public health campaigns, whether sponsored by states, social movement organizations, public health institutes, or the associations of alcohol purveyors tell pregnant women not to drink alcohol during, before, or after pregnancy… at all… or else.

The Centers for Disease Control (U.S.):

The National Organization on Fetal Alcohol Syndrome:

Best Start, Ontario’s Maternal Newborn and Early Child Development Resource Centre:

Nova Scotia Liquor Commission:

These campaigns all target women and explain to them that they should not drink any alcohol at all if they are trying to conceive, during pregnancy, during the period in which they are breastfeeding and, in some cases, if they are not trying to conceive but are using only somewhat effective birth control.

So, the strategy to reduce FAS is reduced to the targeting of women’s behavior.

But “women” do not cause FAS. Neither does alcohol. This strategy replaces addressing all of the other problems that correlate with the appearance of FAS — poverty, stress, and other kinds of social deprivation — in favor of policing women. FAS, in fact, is partly the result of individual behavior, partly the result of social inequality, and partly genetic, but our entire eradication strategy focuses on individual behavior. It places the blame and responsibility solely on women.

And, since women’s choices are not highly correlated with the appearance of FAS, the strategy fails. Very few women actually drink at the levels correlated with FAS. If we did not have a no-drinking-during-pregnancy campaign and pregnant women continued drinking at the rates at which they drank before being pregnant, we would not see a massive rise in FAS. Only the heaviest drinking women put their fetus at risk and they, unfortunately, are the least likely to respond to the no-drinking campaign (largely due to addiction).

Originally posted in 2010 and developed into a two-page essay for Contexts magazine.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

The ideology of intensive motherhood is a cultural approach toward parenting that suggests that competent childcare demands “copious amounts of time, energy, and material resources” and that providing such childcare should take priority over everything else a mother might like or need to do.  In South Korea, this imperative is at work even before babies are born and the practice is called tae-gyo. A reporter for the Korea Herald, a local newspaper, explains:

Since over 600 years ago, expectant mothers in Korea have been practicing taegyo, a series of prenatal routines aimed at nurturing a healthy, virtuous and skilled child. They try to see and hear only the most pleasant things starting from three months of pregnancy.

Koreans believe that a mother’s state of mind and ongoing education during pregnancy determines a baby’s prospects. Their educational and occupational future, even their personality, is dependent on what their mothers do while they’re pregnant. A reporter, below, quotes a South Korean figure who claims that “nine months of prenatal education is more valuable than nine years of post-natal learning.”

Interest in tae-gyo is escalating thanks to declining birth rates and hyper-competition. Fewer Korean couples are having more than one child and they want to give these “single” children an edge by helping them from the womb.  They want their children to survive in a hypercompetitive educational environment.

Accordingly, while the most common tae-gyo used to be listening to classical music, women are facing increasing pressure to do more and more for their child before it is born. During the past 20 years, tae-gyo has incorporated learning calligraphy or floral arrangement, crafts like knitting and sewing, and doing yoga. Expected mothers are doing English and math tae-gyo, meaning that they study English and do math for their unborn children to ensure that they will excel in those skills. Korea’s tourism industry have developed a “taegyo travel package,” which is supposed to be beneficial for babies in the womb.

This can all be quite intensive, as you might imagine, as women are expected to personally practice all of the skills and traits they hope their baby will have. Intensive mothering in South Korea, then, starts before the baby is born.

Cross-posted at Pacific Standard.

Sangyoub Park, PhD, is an associate professor of sociology at Washburn University, where he teaches Social Demography, Generations in the U.S., and Sociology of East Asia. His research interests include social capital, demographic trends, and post-Generation Y.

Medical professionals often have the final say in deciding what counts as a “defect.” Often, their decisions exceed the bounds of medicine, addressing bodies that may deviate from “normal” or “average,” but do not actually cause medical problems.

An alternative might be to allow the patient to decide if his or her body is acceptable, but in doing so they risk allowing people’s deeply subjective and often dysmorphic perceptions of their own bodies determine whether they undergo a risky procedure.

Is there another way?

Pediatric surgeon Norma Ruppen-Greeff and hers colleagues thought so. Pediatric physicians often correct hypospadias: a condition in which the meatus, or opening of the urethra, doesn’t quite make it to the top of the penis during fetal development, such that the urethra exits the penis somewhere along the shaft. This is generally corrected surgically, but physicians found that some men returned to them as adults with concerns that their penis still appeared abnormal.

Instead of dismissing men’s concerns or jumping with a knife, they decided to ask women if they noticed. They had 105 women fill out a questionnaire and rate which aspects of penile appearance were important to them. And, lo and behold, the shape and placement of the meatus was the least important. No need for surgery, plus they can reassure the guys that they’re okay. (Someone should follow up and ask gay and bisexual men; anyone for an awesome senior thesis?)

This is a great way to measure the sociocultural value of a surgery. Whereas we’re used to thinking about surgical issues as psychological (someone wants it) or medical (someone needs it), these physicians asked a distinctly sociological question. They measured how penises are widely perceived and which parts are socially constructed as important. That’s a pretty neat way to incorporate sociological realities into surgical practice.

Cross-posted at Pacific Standard.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

According to the U.S. Bureau of Labor Statistics, fully employed women earn $0.81 for every dollar men make. Some of this discrepancy is due to women working in male dominated occupations, but when men work alongside women in female-dominated occupations, they still earn more.

Nursing is this week’s example. According to a new study in the Journal of the American Medical Association, male nurses out earn female nurses in every work setting, every clinical setting, and every job position except one.

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On average, male nurses make $5,100 more a year than female ones. In the specialty with the biggest discrepancy, nurse anesthetists, they out earned women by $17,290. More at NPR and the New York Times.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

This week the New York Times published an interactive that illustrates the likelihood of pregnancy despite contraceptive use. Risk is divvied up by method, for perfect and typical use, and added up over ten years. The results are a little terrifying (click to see larger or go here to explore):

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Somewhere around half of all pregnancies are unintended.  This is why. It’s hard enough to use contraceptives perfectly but, even when we do, the risk of failure is very real.

Male condoms are the safer sex favorite. But, even when used perfectly, almost one in five women will get pregnant over a ten year period. With typical use, more than four out of five. Withdrawal, one primary foil against which male condoms are usually recommended, is only slightly less effective at preventing pregnancy, as typically used.

The favorite of Americans — The Pill, as well as some other hormonal methods — is more effective than the condom, but not nearly as much as we think it is. Under ideal conditions, only three in 100 will get pregnant over ten years; in reality, almost two-thirds — 61 in 100 — will end up pregnant.

Only the most human-error resistant methods — the IUD, hormonal implants, and sterilization — near 100% effectiveness. These are permanent or semi-permanent and not real options for a large proportion of sexually active Americans during at least some parts of their lives.

Discussions of the right to an abortion and the ease with which they can be attained needs to be had with this information at the forefront of the discussion. Unintended pregnancies happen all the time to everyone.

Cross-posted at Pacific Standard.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.