‘alcohol, pregnancy and harm reduction: a review of the american experience’
DESCRIPTION
In this paper I will briefly review the evolution of policies promoting alcohol abstinence in pregnancy in the United States. I then focus on the battle to place warning labels on alcoholic beverages sold in the United States, on the statements of medical organisations regarding abstinence, and on the material found on the FASD website of the Centers for Disease Control and Prevention of the US government.TRANSCRIPT
Message in a Bottle:Message in a Bottle:
The Making of Fetal Alcohol The Making of Fetal Alcohol SyndromeSyndrome
Janet Golden, Ph.D.Janet Golden, Ph.D.Rutgers UniversityRutgers University
National Organization on National Organization on Fetal Alcohol Syndrome Fetal Alcohol Syndrome
poster, c. 1992poster, c. 1992
Phase I: 1973-1977Phase I: 1973-1977
Discovering theDiscovering theOffspring ofOffspring of
Alcoholic WomenAlcoholic Women
Discovering FASDiscovering FAS
Dr. David Smith and Dr. Kenneth Dr. David Smith and Dr. Kenneth Lyons JonesLyons Jones
““Pattern of Malformation in the Pattern of Malformation in the Offspring of Chronic Alcoholic Offspring of Chronic Alcoholic Mothers,” LANCET 1 (1973): Mothers,” LANCET 1 (1973): 1267-12711267-1271
““Recognition of the Fetal Alcohol Recognition of the Fetal Alcohol Syndrome in Early Infancy,” Syndrome in Early Infancy,” LANCET 2 (1973): 999-1001LANCET 2 (1973): 999-1001
Cigarette WarningCigarette Warning
American Lung Association American Lung Association Poster, c. 1988Poster, c. 1988
Phase 2: 1977-1986Phase 2: 1977-1986
The Crusade to WarnThe Crusade to Warn
1977 Warning from the 1977 Warning from the NIAAANIAAA
• Pregnant women who consume Pregnant women who consume more than six drinks a day incur a more than six drinks a day incur a significant risk of producing a significant risk of producing a child with birth defectschild with birth defects
• Limit drinking to two drinks per Limit drinking to two drinks per dayday
Consult doctorConsult doctor
1981 Advisory on Alcohol 1981 Advisory on Alcohol and Pregnancy:and Pregnancy:
Pregnant women and those Pregnant women and those considering pregnancy considering pregnancy should not drink alcoholic should not drink alcoholic beveragesbeverages
FAS CostsFAS Costs
Warning from the Warning from the NIAAANIAAA
NIAAA PamphletNIAAA Pamphlet
Rate of FASRate of FAS
Phase 3: 1986-1990Phase 3: 1986-1990
The Discourse The Discourseof Law and Responsibilityof Law and Responsibility
Warning LabelWarning Label
Michael ThorpMichael Thorp
The Broken CordThe Broken Cord
National Organization on National Organization on Fetal Alcohol Syndrome Fetal Alcohol Syndrome
poster, 1991poster, 1991
Arizona Department of Arizona Department of Behavioral Health Services Behavioral Health Services
poster, c. 1992poster, c. 1992
Crack MothersCrack Mothers
AMA ReportAMA Report
"Pregnant women will be likely to avoid "Pregnant women will be likely to avoid seeking prenatal of other medical care for seeking prenatal of other medical care for fear that their physicians’ knowledge of fear that their physicians’ knowledge of substance abuse or other potentially substance abuse or other potentially harmful behavior could result in a jail harmful behavior could result in a jail sentence rather than proper medical sentence rather than proper medical
treatment."treatment." Board of Trustees Report, Legal Interventions During Pregnancy, 264 JAMA 2663, 2667 (1990)
Phase 4: the 1990’sPhase 4: the 1990’s
From Victim toFrom Victim toVictimizer—Victimizer—
the Death Row Debatesthe Death Row Debates
Robert Alton HarrisRobert Alton Harris
Charles Krauthammer, M.D.Charles Krauthammer, M.D. : :
““We can either do nothing, or we can We can either do nothing, or we can pass laws saying that any pregnant pass laws saying that any pregnant woman who takes cocaine will be woman who takes cocaine will be sent until delivery to some not sent until delivery to some not uncomfortable, secure location uncomfortable, secure location (boot camp, county jail, house (boot camp, county jail, house arrest--the details are purely a arrest--the details are purely a technical matter) where she can do technical matter) where she can do anything except leave or take anything except leave or take drugs.”drugs.”
Alaska Department of Alaska Department of Health and Social Health and Social
Services poster, c. 2001Services poster, c. 2001
Phase 5Phase 5
An Imagined ResponseAn Imagined Response
SubstanceSubstance Use in PregnancyUse in Pregnancy