The Shame of Drinking Alcohol While Pregnant: The Production of Avoidance and Ill-Health.

In this article, we examine the operation of shame in the alcohol use habits of pregnant women and the responses of their families and associated institutions. Using a narrative–discursive approach, we interviewed 13 women, living in a low-resource setting in South Africa, who had consumed alcohol while pregnant. Narratives showed how both the act of drinking and "inappropriately" timed pregnancy (early and out of wedlock) were judged to be unacceptable. Women who engaged in these activities were positioned as bad mothers or promiscuous. Their actions were seen as resulting in the suffering of others—the future child, the family, and even the community. These narratives were underpinned by cultural and religious discourses. Women managed the shame accruing to them through avoidance and concealment; families instructed women to self-exclude or distanced themselves from the women's behavior; and institutions subtly or overtly excluded women. The shaming of these women, and the mechanisms by which such shame was managed, did little to decrease drinking or to increase maternal health and welfare. Overall, this article demonstrates how the shame of drinking alcohol during pregnancy produces avoidance behavior, concealment, and exclusion, which are not constructive in terms of maternal health and well-being. The implications for a feminist narrative approach to drinking during pregnancy are outlined: moving beyond a focus on individual behavior change to locating personal stories within the meta-narratives and social discourses that shape pregnant women's lives. [ABSTRACT FROM AUTHOR]