‘Can Someone Please Decide?’ How the Media Represent the Risk of Drinking During Pregnancy

  • Hauke RieschEmail author


Advice about low but widespread health and lifestyle risks is difficult for public health bodies to get right. Geoffrey Rose’s “prevention paradox” explains how these risks can look different from a public health and an individual’s point of view. Taking the case study of a UK media controversy from 2007 to 2008 about apparently conflicting risk advice from two public health bodies about the recommended limits of alcohol during pregnancy, this chapter will examine how the prevention paradox can play out in public and explain the delicate public position public health advice can find itself.



The research was first carried out as part of the Winton Programme for the Public Understanding of Risk at the Statistical Laboratory of the University of Cambridge. Many thanks to David Spiegelhalter for inspiring this research, and to Ellie Lee and Jenny Bristow for comments on an earlier draft.


  1. Abel, E. 1995. An Update on the Incidence of FAS: FAS Is Not an Equal Opportunity Birth Defect. Neurotoxicology and Teratology 17 (4): 437–443.CrossRefGoogle Scholar
  2. ———. 1999. What Really Causes FAS? Teratology 59 (1): 4–6.CrossRefGoogle Scholar
  3. Allan, S. 2002. Media, Risk and Science. Buckingham: Open University Press.Google Scholar
  4. American Academy of Pediatrics. 2000. Fetal Alcohol Syndrome and Alcohol-Related Neurodevelopmental Disorders. Pediatrics 106 (2): 358–361.CrossRefGoogle Scholar
  5. Armstrong, E. 2003. Conceiving Risk, Bearing Responsibility: Fetal Alcohol Syndrome & the Diagnosis of Moral Disorder. Baltimore: Johns Hopkins University Press.Google Scholar
  6. Armstrong, E., and E. Abel. 2000. Fetal Alcohol Syndrome: The Origins of a Moral Panic. Alcohol and Alcoholism 325 (3): 276–282.CrossRefGoogle Scholar
  7. Boseley, S. 2007. Confusion Over Advice on Alcohol for Pregnant Women. The Guardian, October 11.Google Scholar
  8. Boykoff, M., and J. Boykoff. 2004. Balance as Bias: Global Warming and the US Prestige Press. Global Environmental Change 14: 125–136.CrossRefGoogle Scholar
  9. Brashers, D.E. 2001. Communication and Uncertainty Management. Journal of Communication 51: 477–497.CrossRefGoogle Scholar
  10. Brown, J., S. Chapman, and D. Lupton. 1996. Infinitesimal Risk as a Public Health Crisis: News Media Coverage of a Doctor-Patient HIV Contact Tracing Investigation. Social Science & Medicine 43 (12): 1685–1695.CrossRefGoogle Scholar
  11. Cavanagh, C. 2009. “You Can’t Handle the Truth”: Medical Paternalism and Prenatal Alcohol Use. Journal of Medical Ethics 35: 300–303.CrossRefGoogle Scholar
  12. Clout, L. 2007. A Daily Tipple Is Safe for Women. The Daily Telegraph, October 11.Google Scholar
  13. Cockroft, L. 2007. Now Women Are Told to Keep Off Alcohol During Pregnancy. The Daily Telegraph, October 26.Google Scholar
  14. Connolly-Ahern, C., and S.C. Broadway. 2008. “To Booze or Not to Booze?” Newspaper Coverage of Fetal Alcohol Spectrum Disorders. Science Communication 29 (3): 362–385.CrossRefGoogle Scholar
  15. Curtis, P. 2007. Pregnant? Then Don’t Touch Alcohol Is Latest Health Advice: Women Underestimate Dangers, Ministers Believe: Evidence in Support of Ban May Be Uncertain. The Guardian, May 25.Google Scholar
  16. Daily Mail. 2007a. Why Our Nanny State Should Keep Mum. The Daily Mail, May 30.Google Scholar
  17. ———. 2007b. Here’s Another Quasi-Scientific Solution to Make Mothers Feel Bad When Things Go Wrong…. The Daily Mail, October 16.Google Scholar
  18. Day, K., B. Gough, and M. McFadden. 2004. “Warning! Alcohol Can Seriously Damage Your Feminine Health” A Discourse Analysis of Recent British Newspaper Coverage of Women and Drinking. Feminist Media Studies 4 (2): 165–183.CrossRefGoogle Scholar
  19. Friedman, S., K. Villamil, R. Suriano, and B. Egolf. 1996. Alar and Apples: Newspapers, Risk and Media Responsibility. Public Understanding of Science 5 (1): 1–20.CrossRefGoogle Scholar
  20. Funtowicz, S.O., and J.R. Ravetz. 1993. Science for the Post-Normal Age. Futures 25: 739–755.CrossRefGoogle Scholar
  21. Golden, J. 2005. Message in a Bottle: The Making of Fetal Alcohol Disorder. Cambridge, MA: Harvard University Press.Google Scholar
  22. Harlap, S., and P.H. Shiono. 1980. Alcohol, Smoking, and Incidence of Spontaneous Abortions in the First and Second Trimester. Lancet 2 (8187): 173–176.CrossRefGoogle Scholar
  23. Hawkes, N. 2008. Why Is the Press So Nasty to NICE? British Medical Journal 337: a1906.CrossRefGoogle Scholar
  24. Helm, T. 2007. Don’t Drink Alcohol, Pregnant Women Told. The Daily Telegraph, November 9.Google Scholar
  25. Hope, J. 2008. The “Definitive” Guide to Pregnancy. But How Long Before the Experts Change Their Minds Again? The Daily Mail, March 26.Google Scholar
  26. Independent. 2007. Pregnant Women “Could Drink”. The Independent, October 26.Google Scholar
  27. Institut National de Prévention et d’Éducation pour la Santé. 2007. ‘Étiquetage: “Zéro Alcool Pendant la Grossesse”’ Actualites: Lettre Bimestrielle sur les Effets de l’Alcool Oct. 35: 6. Accessed 16 Oct 2017.
  28. Inthorn, S., and T. Boyce. 2010. It’s Disgusting How Much Salt You Eat! Television Discourses of Obesity, Health and Morality. International Journal of Cultural Studies 13 (1): 83–100.CrossRefGoogle Scholar
  29. Jensen, J.D. 2008. Scientific Uncertainty in News Coverage of Cancer Research: Effects of Hedging on Scientists’ and Journalists’ Credibility. Human Communication Research 34: 347–369.CrossRefGoogle Scholar
  30. John, S.D. 2014. Risk, Contractualism, and Rose’s “Prevention Paradox”. Social Theory and Practice 40 (1): 28–50.CrossRefGoogle Scholar
  31. John, S. 2018. Should We Punish Responsible Drinkers? Prevention, Paternalism and Categorization in Public Health. Public Health Ethics 11 (1): 35–44.CrossRefGoogle Scholar
  32. Jones, K.L., and D.W. Smith. 1973. Recognition of the Fetal Alcohol Syndrome in Early Pregnancy. Lancet 302 (7836): 999–1001.CrossRefGoogle Scholar
  33. Jones, C., C. Ward, and M. Bailey. 2008. Your Life: Is Booze a Danger to Unborn Babies? (Can Someone Please Decide?). The Mirror, March 27.Google Scholar
  34. Kesmodel, U., K. Wisborg, S.F. Olsen, T.B. Henriksen, and N.J. Secher. 2002. Moderate Alcohol Intake in Pregnancy and the Risk of Spontaneous Abortion. Alcohol and Alcoholism 37 (1): 87–92.CrossRefGoogle Scholar
  35. Kitzinger, J. 1999. Researching Risk and the Media. Health, Risk & Society 1 (1): 55–70.CrossRefGoogle Scholar
  36. Kitzinger, J., and C. Williams. 2005. Forecasting Science Futures: Legitimising and Calming Fears in the Embryo Stem Cell Debate. Social Science and Medicine 61: 731–740.CrossRefGoogle Scholar
  37. Lee, E., R.M. Sutton, and B.L. Hartley. 2016. From Scientific Article to Press Release to Media Coverage: Advocating Alcohol Abstinence and Democratising Risk in a Story About Alcohol and Pregnancy. Health, Risk & Society 18 (5–6): 247–269.CrossRefGoogle Scholar
  38. Lowe, P., and E. Lee. 2010. Advocating Alcohol Abstinence to Pregnant Women: Some Observations About British Policy. Health, Risk and Society 12 (4): 301–311.CrossRefGoogle Scholar
  39. Lupton, D. 1993. Risk as a Moral Danger: The Social and Political Function of Risk Discourse in Public Health. International Journal of Health Services 23: 425–435.CrossRefGoogle Scholar
  40. Lupton, D., and S. Chapman. 1995. “A Healthy Lifestyle Might Be the Death of You”: Discourses on Diet, Cholesterol Control and Heart Disease in the Press and Among the Lay Public. Sociology of Health and Illness 17: 477–494.CrossRefGoogle Scholar
  41. MacRae, F. 2007. Now the Advice Is Pregnant Women Can Have a Drink. The Daily Mail, October 11.Google Scholar
  42. Nathanson, V., N. Jayesinghe, and G. Roycroft. 2007. Is It All Right for Women to Drink Small Amounts of Alcohol During Pregnancy? No. British Medical Journal 335 (7625): 857.CrossRefGoogle Scholar
  43. NICE. 2003. Antenatal Care (Replaced by CG 62). Accessed 16 Oct 2017.
  44. ———. 2007a. Antenatal Care: Routine Care for the Healthy Pregnant Woman (Draft for Consultation). Accessed 1 Apr 2009.
  45. ———. 2007b. CG62 Consultation Comments Table. Accessed 1 Apr 2009.
  46. ———. 2008. CG62 Antenatal Care: Understanding NICE Guidance. Accessed 16 Oct 2017.
  47. O’Brian, P. 2007. Is It All Right for Women to Drink Small Amounts of Alcohol During Pregnancy? Yes. British Medical Journal 335 (7625): 856.CrossRefGoogle Scholar
  48. O’Leary, C., L. Heuzenroeder, E. Elliott, and C. Bower. 2007. A review of policies on alcohol use during pregnancy in Australia and other English-speaking countries, 2006. Medical Journal of Australia 186 (9): 466–471.Google Scholar
  49. Riesch, H., and D.J. Spiegelhalter. 2011. “Careless Pork Costs Lives”: Risk Stories from Science to Press Release to Media. Health, Risk & Society 13 (1): 47–64.CrossRefGoogle Scholar
  50. Rose, G. 1992. The Strategy of Preventive Medicine. Oxford: Oxford Scientific Publications.Google Scholar
  51. Rose, D. 2007. Pregnant Women Told Glass of Wine a Day Is Fine – and Too Dangerous. The Times, October 11.Google Scholar
  52. Rozin, P., and L. Singh. 1999. The Moralization of Cigarette Smoking in the United States. Journal of Consumer Psychology 8 (3): 321–337.CrossRefGoogle Scholar
  53. Ruhl, L. 1999. Liberal Governance and Prenatal Care: Risk and Regulation in Pregnancy. Economy and Society 28 (1): 95–117.CrossRefGoogle Scholar
  54. Shaikh, T. 2007. No Alcohol At All During Pregnancy, Doctors Say. The Independent, May 25.Google Scholar
  55. Stocking, S.H. 1999. How Journalists Deal with Scientific Uncertainty. In Communicating Uncertainty: Media Coverage of New and Uncertain Science, ed. S. Friedman, S. Dunwoody, and C. Rogers. Mahwah: Lawrence Erlbaum Associates.Google Scholar
  56. Stocking, S.H., and L.W. Holstein. 2006. Manufacturing Doubt: Journalists’ Roles and the Construction of Ignorance in a Scientific Controversy. Public Understanding of Science 18: 23–42.CrossRefGoogle Scholar
  57. Thom, B. 1994. Women and Alcohol: The Emergence of a Risk Group. In Gender, Drink and Drugs, ed. M. McDonald. Oxford: Berg.Google Scholar
  58. Thompson, C. 2016. Rose’s Prevention Paradox. Journal of Applied Philosophy.
  59. Wahlberg, A., and L. Sjöberg. 2000. Risk Perception and the Media. Journal of Risk Research 3 (1): 31–50.CrossRefGoogle Scholar
  60. Washer, P. 2004. Representations of SARS in the British Newspapers. Social Science and Medicine 59: 2561–2571.CrossRefGoogle Scholar
  61. Weingart, P., A. Engels, and P. Pansegrau. 2000. Risks of Communication: Discourses on Climate Change in Science, Politics, and the Mass Media. Public Understanding of Science 9: 261–283.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Social and Political SciencesBrunel University LondonLondonUK

Personalised recommendations