"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.
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.
"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.
no data to back that claim up, why encourage patients to take the risk?
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
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
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
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.