Fetal subjects: Pregnancy, substance abuse and interventions in Finland
Department of Sociology University of Helsinki Helsinki, Finland
Women´s increased consumption of alcohol and drugs has resulted in a growing concern for prenatal substance abuse. Heated debates have recently taken place in the Nordic countries about the mother's vs. infant's rights and the justification for coercive treatment on the basis of prenatal subtance abuse. This paper analyses the process by which prenatal substance abuse has, in the last thirty years, become a widely acknowledged problem in Finland. The data for this qualitative study consists of expert articles in professional journals, policy and legislative documents and newspaper articles. The paper is a part of an ongoing PhD study.
Since the late 1970's the medical profession has had a central role in drawing attention to foetal alcohol syndrome (FAS) in Finland. A controversial political debate started in the mid-1990s about whether Finland should follow Norway's example and introduce coercive treatment for pregnant women who continue their substance abuse. The idea was, however, heavily criticised and it was claimed that what is actually needed is voluntary, not coercive, treatment services. New resources were subsequently given to specialised maternity care services for pregnant women with substance abuse problems, and these services expanded significantly at the turn of the century. This expansion of voluntary treatment services took place in the wake of a 'moral panic' around an increase in drug problems in the finnish society at large. In 2009 the idea of coercive measures took new wind and a a ministerial task force has recommended the introduction of coercive treatment for pregnant substance abusers in cases when voluntary measures have failed.
The paper provides a nuanced account of how prenatal substance abuse has been debated and dealt with in Finnnish maternity care during the last 30 years. The paper ends by discussing the ideas of feminist scholars according to whom the 'fetal subjects' constructed in 'foetus-centred' discourses tend to unjustly displace the interests and rights of pregnant women with substance abuse problems. Is this anglo-american criticism justified in the Finnish context?