Pregnancy & Alcohol: Should Doctors Ask?

“I drank socially,” our son’s birth mom told us. “But as soon as I found out I was pregnant, I quit.”  She tells me this while sipping a glass of wine and eating a caesar salad at dinner. We had just met.  She chose us to be her unborn baby’s parents, and I was slow to compute what I was observing.  I was also naive and hopeful. What could one glass of wine really do? Since those days, and a few throw-away comments from the birth dad about parties and hangovers, it has become clear our little guy was exposed to an awful lot of alcohol.  But just how much?  I have never had the heart to ask.

In an article called “Why Ask Why?” a clinical psychologist argues that doctors should not ask women about their alcohol use while pregnant for two reasons.

First, it is, what she calls, a “logical fallacy,” meaning it seeks a cause for some challenging behaviors, and ascribes those behaviors to alcohol use, even when there might be other factors at work. No one can really prove that alcohol causes certain problems, and in some cases, drinking while pregnant doesn’t cause any observable problems, so the diagnoses names a “suspect,” so to speak, when there might very well be other suspects not named.

Second, “it blames the mother for the child’s behavior,” which has long-lasting consequences for the mother’s mental well-being.

Her conclusion is that we should treat the problems, rather than look for a cause.

As an adoptive mom of an FASD boy, I can understand the care that must be taken when inquiring about birth mom alcohol use. In our son’s case, birth mom was a social drinker who didn’t know she was pregnant for the first two trimesters. Even when she found out, she continued to drink a glass of wine each day. However, I have never had the heart to ask her for specifics. Our son has had a tremendously challenging few years (as have we, by extension), and we fumbled around for many months trying to figure out exactly why. I desperately wanted to know how much she drank and when, but the question felt like a huge burden I’d be placing on her shoulders, and I already knew she had complicated feelings about not raising him herself anyway. In the end, I chose not to bring it up. Her mental well-being felt like too heavy a price for the information I wanted, and I was not confident she’d respond honestly anyway.

But I am an adoptive mom, and can, without guilt or shame, treat my son for FASD, join FASD communities, work with an FASD practitioner, and benefit greatly from these supports. I believe they have helped my son as well, because behavior that often appears defiant or stubborn or “baby-ish,” is likely due to his immature neurological system. This is not to say we can’t address those behaviors, nor am I suggesting they aren’t deeply frustrating, but somehow it helps to have a larger context in which to place them, and a community of parents and others who “get it.”

So should we ask “Why?” I think it depends on who is raising the child. If the birth mom is also doing the hard work of raising an FASD child, then it likely will not help the situation. But if adoptive parents, foster parents or grandparents and extended family are doing the raising, then by all means, give them some answers, and most importantly, access to a group of people who can offer some wisdom.

In an ideal world, birth moms who drank wouldn’t feel the stigma or the shame. Many did not know they were pregnant, or they have drinking problems, or didn’t fully understand the risks of drinking while sexually active. But our world tends to move quickly to blame the mom for lots of things out of her control, and it is unlikely these mothers could accept that their own decisions impacted their child so negatively. The problem is, they still need support, wisdom and help, and if not from the FASD community, then from whom?

Price, Kelly J. and Kenna J. Miskelly. “Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder.” Ethics & Behavior, vol. 25, no. 5, Sep-Oct2015, pp. 418-426. EBSCOhost, doi:10.1080/10508422.2014.946031.


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