In many countries, official guidance promotes alcohol abstinence to women during, and also before, pregnancy, on the basis of concern about Foetal Alcohol Spectrum Disorder (FASD). Guidance has moved away from reference to a ‘choice to drink’, claiming absence of evidence about safety of even ‘low level’ drinking as a justification. Scholarship drawing on sociologies of risk and uncertainty has drawn attention to problems with precautionary thinking in this area of policy making, including for women’s autonomy. We build on these insights to assess a more recent type of UK guidance. This is directed not to women advising them to abstain, but instead it is about women, and tasks health professionals with managing the risk pregnant women’s behaviour is deemed to present. Using qualitative discourse analysis, we assess one such example, developed in Scotland, called SIGN 156. We contextualise SIGN 156 first through discussion of the relevant literature, making particular use of Ruhl’s considerations of the meaning of risk and the social conditioning of choice, and second through an account of developments in UK Government advice in recent years. We show that SIGN 156 builds on a policy context where a precautionary approach is explicit, but we furthermore detail how this approach innovates the guidance and practice field. SIGN 156 expands the meaning of risk and uncertainty and so justifies ‘routine’ monitoring and screening, generating the case for an expanded form of surveillance of pregnant women. We conclude with a critical commentary on the implications of this case for analyses of risk and uncertainty, and power.

在许多国家，基于对胎儿酒精谱系障碍 (FASD) 的担忧，官方指导提倡妇女在怀孕期间和怀孕之前戒酒。指南已不再提及“选择饮酒”，声称缺乏证据表明即使是“低水平”饮酒也是安全的。以风险和不确定性社会学为基础的学术研究引起了人们对这一政策制定领域预防性思维问题的关注，包括妇女自主权。我们在这些见解的基础上评估一种更新的英国指南。这不是针对建议她们弃权的女性，而是关于妇女，以及负责管理孕妇行为风险的卫生专业人员的任务。使用定性话语分析，我们评估了一个在苏格兰开发的名为 SIGN 156 的此类示例。我们首先通过讨论相关文献将 SIGN 156 置于语境中，特别利用鲁尔对风险含义和选择的社会条件的考虑，以及其次，通过对近年来英国政府建议的发展进行说明。我们表明 SIGN 156 建立在明确预防方法的政策背景之上，但我们进一步详细说明了这种方法如何创新指导和实践领域。SIGN 156 扩展了风险和不确定性的含义，因此证明了“常规”监测和筛查的合理性，为扩大孕妇监测形式提供了案例。