It’s been 45 years since researchers revealed the risks of drinking during pregnancy. But as Vanessa Hrvatin reports, rates of Fetal Alcohol Spectrum Disorder are three times higher than previously…
It’s been 45 years since researchers revealed the risks of drinking during pregnancy. But as Vanessa Hrvatin reports, rates of Fetal Alcohol Spectrum Disorder are three times higher than previously believed — just as more women are drinking, and drinking more, than ever before. In the first of a three-part series, Postmedia’s Michelle Lang Fellow explores the challenges of eradicating one of the most common — preventable — developmental disorders and what’s at stake if we fail.
Knowlton considered giving up the baby, a second daughter. She even pursued a private adoption. “But once she was born and I saw her I thought, ‘I can’t do this, I need to take this baby home.’” Programs for FASD have improved since her daughter was born, says Knowlton. But the blaming and shaming that often come with talking openly about drinking during pregnancy have continued to have a profound impact: there is no national strategy for research and treatment, and provincial funding is a fraction of that for other brain-based disorders.
That’s triple previously reported rates, and means that FASD could affect more Canadians than autism and cerebral palsy combined. All of which raises urgent questions: We’ve known for more than 45 years that drinking during pregnancy is harmful — more harmful to a fetus than cannabis, crack or cocaine. Why haven’t we succeeded in eradicating FASD? And what needs to change if we can’t?Diagnosing a disorder with 1,000 facesHow a program in Winnipeg is rethinking the classroom for kids with FASDAdoptive parents in Smith Falls, Ont., on creative strategies for living with FASDHow two generations coped with a FASD diagnosis Dr.
At a time when alcohol was often prescribed for morning sickness and hospitals used ethanol drips to prevent early labour, the impact of drinking during pregnancy came as a shock to the medical community. The uterus itself had been considered a protective barrier until the “thalidomide babies” of the early 1960s.
It’s suspected that drinking is most detrimental during the first three to eight weeks of gestation — when cells are quickly dividing to form the baby’s organs — and during the third trimester, when the brain is rapidly developing and specific organ functions are being determined. “Too many physicians in this country still advise women that it’s okay to drink a little bit during pregnancy,” he says. “But what does it mean to drink a little bit? Or is that just an enabling statement that says, ‘Oh I really don’t have to change my lifestyle because I’m pregnant.’”
Presumably the agency was not prepared for the answers to that question: It was both impractical and insulting, wrote a reporter for Jezebel; it was “incredibly condescending,” according the Washington Post; “tone-deaf and paternalistic,” said Forbes of the C.D.C.’s advice. Some women no longer want to cede that power during pregnancy, either. In her provocative 2013 book, Expecting Better, economist Emily Oster argues that, while heavy drinking obviously poses a risk, there is no evidence an occasional glass of Pinot will harm a fetus. Doctors advise abstinence only because they don’t trust patients to stop at just one or two glasses.
Research on FASD may unintentionally reinforce the notion that wealthier women are somehow exempt from the disorder: it has mostly focused on the marginalized — poor women struggling with addiction. But eradicating a disorder is difficult if no one will talk about it and until attitudes shift, too many women will remain silent.
The reality is this: More than 70 per cent of women in Canada consume alcohol, and about 18 per cent of them are at risk for chronic substance use. The impact alcohol has on women’s health is greater than it is for men. Women metabolize alcohol differently, and are more vulnerable to addiction at lower levels. According to some studies, drinking may also bring increased rates of breast cancer and heart disease.
A new project launched by The Canada FASD Research Network aims to fill in some of the gaps in the science of FASD as well, including why some children exposed to alcohol in utero seem less affected than others. So far the team has collected data from more than 1,700 patients at diagnostic clinics across the country: About 65 per cent of them received an FASD diagnosis and 35 per cent didn’t.
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