Drinking While Pregnant on Unborn

¶ … Drinking While Pregnant

ON UNBORN BABY

EFFECTS of DRINKING WHILE PREGNANT on UNBORN BABY

EFFECTS of DRINKING WHILE PREGNANT on UNBORN BABY

"of the legal but preventable activities in which a pregnant woman can engage,

the two most obviously harmful to the fetus include smoking tobacco and drinking alcohol"

(Cave, 2004, p. 4).

Thousands of years ago in Carthage, a country at one time second only to Rome in the western empire (Rollin, 2006), to prevent conception of a defective child, the bride and bridegroom were forbidden to drink wine on their wedding day. In the study publication, "Alcohol abuse during pregnancy," Mirela Eric and Nada Vuckovic, Clinical Center Vojvodina, Novi Sad, Serbia, Marcel Leppie, Zagreb, Department of Pharmacology, School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia and Dragan Krivokuca (2008), School of Medicine, University of Novi Sad, Novi Sad, Serbia, also report that: "The harmful effects of alcohol drinks taken in pregnancy were recognized in as early as the Greek and Roman mythology" (Discussion section, ¶ 2). This thesis asserts that drinking alcohol while pregnant proves harmful to the unborn baby as it may cause serious medical conditions, such as fetal alcohol syndrome.

The researcher also contends that drinking alcohol while pregnant should, in a sense, be illegal if the expectant mother continues to endanger her unborn child; knowing that her drinking proves hazardous to the health of him/her. During this thesis, the researcher uses a number of credible, scholarly sources to address the following questions:

1. In what ways may drinking alcoholic beverages affect an unborn baby?

2. Should drink alcoholic beverages while pregnant be deemed illegal?

Emma Cave (2004) asserts in the book, the mother of all crimes: Human rights, criminalization, and the child born alive, that a number of acts or omissions of a pregnant woman may ultimatley damage the fetus. The pregnant woman may control a number of these hazards, albeit, including passive smoking, as well as, intentionally smoking, and as the quote introducing this thesis purports, drinking alcohol. Failure to abstain from alcohol during pregnancy potentially contains an element of culpability, Cave contends, as the fetus is not capable of protecting itself; totally depending dependence on the pregnant woman.

Supporting Evidence

Effects of Alcohol on Fetus

Eric, et al. (2008) assert that intrauterine alcohol exposure contributes to impairments of fetal development, primarily leading to fetal alcohol syndrome (FAS). FAS includes:

1. Intrauterine growth retardation, referring to body length, body mass and cranial circumference;

2. central nervous system disorders (basal ganglia, hippocampus, cerebellum); and

3. craniofacial dysmorphism (microphthalmos, strabismus, epicanthus, blepharospasm, ptosis, short nose, oblique auricles, occasionally cleft palate). (Eric, et al., 2008, ¶ 5).

Fifty percent of children with FAS experienced cardiovascular anomalies. Other concerns Eric, et al., (2008) report, also described in the literature, include "bone anomalies, genito-anal dysplasia, kidney anomalies, supernumerary mammillae, microdontia associated with poor dental enamel, diaphragmatic hernia and diastasis" (¶ 5). A number of studies and clinical reports find causative relationship with high daily maternal intake of ethyl alcohol during pregnancy highly probable. Consequently, as Ethyl alcohol and its metabolites reportedly constitute the etiologic cause of FAS, drinking during pregnancy contributes to contemporary concerns regarding FAS.

Prenatal alcohol exposure depicts a primary preventable cause of birth defects and developmental disabilities, Dr. Cara J. Krulewitch (2005), Assistant Professor, School of Nursing, University of Maryland, asserts in the annual review of nursing research, "Chapter 4: Alcohol consumption during pregnancy." Fetal alcohol syndrome, Krulewitch explains, denotes a pattern of birth defects children of mothers, who drank alcohol when pregnant, may experience. FAS includes the following four criteria:

1. Maternal drinking during pregnancy,

2. A characteristic pattern of facial abnormalities,

3. growth retardation, and

4. brain damage (often manifested by intellectual difficulties or behavioral problems). (Krulewitch, 2005, ¶ 1)

In addition to FAS, prenatal developmental problems, intrauterine growth restriction, and poor postnatal development, other problems routinely associating with alcohol consumption during pregnancy include "an increased rate of spontaneous abortions, congenital anomalies, problems in childhood development, sudden infant death syndrome, and other causes of fetal, infant, and child mortality" (Krulewitch, 2005, Alcohol teratogenicity… section, ¶ 2). Intrauterine growth restriction (IUGR) mostly occurs during the third trimester of pregnancy, however, functional damage may occur once organs have formed; at any time during the baby's development.

The full spectrum of FAS likely occurs when drinking persists during all three trimesters. Nevertheless, no safe period exists for dinking during pregnancy seems to exist, as individual anomalies still may occur when the mother drinks during more distinct periods.

Although the effects regarding specific amounts of alcohol consumption are not known, early extreme alcohol exposure frequently leads to spontaneous abortion. In addition: "Heavy alcohol consumption during pregnancy is associated with a characteristic facial dysmorphology that includes midfacial hypoplasia, long, smooth philtrum, thin upper lip, small widely spaced eyes, and inner epicanthal folds" (Krulewitch, 2005, Effects of… section, ¶ 1). The assumption is that the mother may not be aware of her pregnant state during the embryonic period. Craniofacial anomalies, resulting from maternal drinking when facial development occurs, most likely occur during this earliest stage of pregnancy; an assumption not yet fully supported.

Each time the pregnant mother drinks alcohol, her developing, unborn baby receives a dose of alcohol, Dr. Eric Chudler (2008) stresses. This occurs as an unborn baby receives his/her food through the placenta and alcohol readily passes through the placenta. Chudler, a Neuroscientist and Director of Education and Outreach at the University of Washington Engineered Biomaterials in Seattle, Washington, stresses in the article, "Alcohol and the brain," that alcohol does in fact disrupt normal brain development. "Fetal exposure to alcohol can impair the development of the corpus callosum (the main connection between the right and left hemispheres of the brain), reduce the size of the basal ganglia and damage the cerebellum and cerebral cortex" (Chudler, 2008, p. 1). Figure 1 depicts factors of babies born with FAS, compared with normal babies:

Figure 1: Characteristics of Babies with FAS (adapted from Chudler, 2008, p. 1).

Figure 2 portrays typical features of children born with FAS.

Figure 2: Features of Children with FAS (Chudler, 2008, p. 1).

Warnings

In the U.S., since 1989, Dr. Barbara St. John (2008), Assistant Professor of Nursing at Western Carolina University reports in "Social drinking among pregnant women, manufacturers of alcoholic beverages haves placed warnings about using alcohol when pregnant on the labels of every container of alcoholic beverages they have sold. In the report, "Alcohol use among pregnant and nonpregnant women of childbearing age - United States, 1991-2005," Dr. C.H. Denny, Dr. J. Tsai, R.L. Floyd and P.P. Green (2009), each with the National Center on Birth Defects and Developmental Disabilities, report that the 2005 U.S. Surgeon General's advisory on alcohol use in pregnancy, specifically advises pregnant women to abstain from using alcohol, Despite this warning: "Alcohol use during pregnancy continues to be an important public health concern" (Denny, Tsai, Floyd & Green, 2009, ¶ 9).

John (2008) points out that despite warnings, public health recommendations and campaigns and professional counseling, too many American women still drink alcohol while pregnant. In John's study, wine and beer depicted the beverages of choice for pregnant participants. These self-identified as older than average and highly educated women admitted to drinking while pregnant, usually during social situations. "Results [from the test John conducted] suggest that some women need support to avoid any level or type of alcohol consumption during their pregnancy" (St. John, 2008, ¶ 1). Women who drink when pregnant during rituals, celebrations, or meals may mistakenly perceive that wine does not harm the fetus as hard liquor.

Legal Considerations

A number of states in the U.S. promote placing pregnant women in addiction treatment programs when they abuse alcohol. Some states, albeit, have sought to punish and jail women who drink alcohol while pregnant. The article, "Female lawmakers and laws criminalizing pregnant women who drink," (2007) published on the National Center on Addiction and Substance Abuse by Columbia University Web site, reports findings from a study conducted by the Pacific Institute for Research and Evaluation (PIRE) regarding this contemporary challenge. This study finds that states with fewer practicing female lawmakers most likely pass the harshest laws on alcohol use by pregnant women (Female lawmakers…, ¶ 1). Sue Thomas, Ph.D., PIRE's study's lead author, states:

Not only is jail an amazingly severe reaction to alcohol abuse during pregnancy, but substance-abuse treatment programs and prenatal care are almost nonexistent in these facilities. While few question the serious consequences of alcohol abuse on fetuses, the best way of avoiding them is to provide treatment for the pregnant women rather than lock them up. (Thomas, as cited in Female lawmakers…, 2007, ¶ 2).

According to the PIRE study, state legislatures with more female lawmakers would be more likely pass treatment-oriented legislation. Those state legislatures with few women in office tended to favor laws that would punish pregnant drinkers. They also tended to require medical staff to report women who use alcohol during pregnancy to authorities (Female lawmakers…, 2007).