In her book, Conceiving Risk, Bearing Responsibility, Elizabeth Armstrong explains that FAS is not just related to alcohol intake, but is “highly correlated with smoking, poverty, malnutrition, high parity [i.e., having lots of children], and advanced maternal age” (p. 6). Further, there appears to be a genetic component. Some fetuses may be more vulnerable than others due to different ways that bodies breakdown ethanol, a characteristic that may be inherited. (This may also explain why one fraternal twin is affected, but not the other.)Exhorting women to avoid alcohol during pregnancy won't do much to reduce the incidence of FAS, and it's least likely to reach the women who are most vulnerable because they are more likely to be addicted. When "exhorting" turns into "shaming and blaming", we move beyond ineffective and into pernicious; it's one more noise in the cacophony of sound bites telling us that we are solely and completely responsible for our children, without any help from anyone, and nothing less than perfection is acceptable.
Tuesday, February 23, 2010
Back To Booze And Babies
~ by Jay
I wrote a three-part series about public-health measures that shame women for drinking during pregnancy. Turns out that drinking behavior is only one piece of the complex picture of causes for fetal alcohol syndrome - check out this post from Sociological Images.
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7 comments:
Sorry, I still can't buy into this. First of all, FAS isn't the only possible effect of drinking while pregnant. The truth is that doctors don't know what is "safe" about alcohol and pregnancy. They don't know what the effects are of even a "moderate" amount of alcohol on a fetus and its developing brain and organs. Secondly, it's alcohol. There is nothing necessary about alcohol. It's nine months of a woman's life. It's not a hardship to avoid anything for nine months. I don't see this as oppressive.
While I don't think shaming anyone for anything is effective, (like Mama) I also feel uncomfortable saying it's ok to drink during pregnancy.
An occasional drink is pleasant, but not a necessity. If it has become one, that's a problem. Any woman who has serious difficulties going 9 months without alcohol ought to look carefully at her relationship with drinking. I'm more concerned about that than anything else.
We do actually have decent evidence that a small amount of alcohol (one drink a week) has no effect on the brain of the developing fetus. I'm not saying it's a hardship to avoid alcohol. What I'm saying is that policing women's behavior as the sole public health approach to FAS - which it is - is missing the big picture. By a lot.
And yes, Mary, I agree that a woman who is drinking at at-risk levels and can't stop for nine months needs to examine her relationship with alcohol, but there's nothing about the current approach that will help her do that. I do not believe that shame is an effective tool for behavior change.
If I want a drink when pregnant, I'm sure as hell having one.
I'm so conflicted about this public health "no drinking" measure. I understand the good intentions...but it is a pretty good example of dishonesty for paternalistic motives in medicine.
I don't consider the recommendations that I have mammograms at a certain age a paternalistic measure...I consider them a reasonable recommendation from the medical community based upon existing evidence on the detection of possible breast cancers. My breasts are my own, and I want the best for them. I chose to care for them.
My child is "my child" and if it is recommended that I refrain from drinking (smoking, taking drugs, standing behind city buses spewing toxic fumes), then I am following the recommendations of the medical/scientific community so that I may provide the best care for my body during pregnancy.
This is zip to do with gender politics, in my opinion. I am using the best available knowledge to provide the best possible care for my family.
If only strangers felt the same readiness to intervene on behalf of an in utero baby when its mother is being beaten (ie. the frequency of domestic violence is much higher for pregnant women than for non-pregnant women), going without enough food, or being forced to live in highly polluted neighborhoods.
Alas, drive-by concern for a baby's health is not so eagerly pursued when it does not also involve controlling women's bodies.
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