Drugs and drinking are a risk factor for birth defects, nobody denies that. That said, the incidence of fetal alcohol syndrome or drug-related abnormalities is certainly <50% amongst drinkers and drug abusers. For that matter, the incidence of phocomelia amongst the children of thalidomide users is under 50%. The majority are lucky, just like the majority of people who play a round of Russian roulette.
That doesn’t mean you should drink, smoke, use drugs, or taking thalidomide during pregnancy. But let’s not get carried away and start locking people up.
I don’t know. I’ve looked up information on drug abuse during pregnancy, and for the particular drugs you seem to be right. But it’s also hard to test for the effects because A) most mothers who are drug abusers while pregnant aren’t honest about it and B) by the time most people find out, it’s hard to tell if potential behavioral effects or learning problems are a result of the drugs or the home environment the child grows up in.
Anecdotally, I’d say drug use has a very large effect, but my anecdotes are also susceptible to the same problems above.
Whether or not we should lock those women up, the child should definitely be taken away if possible.
As a side note, if anyone can point me to good freely available research on this topic, I’d appreciate it.
There are more data on the prenatal effects of alcohol than any other drug of abuse. A freely available review is available here.
Fetuses chronically exposed to heroin will be born addicted, and in their first few days of life they will suffer a very unpleasant withdrawal. Offhand, I don’t know of any studies showing long-term effects.
While the “crack baby” meme was popular a few years ago, more recent studies have questioned whether cocaine really causes birth defects. The jury is still out. For a summary, you can look at this article (not free):
In utero cocaine exposure: a thorny mix of science and mythology.
Am J Perinatol. 2003 May;20(4):165-72.
Vidaeff AC, Mastrobattista JM.
Fetal cocaine exposure has proven to be an area of medicine that has generated more heat than light. Although many reports associate cocaine with a variety of isolated structural anomalies, there is no detectable syndromic clustering, raising doubts about a real causal association or a specific teratogenic action. Potential confounding variables, including the abuse of other drugs, pregnancy deprivations, and socially patterned maternal behaviors, have limited the reliability of observational studies, making it difficult to demonstrate effects solely attributable to cocaine. The clinical expression of in utero cocaine exposure is contextual, critically dependent on the biology/environment interplay. The present work summarizes the fetal structural anomalies that have been associated in the literature with cocaine use during pregnancy, and reviews the putative mechanisms of fetal impairment secondary to cocaine exposure. The final discussion of methodologic issues in cocaine epidemiology highlights the need for innovative approaches to assure that the myths conjured up about “crack babies” are replaced with reliable, high-quality scientific data.
The first study you linked appears to have nothing to do with FAS incidence as related to alcohol consumption. It seems to be trying to quantify the familiarity of New York State “human services professionals” with symptoms and outcomes of FAS.
A little late to the party, but here are my thoughts.
There’s a lot of talk of pregnancy being the woman’s choice because she chose to have sex. But don’t forget the semen dispenser – it was his as well. Maybe a better thing to debate is whether or not men should be required by law to use condoms, unless the woman requests otherwise.
It would be a lot more obvious where to place the blame if men were somehow marked as fathers when conception, implantation, and a few more weeks (to rule out early miscarriage) went by. Maybe, they turned a color to match their mate. Or, like sea horses, women transferred the implanted embryo to them.
How about this for a hypothetical. What if embryos/fetuses could be aborted (i.e., removed from the host mother) and surgically transferred to someone that wants a baby? Is it still an abortion and therefore wrong? What if the risk to the embryo/fetus were considerable? And: is it considered “born” when removed from the host mother and the cord is cut?
What it comes down to is human decency, morality, and foresight. And you can’t legislate that.
I’m shocked that after 8 pages you guys still haven’t resolved this whole abortion dilemma thing. One would almost think you were wasting your time debating two mutually incompatible yet self-consistent world views.
Oops! You’re right. Try this free article instead.
However, estimates of 1 per 100 (1% of live births) being affected by prenatal alcohol exposure have been cited (22). Furthermore, despite the massive educational campaigns about alcohol consumption during pregnancy, the CDC reports that more than half of the women in the United States of childbearing age consumed alcohol in the month before their survey and that approximately 15% of these could be considered moderate or heavy drinkers. Approximately 13% of women continue to use alcohol during their pregnancy and 3% of pregnant women report binge or frequent drinking (7).
Already covered. Manipulating the fetus of a non-consenting mother is assault. Case closed.
Education, not regulation – the latter is impractical. Unfortunately, so many lies have been told in the War on Drugs that I think young mothers are likely to dismiss warnings about fetal damage as scare tactics. When your sex-ed curriculum is abstinence-only, what’s left to believe?
Well at 15 she is a ward of her parents and not an adult. At 18, she should be able to go into a hospital receive counseling about getting an assisted suicide and eventually, if she continues in that belief, be aided.
It’s still a very pointlessly awkward thing to say. Also…if a pregnant mother is using illegal drugs, well…they’re illegal! We shouldn’t start locking people up for things like that?
Most people don’t die from driving drunk, either. By this logic, we shouldn’t be penalizing DUIs.
Well, if you want to put drug users in jail after due process, that’s one thing. But the thrust of the question was whether pregnant women should be treated differently, specifically in regards to where they are confined (a hospital), how long they are confined (duration of pregnancy) and what additional activities are prohibited (binge drinking).
Most people don’t die from driving drunk, either. By this logic, we shouldn’t be penalizing DUIs.
The analogy doesn’t really hold up well. First of all, driving is a privilege: when you get your driver’s license you sign on a dotted line and are expected to abide by certain additional rules that don’t apply to pedestrians. In contrast, you don’t need a license to get pregnant, smoke, or drink - adults can do so in the comfort of their home without any government interference.
Secondly, you assume that DUI laws are models of fairness. However, there’s a growing libertarian backlash against groups like MADD.
I’m curious how you reconcile this position with other activities that are known to be increase fetal risk. For example, the risk of Down’s increases dramatically when women are over 40. Are you willing to take equally intrusive measures to prevent Down’s as other birth defects? If not, I suspect that the underlying purpose of these measures is not to protect fetuses, but to punish women.
