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'Just One Drink' During Pregnancy? Not Worth It

"Everything in moderation." That's the motto of health and happiness, right? It can be applied to so many things. For myself, it should probably be applied to my addiction to cheese, which is anything but healthy. But the one area I've seen it applied in a way that has always made me uncomfortable is with drinking during pregnancy.

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I worked in a bar for years as I put myself through college. It was a great job. I made fantastic tips and many lifelong friends, all while having a good time getting people drunk and enjoying the flexibility to pursue my degree in developmental psychology.

It was in the pursuit of that degree that I first learned about FASD, Fetal Alcohol Spectrum Disorder. Previously named Fetal Alcohol Syndrome (FAS), the name shift occurred as studies began to show this to be a condition that presents more on a spectrum, with levels of drinking during pregnancy being directly associated with the level of symptomology a child might experience (what is known as a dose/response relationship).

We've always known that chronic drinking during pregnancy can result in brain damage for a growing fetus. But then studies started to show negative effects with even what was considered "moderate" drinking. Reduced IQ levels, difficulties with attention, and problems with memory and behavior are the most prominent symptoms among children on what would be considered the lower end of the FASD spectrum.

Why play roulette with how much might be safe during the course of a pregnancy?

For the record, in most of these studies, moderate drinking has been considered to be 7–14 drinks per week, roughly 1–2 drinks a day. When most people talk about moderate drinking during pregnancy though, they are likely thinking more along the lines of a single glass of wine a week with a meal. Or even less. Alcohol consumption at those much smaller levels during pregnancy has yet to be studied, but what has been studied has shown us a spectrum relationship where even lighter alcohol consumption has been associated with greater behavioral difficulties compared to children of mothers who abstained completely.

Which is precisely why the CDC has long issued the following statement on the subject:

"There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including all wines and beer. When a pregnant woman drinks alcohol, so does her baby."

Yet many doctors continue to tell their patients that moderation in drinking is "probably" safe during pregnancy.

Why? With no data to back that claim up, why encourage patients to take the risk?

A series of PSAs about FASD have recently been running on TV in Alaska.

They are fairly powerful and sobering, and address a lot of the myths that accompany drinking during pregnancy head on.

Living in Alaska, every time I see these PSAs, I get a little sick to my stomach, thinking about all the children who are affected by this 100 percent preventable condition.

As the mother of a native child, I struggle with this even more. Native Americans are considered to be a particularly vulnerable population when it comes to FASD, which is likely why these PSAs are being run up here, where Alaskan Natives make up about 15 percent of our total population and where a large number of children in foster care are Alaskan Native. I know how easily my daughter could have been affected. And how many children just like her are affected. Not because these parents don't care, but because in many cases, they don't realize the dangers involved.

And that's the thing. I don't think that mothers who prescribe to the "everything in moderation" philosophy as it relates to drinking during pregnancy are bad mothers. Not at all! I think they are following and trusting in the advice of their doctors, adhering to the common ideology that a few drinks spread throughout the course of a pregnancy "probably" won't hurt.

And you know what? They probably won' t—at least not to those extreme levels we have seen with full-blown cases of FAS. But those few drinks might have more subtle negative effects, and given our growing understanding about the spectrum nature of this condition, it stands to reason that could absolutely be the case.

So the question for me then becomes: Why risk it?

We know that alcohol has the very real potential to cause brain damage for a developing fetus and cause cognitive and behavioral issues. In many cases, that brain damage can actually be seen as lesions on the brain in scans of children with more severe cases. There are also other physical conditions related to drinking during pregnancy, including heart defects, immune problems, renal damage and cleft lip or palates.

No one would say moderation with crack cocaine during pregnancy was acceptable, but the irony there is that recent research is actually pointing to the cause of damage, previously being attributed to crack cocaine use during pregnancy, as actually being caused by concurrent alcohol consumption (among other factors). In fact, there is not a single other recreational drug that has been found to be as damaging to the developing brain as alcohol.

So why play roulette with how much might be safe during the course of a pregnancy, when you wouldn't do the same with any other (potentially far less harmful) recreational drug?

We're talking about a substance that has been proven to cause brain damage to a developing fetus, with pros that really don't extend beyond "I like the taste of it" or "it helps me relax."

The truth is, some of my strong feelings on this subject likely come from the fact that I was never able to personally conceive. Despite doing everything "right," my body just wouldn't cooperate. So in my head, I have always struggled with the knowledge that I would have done everything "right" to protect my child during a pregnancy as well—only I didn't get the chance. And that makes it harder to see children struggling with a condition that could have been prevented so easily. It just seems so unnecessary to me.

I know that I wouldn't have been perfect. For one, I probably would have succumbed to poor eating more than I would have wanted to admit. But with most every decision I ever make, even now, finally as a parent through adoption, I do a risk/benefit analysis. No, I don't map it all out on paper, but I do think about what the potential risks are and whether or not the benefits outweigh those risks. This has been true of every major parenting decision I have ever made—and I am even usually pretty good about recognizing that in most of these decisions, other parents may have a different way of evaluating and weighing those risks and benefits, causing them to come to different conclusions. But with this, I just struggle to understand how the benefit of that one occasional drink might be worth the risk of causing even the slightest damage to that little, developing brain.

Consequently, I am also foster care-certified in the state of Alaska. And because this is such a big issue up here, one of the things drilled into our heads during the certification process was being aware of the signs of FASD.

A young woman came to talk to our class one night, a former foster child who was now a grown adult. She talked about her own struggle with FASD; how it inhibited her ability to process emotions appropriately, often leading to extreme rages all throughout her teen years and periods where she honestly wondered if she was crazy because she didn't feel in control of her emotions at all. What she described was so much more extreme than typical teenage angst. She talked about her troubles focusing in school and picking up on basic social cues. And she discussed how being diagnosed with FASD helped her to finally understand what was going on, but didn't work as a magic cure all for her struggles—struggles she was still working with therapeutic teams to find appropriate coping mechanisms for.

She was a beautiful girl, without any of the facial markers typically associated with FAS. And she was working as an advocate for foster youth in Alaska. But she was also up front and honest about how her birth mother's drinking during her pregnancy had negatively affected her for her entire life, maybe even more so because it was on such a level that she looked "normal," making it harder for those around her to understand the struggles she faced.

I tend to be fairly neutral with most mommy-war topics. My philosophy is do your research and make the decisions that are right for you and your family. So I've asked myself before why this is one I feel so much more strongly about. And I suppose it just comes down to the fact that none of those other mommy war topics carry with them the risk of brain damage. Formula versus breastfeeding; working versus staying home; even extended rear-facing: These are all issues with pretty balanced pros and cons on either side.

But with alcohol, we're talking about a substance that has been proven to cause brain damage to a developing fetus, with pros that really don't extend beyond, "I like the taste of it" or "it helps me relax." While I understand both (I am absolutely a girl who enjoys her wine), I struggle to understand how either might be worth the risk of even minimal damage to a developing baby. When for somebody who isn't an addict, it should be simple enough to just forgo that occasional drink for the relatively short time period of a pregnancy.

I do understand how this topic can become heated. No one ever wants to be accused of doing something that could harm their child—and I truly don't believe that those consuming the occasional drink during pregnancy think for one second that they could be harming their child. This isn't about shaming or judging those moms. It's more about bringing the potential risks to light and starting a conversation that might have those who aren't as informed to think twice before reaching for that mid-pregnancy drink.

Ultimately, people are going to make their own choices—and I do respect that. If you come to the conclusion that moderation with drinking during pregnancy is a risk you are willing to take, I'm willing to trust your judgment; after all, it is your body and your baby. But just do your research, and know that every major medical organization recommends abstaining for those nine months.

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Because there is no known safe amount of alcohol to drink during pregnancy.

Had I ever been able to get pregnant, that would have counted for something with me. And maybe that's why I'm glad these PSAs are coming out now; if only because they are bringing to light an issue I'm not sure everyone is even aware of.

And perhaps that awareness will actually make a difference for at least a few little ones who have yet to be conceived.

Image via Twenty20/kdecurtis

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