On The Side of Caution

"I was twenty when I got pregnant and it was unplanned. I was going out at least once a week to the bar and drinking -- not binge drinking but what I would consider social drinking."
"When I found out I was pregnant, I stopped drinking completely."
"I don't even think people realize they doing it, but when you tell people that your child has FASD [Fetal Alcohol Spectrum Disorder] they have an automatic reaction, and it's not one of sympathy or empathy -- it's judgement."
Wanda White, Waterloo, Ontario

"While the original recommendation [Centers for Disease Control and Prevention: Sexually active women should refrain from drinking if not using birth control] may have been intended to ensure safe pregnancies and healthy children, its underlying message was unmistakable: Women should consider themselves first a vessel for human life and make decisions about their health and behaviour based on that possibility."
"[It was] incredibly condescending, tone-deaf and paternalistic."
Rebecca Rutz, Mashable.com 

"The focus shifted from the woman who was essentially killing herself through alcohol abuse to the idea of having to protect the foetus."
"In a sense what we've done is create three categories of people: men, women and pregnant women."
Janet Golden, professor of history, Rutgers University

"To put it mildly, I'm not crazy about the implication that pregnant women are incapable of deciding for themselves -- that you have to manipulate our beliefs so we do the right thing."
Emily Oster, economist, author Expecting Better

Well, that's all fairly interesting, the discussion the epidemic of FASD in society and linking it deleteriously in the sense that women should be alert to the dangers they place their future children in by asserting their independence and social culture through refusal to allow the medical community to steer them toward safety in giving birth to children who have the right to a normal life. Women may have the right to determine whether they will carry a foetus to full term and birth, but morally do they have the personal authority to refuse to ensure that child will develop normally?

When the Centers for Disease Control and Prevention issued its unequivocal recommendation in 2016, alerting women of childbearing years who also imbibe alcohol of the dangers involved, they were performing their moral duty to society and to women as well as their children. That women chose to slam that advice as condescending is both defensive and offensive; in short they have the right to ruin both their lives and that of their offspring in the interests of complete autonomy. And, of course, society should uncomplainingly pick up the pieces, as it were.

The CDC did rear back, though having given notice that three million American women were at risk of exposing their babies in utero to alcohol, and in the words of Anne Schuchat, principal deputy director of the CDC, "Why take the chance?", had every reason to think their sensible advice would be taken as it was meant to: a caution. It meant, it later responded, to "empower" women to enable them to make a choice that would be healthy both for themselves and for their children.

Women were offended, feeling placed in that old category of straitened society where when women were seen to imbibe it must be proof positive of their degraded values as "skid-row prostitutes", as Professor Golden of Rutgers put it. Women, having reached the point of societal equality with men, feel no restrictions should be placed on their alcohol consumption just as none are placed on their male counterparts. Who don't, after all, get pregnant and give birth to vulnerable little human beings.

Alcohol, to a good many women, means liberation from mean societal attitudes.

As such they feel convinced there is no need to change their routine of social drinking during pregnancy. Emily Oster in her 2013 book argues while heavy drinking poses an obvious risk, no evidence exists that an occasional glass of wine will do harm to a foetus, that abstinence is advised by doctors simply because they don't feel women are possessed with the free will and strength of character to stop at the first drink in favour of caution.

It is certainly interesting that research on FASD seems to reflect an idea that women of financial means will never have their lives disrupted by the danger of FASD, that it is the poor, intellectually impoverished marginalized women who are susceptible to having children whose intellectual and physical milestones will be degraded as a result of mothers who drank while pregnant. Smart, rich women don't get addicted, right?

According to sociologist Caroline Tait, the early studies in Canada on FASD focused on reserves primarily; "Indigenizing the diagnoses", whereas in the United States, children of minority groups became the focus of FASD. New studies appear to agree that over 70 percent of women in Canada consume alcohol but since 18 percent are at risk for chronic substance use, this is really an issue of social importance. Women metabolize alcohol differently than men, are more vulnerable to addiction at lower levels.


Beyond this, alcohol has a greater impact generally on women's health than it does for men's. Studies indicate that drinking may herald increased rates of breast cancer and heart disease. Alcohol-related harm which includes FASD makes no discrimination between social class, education or profession. Women of all socio-economic groups are vulnerable. Educating and treating women who remain defiantly resistant to reality becomes a priority -- to be convinced that sometimes decision-making is driven by proven repercussions.

In Canada a new project has been launched by The Canada FASD Research Network with the aim of filling in some gaps in the science of FASD; why are some children exposed to alcohol in utero less seemingly affected than others? Data has been collected from over 1,700 patients at diagnostic clinics cross country; 65 percent having received a diagnosis of FASD; 35 percent did not. "We want to know what's different about the brains of people who didn't get a diagnosis but still had prenatal alcohol exposure", Jocelynn Cook, chief scientific officer for the Society of Obstetricians and Gynecologists of Canada explained.

"Our parents with FASD kids are under more stress. If the caregiver is a biological parent, then they're also in the burden of guilt and shame and grief. And the kids who are adopted often those parents didn't sign up for FASD, so they deal with a whole other level of emotion and stress", is how Edmonton pediatrician Dr. Gail Andrew put it. Research has shown early intervention -- occupational and speech therapies, medication to address anxiety or attention-deficit behaviours, training caregivers on coping strategies -- can improve outcomes for children with FASD.