When was fetal alcohol syndrome discovered

In many ceremonial religious observances today, wine features heavily. Arguably, alcohol continues to keep us warm and cosy in supportive social bubbles surrounded by good friends, food and other trappings of a fortunate life. However, by this fireside we are joined by evidence-based research which now points to many health and societal harms caused by alcohol. One of the most serious is the potential outcome from an alcohol-exposed pregnancy.

Jones subsequently observed that the research was disbelieved, with critics claiming that pregnancy and alcohol had been intermingled for many years without harm.

His comments highlight the continuing problems which plague public health and community initiatives to prevent ongoing harm to unborn children through alcohol exposure in the womb. FASD is not new. This work arguably commenced the modern era of research and knowledge associated with alcohol and pregnancy. What of the old era? How hard is it to find evidence of the knowledge of harms caused of alcohol exposed pregnancy?

In ancient Carthage and Sparta there were laws prohibiting the use of alcohol by newly married couples to prevent the birth of children with birth defects. While these ancient historical records have been contested, there can be no doubt of the meaning and concerns about alcohol in the 19 th century.

Even before the report could be published Hansard records a heated discussion between elected members Hawes and Buckingham. In addition, it is more widespread within the general U. In the alcohol-abusing population, the FAE incidence was found to be nearly four times greater. There are even occurrences where FAE have resulted in death. Various clusters of these actions grouped together might be the result of any number of things other than maternal alcohol abuse.

However, when physical and behavioral abnormalities "more or less coalesce into a repeated, cumulative set of fixed actions or signs, the alarm bell sounds. May found that the FAS rate among Plains Indians is one birth in 97, about one percent of all babies born. Among Pueblo and Navaho tribes, the rate is one infant out of born, which is about 0. The low FAS incidence among these latter Indian tribes may reflect the fact that women who drink alcohol reportedly are ostracized.

Nationwide, the ratio of women alcoholics to male alcoholics 30 percent and 70 percent, respectively , is slightly higher than for female and male alcoholics in treatment. A comparative study found that a higher percentage of women than men who completed treatment abstained from further alcohol use.

The type of treatment facility utilized seemed to have influenced this result. It was discovered that women had higher abstinence rates if treated in a medically oriented alcoholism facility, while men experienced higher abstinence rates if treated in a peer group-oriented facility.

Some experts believe that separate treatment facilities for women might better meet their needs. The study found, however, that "treatment outcome was better for women treated in a facility with a smaller proportion of female clients and better for men in a facility with a larger proportion of female clients. Dysmorphologists are experts in dysmorphology, which is the study of abnormal development of tissue forms.

Illustrated Stedman's Medical Dictionary, 24th ed. Abel, Ernest L. Fetal Alcohol Syndrome. Warren, Kenneth R. Public Health Reports, v. Abel, Fetal Alcohol Syndrome, p.

Yet each of these drinking patterns represents potentially very different levels of alcohol exposure for the woman and her fetus. Only a handful of researchers, such as Jacobson et al. For example, in evaluating children whose mothers drank during pregnancy, Jacobson et al. Since none of the mothers studied drank every day, they acknowledged that the average did not represent a typical drinking day. Similarly, Ernhart noted that a woman in her study who consumed an average of one drink a day during the course of her pregnancy, confined her drinking to the first 3 months of her infant's gestation, when she drank a gallon of wine, and a half case of beer, every Friday and Saturday evening.

After that she did not drink for 3 months. Nevertheless, because drinking was averaged over the longer period, the woman's drinking appeared to be very low. This bias in the medical literature has been magnified in the popular press and in lay pregnancy manuals and public health educational materials. Although many researchers recognize the significance of binge drinking as a risk for FAS, the distinction between number of drinks per drinking episode and number of drinks per week or month has been largely glossed over in public discussions of FAS, which tend to present any type of alcohol consumption as dangerous.

The essential criterion for any social problem is its universalization Wagner, As long as a problem is orphaned, especially if it is identified as a problem only within a minority race or social class, it has limited impact on society as a whole.

Liberal-minded social scientists are especially wary of associating a stigmatized behaviour with race or class, because such associations perpetuate discrimination Wagner, By disassociating race or class from a stigmatized behaviour, the problem is more likely to gain public attention, because everyone now feels a vested interest in its elimination.

The language of democratization therefore characterizes most social problems, e. FAS has not been immune to democratization. What Jones and Smith and their colleagues did not emphasize was that the eight children, and virtually all the other children they and others subsequently examined, were seen in hospitals serving a predominantly lower socio-economic status population.

Groups whose members suffer disproportionate poverty, such as Native Americans and African Americans, are especially prone to this disorder. While it is true that drinking occurs across all social categories in the USA, FAS is undeniably concentrated among disadvantaged groups.

The very large socio-economic differences in FAS rates Able, are not due to differences in the number of alcoholic women among the poor compared to the middle classes.

In fact, drinking is much more common among the middle and upper classes than among the poor Abma and Mott, ; Caetano, ; Abel, a. Democratization disguises the extent to which moral panic about FAS may in fact spring from much deeper social unease about changing gender roles and about class and particularly race differences Armstrong, a.

Many legal commentators in the USA have noted that the recent rash of prosecutions of pregnant women for substance use and purported fetal harm are concentrated among poor and most often minority women Roberts, ; Gomez, Although a debate exists about the extent to which the USA differs from other countries with regard to the incidence of FAS, there can be little doubt that the American response to drinking during pregnancy is exceptional.

The USA remains the only country to legislate warning labels on alcoholic beverage containers; the American Surgeon General's warning about drinking during pregnancy is unique in the strength of its recommendations that women should abstain from alcohol altogether and should, moreover, be vigilant about the miniscule alcoholic content of food and drugs.

In this respect, the moral panic over FAS echoes earlier periods of concern about alcohol in American history; to wit, the prolonged struggle over temperance in the nineteenth century and the prohibition of the manufacture, sale and consumption of all alcohol in the USA between and However, the moral panic over FAS in the USA, unlike earlier periods of social preoccupation with alcohol, is driven as much by gender division as by class or socio-economic divisions.

Although its sufferers appear to be concentrated among the poor, the public image of the condition as a universal one resonates with issues of social control and gender. As Armstrong a has noted in an earlier analysis, the diagnosis of FAS arose at a period of intense gender agitation in the USA, and thus reflects widespread social unease about the conflict between the traditional maternal role of women and their efforts to embrace more diverse roles in modern society.

Historically, moral entrepreneurs have mobilized moral rhetoric when they have felt social norms threatened by outsiders or newcomers to society; in other words, as response to social deviance. Moral panics may arise when social elites seek to preserve or defend their status in the social hierarchy Gusfield, ; alternatively, moral panics may serve to deflect political attention from intractable social problems, or inequality inherent in the social structure Hall et al.

As Plant has noted in the British context, the moral panic ignited by FAS in the USA served the further purpose of diverting attention from social inequality and displacing blame for poor pregnancy outcomes to individual mothers rather than social circumstances. The case of FAS illustrates that this is still true. The moral panic ignited by concern over FAS, with its exaggerated claims, especially regarding the dangers of social and moderate drinking, and its universalization, has important implications.

There have been countless reports of visibly pregnant women who were harassed by indignant strangers when seen to be drinking in public; likewise, there are accounts of morally righteous waiters and barstaff who have refused to serve visibly pregnant women alcoholic beverages. Even some American clinicians have fallen prey to this misunderstanding Abel and Kruger, , which has caused some women to become so anxious that they have considered termination of their non-threatened pregnancies so as to avoid giving birth to a child with FAS Armstrong, b ; Lipson and Webster, ; Koren, If we are to reduce the incidence of FAS, we must first accurately comprehend the problem at hand and abandon the rhetoric of moral panic.

There is no epidemic of FAS births. However, the risk is considerably greater for the relatively small number of women who abuse alcohol on a regular basis, and it is even greater for those women who have previously given birth to a child with FAS and continue to drink Abel, While government has a moral duty to alert citizens to potential dangers Abel, b , public education measures, such as warning labels, have no noticeable effect in reducing drinking during pregnancy Hankin, , as evidenced by the fact that more, not fewer women, are now drinking during pregnancy than before the appearance of the labels CDC, Such broad-based prevention efforts are doomed to fail, because women who give birth to children with FAS are not simply a variant of the general drinking population.

A small proportion of women of child-bearing age, especially those who are most disadvantaged by poverty, bear the greatest burden of risk for FAS. If we are going to reduce the incidence of FAS, we need first to know who those women are, as well as what puts them at risk.

If we hope to reduce the incidence of this birth defect, we must reconstruct the problem not as a moral panic, but as a moral imperative to find and help those women most at risk of adverse outcomes.

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