NHS proposal to log all alcohol consumed during pregnancy criticised as privacy breach

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Plans to record every drink a mother has during pregnancy on the baby’s file have been condemned as an invasion of privacy.  

The National Institute for Health and Care Excellence (NICE), which creates guidance, policies and standards for the NHS in England and Wales, made the proposal in a consultation on how to better treat foetal alcohol spectrum disorder (FASD).  

If the guidelines, modelled on existing rules already in place in Scotland, are adopted, expectant mothers would be asked exactly how many drinks they have had and what type at antenatal appointments and by midwives.  

This information, which would include even having a single glass of alcohol before a woman realised she was pregnant, would then be permanently attached to the child’s own medical records.

NICE said this was necessary because identifying children who might be at risk of FASD relied on accurate information on how much alcohol their mother had consumed during pregnancy.  

This was particularly relevant for healthcare professionals treating children who are adopted or taken in to care and where it may not be possible to gather information from the biological mother later.  

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But a range of pregnancy charities and even the Royal College of Obstetricians and Gynaecologists said the proposals were concerning.  

The British Pregnancy Advisory Service (BPAS) said there was “no compelling research” which showed unborn children were harmed by low levels of drinking and argued the plans were “unjustified and disproportionate”.

“Women do not lose their right to medical confidentiality simply because they are pregnant,” said Clair Murphy, a spokesperson for BPAS.  

“Most women report drinking very little alcohol in pregnancy if any at all, even if they may have drunk before a positive pregnancy test."

Another charity, Birthrights, said they also had “serious concerns”. “We have serious concerns about Nice’s failure to recognise the need for informed consent to screening and transfer of information to the child’s health record.  

“It is unacceptable to propose such measures without any assessment of the impact on women and pregnant people, and their relationships with healthcare providers.”

In a statement, the Royal College of Obstetricians and Gynaecologists said it shared some of the worries raised by the charities, “including the definition of prenatal alcohol exposure and the proposal to transfer information from a woman’s health record to that of her child, and we will be responding to the consultation in due course”.

Data protection lawyers have even warned sharing details from the mother’s records to the child’s file after birth could be illegal and incompatible with the GDPR.

Matthew Holman, a data privacy lawyer, told The Times: “Any attempt to force disclosure against the mother’s wishes is likely to be unlawful except perhaps in the most limited cases where there is a clear and present risk to the unborn child”.

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However, a NICE briefing paper on the consultation argues there is no known safe level of alcohol consumption during pregnancy and even small amounts of drinking could damage the child’s health into adulthood.  

Surveys show 97 per cent of midwives advise women at the first appointment not to drink any alcohol while pregnant, but a 2010 poll suggested 41 per cent of mothers did drink while expecting a child.  

A spokesperson for NICE said the proposed guidelines were based on the Chief Medical Officer’s recommendations on alcohol use and rules already in place in Scotland and elsewhere around the world.

“The feedback we receive from external organisations and members of the public during this consultation period will help us better understand what works, and what doesn’t, for practice in England.”

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