My Turn: Clearing up misconceptions about fetal alcohol syndrome

Posted: Monday, October 18, 2004

H oping to get some good copy for this column, I recently conducted an informal survey of persons I met in the wharf mall about fetal alcohol syndrome.

I asked men and women whether they know anything about FAS (more often referred to now as FASD, fetal alcohol spectrum disorders); whether they think it is OK to drink any amount of alcohol during pregnancy; the percentage of American women whose pregnancies are unplanned; and whether or not they think that the male partner (if present) has any effect on whether or not the woman drinks during pregnancy.

I also asked if there was anything else they wanted to say on the subject.

For the most part, my encounters were pretty blasé: Everybody acknowledged having heard something about FASD; a couple of women didn't want to respond; and a pair of middle-aged women, presumably too old to get pregnant, declined to be interviewed, saying "We're way beyond that point." The question regarding the percentage of American women having unplanned pregnancies resulted in guesses ranging from 10 to 60 percent. (The correct answer is 50 percent.) Some women stop drinking once they know they are pregnant, which might mean one month or so of unwitting pre-natal exposure. One woman's parting comment was that women should never have unprotected sex unless they want to get pregnant, which would reduce the risk of a woman drinking without knowing she is pregnant, provided that she uses reliable contraception correctly.

A man made the alcohol-sex connection explicit by saying that the only way some women can have sex is by drinking alcohol. Whatever his exact meaning may be, it is certainly true that both persons often consume alcohol as a prelude to sex. And if the sex results in a pregnancy, both are culpable, not just the woman. The idea that sperm contributes genetically to the development of FASD is getting attention as a way of implicating the man. Although this is unproven, any attempt to spread responsibility for the problem onto men would be a good sign. It is problematic though, because the best news about FASD is that it is entirely preventable, and caused by prenatal exposure to alcohol, not defective sperm.

One solution is no drinking during pregnancy, and men can affect that. Nearly half of the survey respondents thought that the man influences whether the woman drinks, which is true. If the man drinks, the woman is more likely to. Conversely, if he does not, she is less likely to. That is one way that a man can help share the responsibility for preventing alcohol-related birth defects. Another way is for the man to use reliable contraception himself.

My favorite encounter was with a trio of smart, lively and engaging women from Manchester, England. While generally sympathetic, they weren't going to just let me have my way with them. They challenged my knowledge, the soundness of my logic, my sources, and the quality of the research backing up my claims. Their remarks reflect the fact that nearly half (40 percent) of the respondents stated that it is OK to drink moderately while pregnant. This perspective may derive from the experience of women who drank during pregnancy and had healthy kids (although some effects are invisible, such as learning disorders); from the false belief that one needs to be an alcoholic to be at risk; and from the fact that some medical doctors (20 percent of physicians polled in Alaska) still say it is OK to drink some alcohol during pregnancy.

The point that not all alcohol consumed by women during pregnancy results in babies being born with the symptoms of FASD is no consolation to the ones who are. Various factors may prevent it from affecting a given individual, but the danger is there, and the higher the level of consumption the greater the risk. When you consider the consequences of the damage done, it is easy to understand what is meant by "no safe level of consumption has been (medically) established." Considering the consequences, there is no acceptable level of risk. Both men and women need to work to prevent this, and if that means getting support, there is a wide variety of help available in this community.

• Paul McCarthy is an advocate in Healthy Change, a non-faith-based FASD prevention program at Catholic Community Service agency.



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