Fetal Alcohol Spectrum Disorders in MN: How Can We Do Better?

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I’m sad today for number of reasons. It’s my dad’s birthday; he would have been 87 years old. He died three years ago so it’s clear he had a long life and those of us who loved him know it was a good life, too. I’d so like to call the last telephone number at which I could reach him, which I keep next to my phone to this day. I know I’d probably (and seriously, I couldn’t delete that ‘probably’) get someone else, another person now living out their last days in that room. But as long as I don’t actually pick up the phone I can imagine he’d answer, with a voice stronger than it had been in years and maybe calling me by the goofy name he had for me when I was small. He was a good man and a great father. I miss him terribly, every day.

I’m sad, too, because I’m waiting for a big-time judgement of my work from some big-time players. I’m not good at waiting. And right now I’m not dealing particularly well with what happens if I’m turned down, once again.

So add to that the story on fetal alcohol spectrum disorders on the front page of today’s Star Tribune and I’m in a considerable funk. As you can see in the above (and courtesy of the University of Washington, Seattle),

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.

You may be more familiar with the term fetal alcohol syndrome (FAS), but apparently that has now been rolled into FASD, with FAS simply being the most severe form of FASD. It makes sense, since no one knows what level of alcohol consumption in the mother will have negative effects on a fetus. I think the particular consumption limit is likely unique in all the ways people are unique, plus the ways a fetus is unique in itself and its development.

There is a particularly irritating graphic in the Star Tribune article, with this heading:

PUTTING INFANTS AT RISK
 In 2013, Minnesota had the nation’s second-highest rate of alcohol consumption among women of childbearing age (ages 18-44), a key risk factor for FASD in newborns.

I find it irritating because it will irritate a lot of people, this apparently broad brush painting any woman who drinks as putting a child at risk for FASD. So I checked what fraction of MN pregnancies are unplanned, or unintended, and the number doesn’t help: 40%, according to a study by the Guttmacher Institute.

No wonder the risk factor is alcohol consumption in any woman of childbearing age. If a woman able to conceive a child drinks alcohol, and the rate of unintended pregnancy is 40%, it’s not, in fact, so terribly unlikely she may be exposing a fetus to FASD.

What a mess.

I would suggest it’s a mess for one reason not considered in the article: this percentage of unintended pregnancies. The article actually is taking a different, perfectly legitimate direction: letting people know how to recognize the signs of FASD, so that kids can get the proper intervention. But I’d like to back the discussion up a little bit, to these unintended pregnancies.

We can get all hot under the collar that the Star Tribune graphic, in particular, seems to be saying that if you’re a woman who can get pregnant you shouldn’t drink, or that if you are a woman who is engaging in sexual activity then if you really love your baby (which you didn’t intend to conceive), you’d better sign off alcohol for 40 years.

These notions aren’t realistic. What IS realistic is better education of women and particularly teens in the use of effective birth control, and improved access to the best kind of birth control for each and every sexually active woman.

THAT’S the graphic I want to see: Alcohol consumption among women of childbearing age who are NOT using birth control. Not to blame, but to work on revealing and getting that number of unintended pregnancies down. This other graphic just gets people angry, gets their hackles up about women’s rights and paternalism and what about men? Why shouldn’t they stop drinking, too? Wouldn’t that be fair?

Personally, I think the concept of fairness here is entirely beside the point. It is useless to argue that it is fair or unfair for women to have the biologic responsibility of pregnancy. We do. Some of us like to drink. Nobody should be getting drunk on a regular basis for so many reasons it hurts my heart. But neither can you, realistically, expect all women of childbearing age not to drink so much as a glass of wine (the effects of which can be, many believe, significant and negative to a fetus) for 40 years.

What you CAN do is try to reduce the incidence of unintended pregnancies, for a whole host of reasons, one of which is FASD. I’ve heard arguments that this is no one’s business either, that a woman can get pregnant and consume as much alcohol as she wishes. Clearly, she may, and can, and, unfortunately, in some instances, will.

But I will gladly talk about unfair in this scenario.

 

 

 

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