Anyone who's worked in the field of child or adult protection in this state is all too familiar with fetal alcohol spectrum disorder (FASD) and its even more devastating relative, fetal alcohol syndrome (FAS). Kids who otherwise might have had a chance for a good future if removed from an abusive and/or dysfunctional family have no chance of ever really escaping because of the damage done before they were born. No matter how hard they try, the crossed lines in their brain cannot be uncrossed. With a lot of work and effort, these kids sometimes are able to overcome the difficulties FASD produces and lead relatively healthy lives. But they will never ever achieve what might have been possible had alcohol not damaged them before they took their first breath.
Over the years, I've watched mothers stay drunk their entire pregnancy and still deliver healthy babies. Clearly something protects some fetuses in the womb. But just as clearly, many women don't have that built in protection for the babies they are carrying. When they drink, the alcohol negatively affects fetal development. Since we are only beginning to understand when alcohol will affect which part of development, staying sober throughout a pregnancy is the most effective way to protect the fetus.
The issue I've found myself dealing with frequently when working with families where this problem was clearly evident is that it often has a generational component that's extremely hard to overcome. If mom and dad are both FASD, their ability to understand the need for sobriety is often very limited. They might agree with you wholeheartedly as they sit in your office discussing the pregnancy. But the minute they go out the door and get distracted, the conversation can be forgotten and the first offer of a drink accepted. After all, their mothers drank while pregnant with them so why shouldn't they also drink while pregnant.
I've also dealt with the angry, indignant male who felt that his partner should not drink no matter how much he did because she was pregnant. While there is a point being made there, the reality is that if your most important support system is drinking, the likelihood that you will stay sober is minimal. And if some social services type confronts you about what you're doing, you get tell them to stay out of your business. And so the cycle continues.
I'm not at all sure what you can tell a pregnant woman to keep her from drinking if telling her that doing so will damage her child's brain doesn't work. There has occasionally been some movement towards incarcerating a pregnant woman who didn't stay sober in order to protect the unborn child but that leads to a whole series of questions about a woman's body and boundaries that can get pretty messy. Given our already overcrowded prisons, is adding pregnant women to them really a solution?
My most fervent admiration goes to those wonderful families who adopt or foster children with the kind of special needs created through FASD. For some, the battle to get treatment for their child is never ending. First they have to find someone who will give them a clear diagnosis in order to qualify for programs specific to FASD or FAS children. Then they may find themselves fighting a health insurer that questions whether suggested treatment is covered and an overwhelmed educational system that is hard pressed to meet their child's needs.
Even if they overcome all barriers and get all the help possible for their child, the outcome remains a crapshoot. All the extra attention and support allows some kids to push to their limits and exceed beyond what anyone thought possible. For others, all the help in the world can't overcome the handicap their mother's drinking visited on them before birth.
Our health care and education systems can only do so much. Even the best of parents can only do so much. The reality is that a child born with FASD or FAS is a child born with problems that are not easily overcome. The question that seems so hard to answer is where in this alcoholic cycle do we make the break so that it's effective. Anyone who has that answer holds the key to the future for far too many Alaskan children.
Elise Patkotak's latest book, "Coming Into the City," is available at AlaskaBooksandCalendars.com and at local bookstores.