What a bad feminist. I quickly read the CDC’s newest Vital Signs report, Alcohol and Pregnancy, and I thought sure, right on. Because alcohol affects fetal brain development–and because half of pregnancies are unplanned–the CDC recommended that women of child-bearing age not drink alcohol unless they use contraception.

Seemed perfectly reasonable. Then my news feed erupted.

I was genuinely surprised. FASDs are prevalent, under-diagnosed, and irreversible. “Why take the risk?” asked the CDC, and I had to agree.

I sat down with a few women friends and asked them why the word from CDC got their goats. “Really rant at me,” I said.

They did a good job. They reminded me about inadequate insurance coverage for contraception. They pointed out that the CDC’s advice had entirely ignored their right to an abortion. And they felt the CDC was taking part in an ongoing sexist dialogue about women’s bodies. Remember “the female body has ways to shut that whole thing down“?

Yow. Of course. I started to see why people were put off.

But the same group of women that coached me into a new understanding also had very little knowledge of Fetal Alcohol Spectrum Disorders. Which is not a criticism of them. It’s indicative of a widespread knowledge gap that the CDC (and IRETA) has being trying to fill. And clearly, we still have a long way to go.

Information about FASDs is available on the CDC’s website. Here are just a few factoids:

  • As with autism, Fetal Alcohol Spectrum Disorders exist on a continuum, a spectrum. Some effects of maternal alcohol use are much more apparent than others.
  • The prevalence of FASDs has been estimated at 2-5% of the population.
  • Few professionals are trained to diagnose or treat FASDs.
  • Symptoms of FASDs are often misdiagnosed as ADHD or other behavioral disorders.
  • If your child has FASD, it is likely that no one will ever figure it out.

FASDs are irreversible

Here’s a baby with neonatal abstinence syndrome caused by maternal opiate use (that’s painkillers or heroin). This baby is all over the Internet, usually accompanied by harsh criticism of mothers who use drugs.

What this video doesn’t say is that the baby (if treated appropriately for withdrawal) will probably be fine! As with cocaine, opiates have not been shown to cause long-term irreversible damage to exposed fetuses.

On the other hand, this baby…

Portrait of a crawling baby

Or this baby…

happy young baby child sittng on grass on beautiful summer day in park

Or this baby…

…may struggle in many stages of life. Nobody will know why. Doctors and therapists won’t ask the child’s mom about prenatal alcohol use, especially in the weeks before she knew she was pregnant. In all likelihood, the child’s mom never received advice that her alcohol use might someday affect the health of her child. It won’t be anybody’s fault. It will be the result of a knowledge gap throughout society.

 

How Does IRETA Work to Prevent FASDs?

IRETA works with the University of Pittsburgh under a CDC grant called Improving FASD Prevention and Practice through National Partnerships, an effort to spread training and tools for FASD prevention to specific health professionals, including physician assistants, OB/GYNs, pediatricians, nurses, and family physicians. We are helping to create an online course called FASD 101 that will be available to health professionals and the general public.

More broadly, we work to promote the effective responses to at-risk substance use using the evidence-based practice SBIRT (which stands for Screening, Brief Intervention and Referral to Treatment). The implementation of SBIRT in primary care and OB/GYN settings can help reduce the incidence of FASDs.

 

At The End of the Day

At the end of the day, it is imperative that women be free to make decisions about their own bodies. I wouldn’t have it any other way.

Substance use is not something that we, as a culture, talk about particularly well. It hits a lot of nerves. Health professionals and members of the public need accurate information about substance use delivered without judgment. That way, our personal health decisions–and substance use and pregnancy are both so personal!–will be the best they can be.

 

More

Alcohol Affects Fetal Brain Development

The Media Makes a Mess Out of Alcohol and Pregnancy

Babies Aren’t ‘Born Addicted’ and Other Misconceptions About Drug Use in Pregnancy

SBIRT in Early Start Program: An Integrated Model of Substance Abuse Intervention for Pregnant Women