This coincides with our society's attitudes towards pregnant women, in which they are treated more as an incubator with legs than as a full human being.

Pregnancy causes a woman to lose a portion of her person hood.

(For reference, I am a woman, a sober alcoholic, and a feminist.)

I fail to see how this constitutes "social control" of women -- alcohol consumption may not be the SOLE factor in FAS, but is a significant one. What harm is there, then, in warning women not to drink or smoke during pregnancy? That's not oppression, that's common sense.

I've known people who said that when they were in their mothers' bellies, their moms drank and smoke plenty. They turned out to be fine.

It is a logical failure to write

"drinking during pregnancy does not appear to be a sufficient cause of FAS, even if it is a necessary cause"

only to write a few sentences later that

"To sum, drinking alcohol during pregnancy appears to contribute to FAS, but it by no means causes FAS."

If X is a necessary cause of Y, then how can you say that X "by no means causes" Y? Only if you think of a cause as something that produces an effect 100% of the time - but a such a model of causation is inappropriate for any science outside of physics and chemistry.

If X raises the probability of Y (but not through spurious correlations), then X is a cause of Y. And if drinking during pregnancy increases my chances of having a FAS child by just 1%, then I'd want that into factor into my decision whether or not to drink.

It would appear that the efforts to prevent FAS are indeed too narrow. But they are focused on the controllable aspects. A woman can choose not to drink; it's a heck of a lot harder for a woman to choose not to be socially deprived.

The public-health efforts, therefore, are a band-aid, not going after every cause; but when you're actively bleeding, sometimes a band-aid helps a lot!

Fix the system -- but don't throw the baby out with the bathwater.

This is called "second-hand smoking" of alcohol during pregnancy. To "second-hand smoke" a behavior is when you marshal massive social support distort the harm of a behavior or substance far beyond all scientific evidence. Is second-hand smoking bad for you? Absolutely. In the quantities most of us have historically faced it? Absolutely not. Is drinking while pregnant bad for the child? Of course. Is having one drink a week, for instance, going to give your baby FAS? Science says no.

I'm sorry, but this entire argument is flawed. Seriously, seriously flawed. To recieve a diagnosis of FAS requires facial features (thin upper lip, low set ears, wide set eyes and a few other ones). These abnormalities are caused by exposure to alcohol during a very short time span during the pregnancy. However, drinking may cause a wide range of FASDs (Fetal Alcohol Specturm Disorders) which do not include those facial features, including pFAS (partial FAS), FAE (Fetal Alcohol Effects) or ARND (Alcohol-Related Neurodevelopmental Disorder).

Mental retardation is associated with, but not a symptom of, FASDs. In fact, it is considered a "protective" trait and is associated with better outcomes. Neurological symptoms of FASDs include lack of impulse control, high distractability, and difficulty with cause and effects thinking and abstract thinking. You can have a FASD and be of average, or even above average, intellegence.

FASDs are a gradient. While the full FAS diagnosis may be found mainly among alcoholic mothers, that does not mean that a lack of an FAS diagnosis means no damage has been done.

The problem goes further back than controlling women's behaviour during pregnancy, though. The whole way this illness/syndrome/disease (what is it, anyway?) is defined is to link a wide range of developmental and health problems to a single issue. It's like saying that children who die in car crashes are victims of "maternal driving syndrome", where the reality could be any number of complex scenarios like car seat failure, break failure, other drivers, whatever. Just because the mother is doing somethign while the problem occurs doesn't mean that she has a leading causal part to play. It's a manufactured disease, like female hysteria in the 19th entury was: despite the fact that the symptoms are all real, it's not a given that they all stem from the same cause which is also conveniently a female failing.

If somebody suddenly discovers the gene(s) that make fetuses more susceptible to this collection of damages, and the whole thing gets renamed "SmithJones Syndrome" and is treated as a genetic condition, then two things will happen: 1) all sorts of diagnoses from strict teetotalling families will start cropping up from where they'd been ignored or misdiagnosed before due to the crucial component (maternal drinking) being absent, and 2) the moral dimension to the mothers' behaviour will have lost its bite. Of course from the babies' point of view this will hardly have been an improvement, since all the other implicated contributing factors (poverty, stress, deprivation) will still go by the wayside. Easier to deal with neat ireducible causes.

I remember looking into this when I was pregnant. The statistic at that time was 10% of babies born to alcoholic mothers who were heavy drinkers. There was no information available on babies of women who had 2 glasses of wine during their pregnancy (one at Thanksgiving and one at Xmas). I decided that it was okay for me to have those 2 glasses of wine, which I didn't even finish; it was more the idea of it, what? Or any information available on any level of drinking other than the heavy drinking alcoholics.

So based on my experience, the campaign isn't very effective if the desired result is zero alcohol consumption in pregnant women. I was much more concerned about 2nd hand smoke and fumes from gasoline.

I find it very interesting that one of the statistically correlated risks is poverty. Perhaps we should be telling poor people not to reproduce. The same is true for advanced maternal age, which does get negative feedback.

When I read this post I thought, wow, this is going to push some buttons and I'm so glad you posted this. FAS = alcoholic mother is another one of those quasi-medical tropes that people like to believe with their whole hearts, without ever having seen the actual statistics. I first heard about FAS in the 80's in relation to problems in American Indian communities and what you're describing here is just like the patronizing, pitying attitudes at the time toward those mothers. In mainstream media, there was never any analysis or description of the nutrition issues, poverty, or social deprivation of those women, it was conveyed simply that they were alcoholics who were killing their children. You know, because it fit so nicely with the dominant view of American Indians and alcohol, as well as the other dominant view that women are to blame for anything that goes wrong for babies.

Sigh, has anyone considered that there are other cultures that actually promote some midway of drinking moderately? Like the French for instance? Also, I think it's kind of sad that when a child is born with some 'thing' it is considered a deficiency, it allows no room for the child to just be. As if society rules them out as being unnecessary products and that their contribution and existence is completely and wholesomely useless. So what if the child has a 'thing' does it need to be judged as something outside of social norms?

The reasons for poor birth outcomes are complex, so maybe breaking it down into chewable parts is a strategic move on the part of public health. Several generations of women's fertility will come and go while we're waiting for structural changes to happen. In the meantime, there are a list of things individual women can do before they get pregnant to counter balance the system that works against them. Here's what I've already written about this: http://heatherleila3.blogspot.com/2009/11/preconception-counseling-where-feminism.html

They can eat better, if they can't eat better they can take folic acid (present in almost all of our cereals and bread now), they can get immunized, they can quit smoking. It goes on. With alcohol, we can't know who is genetically susceptible to FAS and who isn't, just like we don't know why some kids turn out great even though their mom smoked while pregnant and some didn't. Why do some smokers live to be 98 and other die of cancer in their 50's? We can't know, so it's easier to cast the net wide, make health suggestions for everyone that are easy to digest. Zero alcohol while pregnant is easier to understand than 2-3 glasses starting in a certain week of pregnancy, not more than a certain amount of oz. each....

No, women are not incubators, but we are in a position not awarded to men - we do house the next generation in our bodies and what we do to our bodies, however much they are ours, matters.

Compare drinking while pregnant to drinking while driving. In both cases the chance something bad happening is quite low, but if something bad happens it is really bad. There are very different laws about them (drunk driving: illegal, drunk pregnancy: legal) but culturally we react similarly. In both cases the standard response to seeing driving/pregnant people drink is shock at the level of irresponsibility.

To extend the drinking/driving analogy over to the necessary/sufficient cause argument:

Not wearing a seat-belt is a necessary cause to being thrown out of the windshield in a car crash (barring unpredictable factors like the material breaking). It's not sufficient cause; other factors include speed, angle of impact, type of car, brake conditions, etc. However, it's a heck of a lot easier, and a heck of a lot more effective, to tell people to wear seatbelts than it is to get them to obey speed limits, buy safe cars, maintain those cars, etc. The cheapest, easiest, and most effective way is to just make everyone buckle up. Additionally, seatbelts have significantly more downsides than not drinking, as they can actual decrease survival rates in some types of crashes, or when worn incorrectly. Would anyone argue that encouraging seat belt use is a bad thing?

The article seemed to me to be addressing a point while surrounded by two large confounding problems (both of which were addressed independently by others above, but which I will reiterate here because I can't seem to reply directly for some reason).

The first one is the definition of "syndrome" is a lumping definition. Many times it seems that a syndrome is categorized based on how they are expressed and seem to be caused. Others include diabetes, cancer, and autism. These are good at describing outward similarities, but of mixed use in describing their cause or underlying mechanisms.

The second problem is the role of institutions. Looking above, except for the National Organization on Fetal Alcohol Syndrome, the rest seem to be governmental or semi-governmental organizations that are related to the "health" sector. The traditional role of the CDC was disease control. Note to editor: Only recently did it add "and Prevention" to its name (although not to their acronym). Their role has been related to the prevention of disease through science-based medicine, and not through lifestyle change. While they are really good at addressing problems of emergent vector-based pathogens, they fall down when disease control (or prevention) requires massive social change (or "social engineering" or "big brother government") not only because (imho) they don't have lots of people specialized in this area, but also haven't felt it to be very important. If you go to their webpage, under "Health & Safety Topics" (how very OSHA sounding), there are eight categories, three dealing with vector-based diseases, three dealing with prevention of bodily harm, one with health concerns for different population segments (both control and prevention of disease and bodily harm), and only one dealing (apparently) only with prevention. Still, though, there's a lot more under "Workplace Safety & Health" than "Healthy Living" -- mainly (again, imho) because there are so many more laws (and medical-scientific examination) about workplace safety and health. CDC seems to be "typical" in terms of how government (at least in the US) approaches the topic of health: disease control based on scientific investigation, which is itself based in a medicine/physiology approach rather than a social-change approach.

Put together, and this is more like a damning proposition to the methodology of the United States' premier public health administration, since the fundamental starting point of the CDC is medical science (i.e., physiology not sociology) based approach (in which the mother is the only controllable variable, and therefore the only important variable to consider) that is used to try and tackle a symptom that may well be caused by an interaction of many underlying causes (as the author points out), but to which they are methodologically and philosophically blind.

Furthermore, moving away from this (admittedly perverse) approach advocates for a direction of change that is unlikely to win a lot of popular sentiment among a populace that is more willing to marry the images of woman-as-mother to the puritanical image of alcohol-is-evil.

This is a pretty fascinating discussion - I'm more on the side of thinking there is way too much pressure on pregnant women to be a certain ideal (Don't drink! Don't smoke! Don't lift anything! Eat your vitamins! Don't eat fish or cheese! Don't dye your hair! Don't work too hard! Be perfect!) and I think the statement that "no amount of alcohol is safe" is utterly ridiculous, because many doctors will tell you a glass of wine a day (and, thus, almost 300 glasses throughout the pregnancy) is just fine. I agree that public education about this condition is important too, though; the problem isn't the effort, it's the tone and the target. While educating pregnant women is a noble cause, scaring them and providing them with a "just say no" directive reminiscent of anti-drug commercials is wrong and ineffective.

What I'm most interested in, though, is something different entirely; the "Best Start" advertisement says "My family wanted me to be as healthy as possible" and then states "My mother didn't drink..." etc. The ad seems to completely equate mothers with families; doesn't anyone else find that interesting? The family wants the best for the kid and so the mother acts on that decision. The mother is the family, personified; or, maybe, the mother is simply being used to carry out the family's decisions. Who is the "family" here? Is it a democratic institution that collectively decides how much the mother may drink, meaning the fetus's father, grandparents and siblings can have as much say over her pregnancy as the mother herself? Or is the mother simply so ingrained in our culture as a figure who thinks of her family first that the terms can be used completely interchangeably?

(I'm being facetious here, I don't actually think the ad agency went to any lengths to make some statement about women's role in the family; I just wanted to point this out because I'm a bit of a word buff and I like to analyze unintended but very real motivations and implications of certain word choices.)

Couldnt help but notice the fetus/embryo = baby attitude.

I have a question. Would you see it differently if these ads were about the dangers of, say, crack cocaine and prenatal exposure?

Speaking of which...

This story has been in a number of Canadian newspapers.

Should women who deliver FAS children be sterilized?

I'm reminded of a case that was in the local news one of the times I lived in Manitoba. A pregnant woman was put into custody at the request of social services. She was a glue sniffer and had already given birth to babies damaged by her addiction, all of which became wards of the state, all of which were so badly damaged, they would never lead normal, productive lives - and cost the state huge amounts of money to support, since the mother was incapable of doing so. Her social workers wanted to have her kept in custody, where she could recieve treatment for her addiction, health care for her pregnancy, and hopefully give birth to a healthy child, at which point she would have been released. (There was more to it than that, but I'm going by memory of something that happened quite a long time ago.) I don't recall that the mother was particularly against the idea, either. Still, it was taken to court as a human rights issue and it was determined the state had no right to force her into treatment to protect her fetus. Issues of race were brought up, since she was Native.

I don't know that anyone ever followed up on how the child turned out, or if the mother was able to battle her addiction outside of custody.

I don't see anything wrong with warning people about the dangers of heavy drinking while pregnant, because if it can increase the chances of harm, it should be prevented. What I dislike about these adverts however is the 'all-or-nothing' approach: If you have one drink you are a terrible selfish woman and will damage your future child!

This article came out a while ago on the BBC, I remember reading it so dug it up:
http://news.bbc.co.uk/1/hi/health/7699579.stm
It doesn't focus on foetal alcohol syndrome specifically, but reported a study which suggested that light drinking during pregnancy did not increase the occurence of 'behavioural problems and cognitive defects' in children (1-2 drinks per week). It also had an interesting point on how social advantage can greatly affect the correlation between drinking and the child's development (for example they found boys born to light drinkers were 40% less likely to have conduct problems and 30% less likely to be hyperactive than those whose mothers had abstained, but light drinkers were more likely to be wealthier, more educated, and smoked less than abstainers...)

I don't know enough of the data to comment on it, how valid it is, but what I do not like is this approach:
'..Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said: "We are concerned that the findings from the UCL study may lull women into a false sense of security and give them the green light that there is no problem with drinking during pregnancy. This is not the case. So-called 'heavy' and 'moderate' drinking harm the unborn baby. Very light drinking may or may not. The BMA believes the simplest and safest advice is for women not to drink alcohol during pregnancy."'

It seems like the attitude is: we have no evidence that light drinking does harm, but if we say 1-2 drinks per week is ok, these women are not responsible enough to deal with that information and will be drinking like fish!! And that is what bothers me about these adverts in this post.

Reminds me of Samantha Burton's case, in which she was imprisoned in a hospital and became, as her lawyer David Abrams described, “nothing more than a fetal incubator owned by the state of Florida.”

http://www.tampabay.com/opinion/editorials/florida-trampled-womans-rights/1070816

Sometimes I wonder how any woman over the last however many thousands of years ever managed to have a healthy baby. You know, before they knew about the perils of drinking alcohol, or eating soft cheese, or not taking folate supplements, or lifting heavy weights, or drinking coffee. My own personal view is that pregnant women don't need to be wrapped up in cotton wool. It's important to look after yourself while you are pregnant - much like any other time of your life. But we are provided with so much information about how to look after yourself that sometimes I think we take it all too far and even misunderstand the information.
The thing that makes me laugh the most is women who are worried they might have harmed their baby because they ate some ham, or some camembert, even though the reason to avoid those things is to avoid a particular (rare) bacteria that can have horrible effects on the baby, not because there is something about those foods that is harmful.

I'd like to point out that babies can't get FAS without a mother who drank alcohol. Yes, there are factors that influence the chances of a mother who drinks, but there is zero chance with a mother who doesn't drink. And since there's no reason that anyone needs to drink, I'd say there is no acceptable risk level for FAS.

Since alcohol is the mechanism by which babies are born with FAS, it is accurate to say that alcohol causes FAS. There are factors to determine the risk a child is at, but without alcohol, there is 0 risk.

These advertising campaigns state two facts: one is that alcohol in pregnancy causes Fetal Alcohol Syndrome. This is true. Those mothers who don't drink will not get fetal alochol syndrome. The second is that we [the medical profession] don't know what level of alcohol is safe in pregnancy. We simply do not have that data. If we recommended a level of alcohol to a pregnant women, and we were subsequently shown to be wrong, we'd be liable.

We don't know which mothers will have babies affected by FAS, so we have to recommend no alcohol to everyone. When there's a genetic marker identified for women who are at risk of developing FAS, we can start making targeted recommendations.

Maternity and public health professionals do not exist to control the behaviour of pregnant women, and the isolated behaviour of the few who promote legislation to defend fetal wellbeing at the expense of maternal rights are not representative of the main body of professional thought. Also, the standard of antenatal care in America cannot be held up as an example of how everything else works elsewhere.

Good maternity professionals care deeply about the health of the women they care for. It is heartbreaking for us to see women fall ill, die or end up with a bad outcome of their pregnancy. Ultimately, we respect the right of women to choose their course of action during pregnancy, but we cannot stand idle at the roadside witholding information that may make a difference to the outcome.

If heavy drinking of alcohol by men hurt unborn dolphins and baby seals, most commenters here would be totally against such drinking and would support ads demonizing heavy drinking by men. But somehow, because the subject is women and human babies, many commenters seem to hardly care about the outcome of heavy drinking while pregnant.

Correct me if I'm wrong, but social inequality doesn't cause diseases. It forces people into conditions that are not easily surmounted such that they are more susceptible to disease and risk factors, but it is fallacious to say that social inequality is linked via causation with FAS.

It's also irresponsible! Correlations are not the same as causations! If there are scientific, peer-reviewed, blinded, random studies done that state that FAS is correlated with poverty, malnutrition, stress, addiction, etc., then that means that in cases where those risk factors are present, FAS MAY OCCUR AT HIGHER RATES. It doesn't mean that one causes the other. Period. And thus, it is incorrect to conclude that the current strategy of putting the burden of fetal health squarely on the mother is in any way flawed BASED ON THESE CONCLUSIONS.

Conversely, because these studies represent a sample of processed scientific data, it is also incorrect to assume that a mother's actions are entirely responsible for the health of her fetus. The assumption made in these ads is that all mothers have the time and money to do everything exactly by the book in regards to fetal health. That assumption is discriminatory and makes invisible the plight of a huge percentage of pregnant women.

BUT. Be that as it may, watch out for those logical fallacies. A much better argument is made by maintaining the rigor of the scientific process throughout a sociological analysis when statistical data is being used as evidence.

"Reckless" women who miscarry will soon be able to be prosecuted in Utah. We'll have lots of opportunities to debate correlation and causation with those cases.

Among all these comments I did not see the one that I wanted to see and it relates to the fact that the results for the percentage of children who have FASD is absolutely skewed by quite a few things.

A diagnosis of FASD does *not* require a physical defect in association and saying so simply encourages discrimination against people who have those facial features. A diagnosis can come from trouble adjusting to change (being extremely distraught by change), light and sound sensitivities, memory trouble and interpretation problems that result in what can be categorized as a 'behaviour problem'. The vast overwhelming majority of people with FASD do NOT have a physical defect.

Fetal Alcohol Spectrum Disorder is called that because it is a spectrum, it has a range of effects and a person who has FASD might only be plagued by an extreme sensitivity to light. They might display all symptoms a little, or they may display one or two or more very strongly and others not at all. That's the nature of a spectrum disorder.

Not all women who drink while pregnant have children that display the WORST symptoms. Alcohol is a small molecule and will pass through the placenta, there IS NO KNOWN safe level of alcohol to drink while pregnant, there has been no study based around how much alcohol will give your child a certain level of severity of symptoms because that would be wildly unethical. It is postulated that there it is best to completely avoid alcohol while pregnant as a precaution because even infrequent drinkers can have a child that displays light symptoms. My partner is one of those people. He displays all symptoms of FASD a very little bit, and though they cause him trouble it is manageable trouble.

The reason why the numbers of women who have children with FASD is skewed and will never be able to be trusted is because there are two categories of children who have FASD bad enough to receive any kind of diagnosis. (This does NOT include the children who have FASD that are not effected badly enough to be noticeable to teachers and parents.) The two types of child are usually First Nations and other minority children whose mothers are put under extreme pressure to confess drinking while pregnant and often do, resulting in a diagnosis of FASD. The second type of child that has FASD badly enough to receive a kind of diagnosis is the child who is diagnosed with ADD and ADHD. This child is usually Caucasian and their mother is often not pressured to confess to drinking while pregnant. My mother-in-law is a key worker for FASD and yes, she used to be an alcoholic. She sees it time and time again, especially on Vancouver Island where we have a large native community that is highly discriminated against.

The diagnosis of FASD usually hinges on the confession of the mother. Again, NOT a physical attribute. And Caucasian women are never put under the same kind of pressure that minority women are put under, and even when they are asked they will usually deny it until the cows come home.

There are thousands, if not hundreds of thousands of children, and men and women running around with ADD and ADHD diagnoses. This excludes the children that are diagnosed with ADD and ADHD because they are exuberant or intelligent or otherwise hard to handle and this excludes the children and adults who legitimately DO have ADD and ADHD.

In the same way that straight men and women who don't do intravenous drugs are diagnosed very late for AIDS (this is changing though thank god) because up until very recently HIV seemed to be considered impossible to contract unless you were engaging in some kind of 'risky' behaviour. Caucasian children with FASD are not considered for a diagnosis of FASD because FASD is a 'Native's disorder' here.

Now, I'm not quite sure what other people's experiences of FASD are in other parts of the country, or in the United States, but on Vancouver Island, the diagnosis of FASD is highly racialized and it isn't because Caucasian women don't drink while they're pregnant.

The other point I'd like to make is that there seems to be no talk of what fathers can do. There is a HUGE degree of social control in FASD, and it falls almost solely on the shoulders of a pregnant woman who is expected to simply stop drinking, I skimmed the comments but I didn't see anyone talking about how social circles and fathers hold some of the blame for not providing an environment in which a woman can be anything but a social pariah if she isn't drinking. While ultimately it is a woman's responsibility to monitor what goes into her mouth, it can be very tempting to have 'just one drink' when no one around you stops drinking.

There are many social circles and relationships that are based around alcohol and simply telling women to stop drinking is the crux of this issue. The subject of social control is the one who receives punishment in the form of shame and disapproval when there are more factors that can be addressed in the 'blame game' than just the pregnant woman.

I had/have no problem not consuming alcohol while trying to conceive, while pregnant, and during our (so far)18 months of breastfeeding.. My partner also abstained from drinking for a long period before we conceived, because we were aware that it can mutate sperm. I know a lot of children/adults that are affected by FAS, and there's no way that I would risk that happening to my child. Just because it doesn't happen every time doesn't make the risk acceptable. And I personally think that it is the worst form of child abuse. You're supposed to be giving your child the best possible start in life. Not gambling with their future just because you feel like consuming alcohol. Fucking hell, people really make me sick.

You're confusing a great many things in this post. Others may have already pointed these things out, and if they have, I apologise for repetition.

FAS (fetal alcohol syndrome) falls on a spectrum of disorders related to prenatal exposure to alcohol, hence it is a subset of fetal alcohol spectrum disorders (FASDs). Alcohol is the *only* cause; there are certainly risk factors associated with the likelihood of having a child that experiences an FASD, but those risk factors are *not* causes. FAS is partly defined by a set of facial features that only present if the exposure occurs during a very narrow window of time - between the days 19 and 21 of pregnancy - and they may not even know they are pregnant at the time! Outside of that window these facial features are less likely to occur, but damage to the central nervous system is still possible. Indeed, most of the effects of prenatal alcohol exposure appear in the central nervous system: problems with executive functioning, cognition, motor function, and social skills. Lack of recognition of these problems, and often because these individuals look 'normal' (i.e., they don't appear to have any physical effects of prenatal alcohol exposure) they experience a disproportionately high rate of secondary disabilities over the course of their lives.

The unfortunate fact is that there are are a variety of factors that appear to contribute to how affected a particular individual will be to prenatal alcohol exposure - the mother's ability to metabolize alcohol, the timing and amount of exposure, the embryo or fetus' genetic makeup, the age of the mother, her BMI, whether she ate with or prior to consuming alcohol just to name a few. It is not only heavy, consistent drinkers that have a higher risk of having a child affected by prenatal alcohol exposure; women who occasionally binge drink are also at higher risk. Given this, the only safe message is that if you are sexually active and not using contraception, or you are pregnant, don't drink alcohol. That first part *goes for men as well*, since women are more likely to drink alcohol if those in their social circle are also drinking.

Yes, there are a variety of social and cultural elements that surround alcohol consumption, especially alcohol consumption by women (issues of control, issues of women's rights, a woman's right to control her own body), and we need to be aware of and fight to change some of these attitudes. I fully support a woman's right to do whatever she wants with her body (it's hers, first and foremost), and nor am I anti-alcohol. Research shows that women who are educated about the risks are more likely to cut back on or halt their alcohol consumption. The public health message of no alcohol while pregnant is one that is designed to speak to *all* women, to make them aware of the risk. No woman ever sets out to intentionally harm their children by consuming alcohol while they are pregnant, not even those who experience addictions. This message is not about the social control of women, but about preventing the range of disabilities that have been shown to be associated with prenatal alcohol exposure and that therefore prevent individuals from experiencing their full potential.

This is perhaps the most thoughtful and impressive discussion I've read on the web. Ever. Thank you.

it disgusts me when i see people complaining or not taking heed to concerns that drinking and smoking can harm or are dangerous to fetus. you know why these people get pissed off when they're told not to drink or smoke while pregnant coz they're guilty of it and they just don't wanna keep on remembering they're guilt and the fact that they don't have self control and are just selfish... honestly i don't see anything wrong at all just staying away from smoking and drinking and much worse taking illegal drugs while pregnant.. people who are pregnant don't become a public property, you're soo soo soo wrong about that... doctors and other people concern just wanted to let every pregnant person know about the dangers in drinking and smoking while pregnant... those fetuses are totally fragile.. and weak, unable to protect himself or herself when his or her selfish mother feeds him or her, her personal, selfish satisfactions.. !

You apparently are not well-informed of science. Alcohol does harm the developing fetus and since women are the only gender capable of carrying a developing fetus, it is the choice they make to drink when pregnant that does cause fetal alcohol spectrum disorders.

My husband and I adopted a little boy from Ukraine who is exceptionally bright, but pays the price every day of his life for the fact that his birth mother didn't know or care about the damage drinking alcohol could cause. He is hearing impaired, processes information extremely slowly (I've heard it described as processing information at a 10 second rate in a 1 second world), has extreme challenges in understanding the complexities of social interaction and making and keeping friends, has trouble understanding and controlling his feelings and gets sooo frustrated that anyone with a heart who got to know him would NEVER drink a drop during pregnancy. An MRI clearly shows the damage to his developing brain. He tries ten times as hard as any typical child to learn half as much and all because of alcohol. I suggest you talk with adoptive moms about their children effected by alcohol and you will have a very different attitude about whether drinking during pregnancy is really worth the risk. Our son is lucky; he is continuing to learn in spite of the brain damage. Others aren't so lucky; they are severely retarded and can never be independent. They didn't have a choice; their drinking birth mothers did.

I don't care if it's one sip, 2 sips, one drink or 3 drinks, women should not have any alcohol at all during their entire pregnancy, why in the hell would you even want to take a chance, my god if you vant though 9 or 10 months without a drink then you have a problem, this is a life you are bringing into the world, a human being, wouldnt you think you would want take all the precaution you possible could to protect your baby, i dont care what the statistics show, how its ok when your further along and if its a one glass, bullshit you should not have one sip, whats wrong with you people? there are some full grown people who are 100, 110, 120 pounds and who can have one drink and smashed, can you imagine what that does to the unborn child?

Hmmm... well I think there is a fair bit of cultural input here as well... I'm quite certain the social stigma attached to a pregnant lady in north america enjoying a glass of wine at dinner... is either absent or somewhat less noticeable than in say France...

the other thing they fail to mention here is it would be immoral to truly test this... imagine bringing in the pregnant mothers and setting up the groups to consume alcohol at various volumes during the pregnancy against a control group... don't think so... not going to happen... so the precautionary principle applies... when in doubt err on the side of caution...

Alcohol doesn't cause FASD? Hmm... Here's the thing, you can drink alcohol and maybe your fetus will only have a few brain cells die--maybe so few that you don't know and there is no visible abnormality. Maybe. You'll just assume the ADD and chronic ear infections are unrelated, I guess.

But if you abstain from drinking, I can guarantee you that your child will not have an FASD. Period.

But if Merlot is worth the gamble, then that is your business--and eventually you're child's. But remember, it is a gamble, and you're playing with developing cells.

You are an idiot.

You must be out of your mind.  Alcohol is a toxin.  Would you drink paint thinner while you were pregnant?  Alcoholics will go to great lengths to continue drinking for 9 months.  I would love to be there when you explain to your child that you took 20 pts off his IQ because you thought not drinking while pregnant was some sort of plot.

Many children w/FASD (it is a spectrum) have Autism dx to get services. Surely you're aware of the epidemic of special-needs children. Many are under behavioral-health or mental-illness dx's that are common in families that drink alcohol regularly across all socio-economic levels. It likely plays into the massive increase of ADHD and explosive tantrums since those are core symptoms of FASD. 

Their social-emotional developmental age may be as much as 50% below their chronological age. Many of the immature, trantruming, oppositional-defiant, obsessive, highly impulsive kids were/are affected pre-natally by alcohol which is a teratogen. It causes static-encephalopathy in children that appear physically normal, most even have normal IQs. The social-emotional & learning gap usually increases as things become more abstract and expectations increase. 

You are unaware, if you believe this is not an increasing problem in the schools... and especially children in the foster, adoption and legal systems. You cannot measure lost IQ points (most have normal IQ's but don't do advanced math, have poor judgement & organizational skills), inability to control impulsivity, predict, understand cause & effect, which are "executive functions" damaged by prenatal alcohol. It also leads to unhealthy relationships, trouble with the law...multi-generational passing along fetal alcohol spectrum disorder, generation after generation. You protest too much. :) It is not a big deal to stop drinking for your babies' sake....unless you have a drinking problem. 

A recent article of note:

Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder Kelly J. Price & Kenna J. Miskelly
ETHICS & BEHAVIOR, 25(5), 418–426

Abstract: A diagnosis of Fetal Alcohol Spectrum Disorder (FASD) ascribes cause to developmental disability; however, there are logical issues in causation with ethical implications. This article focuses on the use of fallacious logic (affirming the consequent) in FASD, focusing on the Canadian Guidelines for diagnosis, and knowledge translation issues from science to practice. The clinician’s logical fallacy is an ethical issue of veracity in the clinician–patient relationship; this then leads to issues of nonmaleficence, because the diagnosis in turn blames the mother for her child’s difficulties. Suggestions for revised diagnostic practices that avoid allusions to causation and responsibility are discussed.

BUT it is also important to note they state (p. 424): "Prenatal alcohol exposure is clearly associated with changes in brain development. Public health efforts to curb alcohol use in pregnancy are absolutely critical."
I do think it's irresponsible to suggest alcohol use in pregnancy will not have harmful effects. It certainly can, and if you've worked with people diagnosed with FASD it is frankly heartbreaking to see their frustration with their limitations. We don't know the whole of the story, and to pretend otherwise is just as irresponsible as claiming any amount of alcohol will harm the fetus. Alcohol use in pregnancy can lead to severe mental impairments - it's those women whose choices are extremely limited that this message is most difficult to work with, and they are most likely to be blamed for any choice they make.

When I was an undergrad I did research for a paper on marijuana as a teratogen. I found an utter lack of accounting for covaribles similar to those listed in this article. Socio-economic, use of other substances, etc was not accounted for in any article that concluded pot is a danger. I found one study out of Jamaica that showed women smoking marijuana without the use of other drugs, and with educated middle-class women, this study did not find marijuana to be a teratogen.

The author doesn't seem to know what the definition of "necessary" is. When she asks if it's "necessary" everything she answers with are things that would also go in the "sufficient" category i.e. other contributing factors.

The question as to whether drinking during pregnancy is "necessary" to cause FAS is the question as to whether FAS occurs in women who do not drink. And it does not. Ergo, while drinking during pregnancy is not sufficient to cause FAS, it is, in fact, necessary.

You can argue that this is social control of mothers. Fine. But learn what the word "necessary" means. Thanks.

It appears to be the case that a large proportion of scientific research results are too general to implement any real change. I have tried several times to quit smoking for all the reasons research gave me. I buried my mother in law last week after she died from lung cancer. She never smoked in her entire life.

Nice one: taking the science out of social science! If you would like to say something cogent on this topic you might want to learn a little about statistics and epidemiological research.

"Very few women actually drink at the levels correlated with FAS."
Sure, because diagnosed FAS is at the most extreme end of the spectrum of outcomes from prenatal alcohol exposure. But if you look at the latest research you will find that alcohol consumption at the level of 3 to 6 drinks per week is strongly associated with detrimental neuropsychological outcomes for the child.

http://www.ncbi.nlm.nih.gov/pubmed/23905882
http://www.ncbi.nlm.nih.gov/pubmed/26190723

Are there any cases of children being born with FAS when no alcohol was consumed during pregnancy? If not, then I think it's still safe to say that alcohol consumption is a better predictor of FAS than socioeconomic or genetic factors.

How in the world could you write such an inaccurate article? I'm appalled at your ignorance and I'm so sorry for the women you will encourage to drink during pregnancy. So sad.

Can I briefly look at this from the point of view of my son. His life is forever tainted. He has a set of facial and physical features that are his till he dies. He also has huge problems processing language that is spoken to him. He can't understand humour and does not see consequences to his actions. This was ok when smaller but now he is 21. Never being able to do something and to learn from the consequences of it is a hugely disabling situation.
He cannot understand other people well. He didn't see that the man of his own age who he was introduced to was asking for his money because he wanted to take advantage of my son. My son thought this guy was his friend and was happy to pay him many hundreds of pounds from his savings.
He has tried to hold down jobs....needing much support from others to do so but in the end the social aspects to the job become so overwhelming for him that he becomes too anxious and depressed to continue.
He will never be independent enough to live alone in our society. I doubt that he will ever find a partner due to his lack of social awareness and understanding of people.
He isn't like other guys his age...he is more like a 10 year old.
He lives with the knowledge and the guilt of being different each and every day. But what he also lives with is a label that is not socially acceptable. He is ashamed to be open and honest about himself because doing so raises questions about me...people assume I was the cause of it. So to protect me from this he must constantly tell others that he's adopted.....a situation loaded with unimaginable emotions for him.
Just uttering the name of his condition, the one he tries so hard to live with, stigmatises him and his future life to a degree that we cannot fully comprehend.
Just saying he has fetal alcohol syndrome tells the world his life story.....

I am sad every day for my son.... and the future we must try to carve out for him so that when we are gone he can have a life of dignity and not fall foul of his disabilities and society.

It is the babies, the toddlers, the children, teenagers and adults that we must focus on.. NOT the rights of any woman to decide to consume an alcoholic drink or not.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104937/

I
found this article interesting because I have always believe drinking during
pregnancy is the cause of a child being born with an effect, I would have never
guess poverty, age, and the number of children has had plays a role in it. This
article is an eyes opening article for me, and the shocking new discover I have
learn from this article is the fact a pregnant women plays a very small role in
her delivering a child with effects, base upon her actions during the
pregnancy; now I am aware her DNA plays a big roles in it.

Although,
the change of a mother delivering a child with effect is 5% if drink during pregnancy,
I would never take the risk because let’s say, for instance, you do drink
during the pregnancy as the result the 5% goes against you and you give birth
to a child with Fetal Alcohol Syndrome. What would you say? And let’s say the child grows up and read an
article like this one and ask you mother what action of yours while caring me
contributes me being born like this?

Just an excuse for young ones to get out of any crimes they commit and no sympathy for the victim. We had a 18 and 19 year old both kill their new born babies and no charges laid against them because of their young age and no sympathy for the babies. They want to reduce the voting age. These people would be unable to vote if they are not in their alleged right minds.

Drink up ladies!!! Get drunk every night!! Your baby will be fine! If your baby has FAS it is a result of poverty. Give me a break!! Yes!! These women should be prosecuted! Same goes for crack users.

So you guys fight for the right to kill your babies? Nice.

I think this woman drank while pregnant! Why would this be called Fetal ALCOHOL Syndrome if it had nothing to do with alcohol, idiot!

An absurd article. To say that FAS is not caused by alcohol is like saying AIDS is not caused by HIV. True, HIV does not result in AIDS in all untreated patients, since some small percentage of the population is immune, just as some unknown percentage of the population may have an effective genetic defense against the harmful effects of exposure to alcohol in the womb. By the author's politically correct logic, should public health authorities refuse to warn people to avoid unsafe sex or the sharing of hypodermic needles?

Even though there is no established cure for the disease, the only time that the person with Peter Pan Syndrome is treated is when the individual shows willingness and awareness of their disorder.

http://syndromespedia.com/peter-pan-syndrome.html

I did not know I was pregnant for 6 months of my child life. I was still drinking everyday some months.😪😪😪😪😭. I regret everyday not paying attention to my body, but when you are intoxicated how can you,smh. My son has FAS, I have come to realize. I thought maybe because I was older he be Autistic but after reading more into it, this is the cause of my son behavior issues.

Oh great! That will let the most irresponsible brood on earth and perpetual victims, semi-educated Western women, off the hook now, even in THAT respect!

Don’t do it ladies! It is not worth the angst and suffering.
I drank low risk amounts while pregnant and I regret it every second of everyday. The stress and worry are all consuming that I can barely hold my baby from guilt, I cry everyday.

I must add they have been assessed and the likelihood of FASD is low but IMO its still to early to tell.

Look after your baby from the moment you plan to have them and you will never suffer the guilt.

I drank 3-4 ounces of red wine during my third trimester. I was assured by a professional that it was okay. Nine years later my daughter has been diagnosed with autism, adhd, and anxiety. I can’t describe the guilt and the stress this has caused. The thought that something I did had made her life as hard as it is sometimes is unbearable. Was it the alcohol? Maybe, maybe not. I will never know for sure and carry this guilt forever. It is not worth it! Do all you can to mitigate the risk so if God forbid something should happen you know you did your job as a parent to do all you could to have a healthy baby.

Understanding Fetal Alcohol Syndrome (FAS) has deepened my awareness of the challenges faced by convalescent home Long Beach affected families. The social control of mothers in this context often leads to stigma and isolation. It's crucial to advocate for support and education rather than blame, fostering a compassionate approach that prioritizes the well-being of both mothers and children.