Monday, 20 February 2017

The Dangers of Drinking During Pregnancy

by Katie O'Flaherty

FASD - Foetal Alcohol Spectrum Disorders. They affect 1% of the population, which in the grand scheme of things is a significant proportion of the developed world. FASD is is caused when a woman drinks during pregnancy. The placental barrier does not prevent the alcohol from entering the developing baby's bloodstream. Unlike the mother, the unborn baby does not have the enzymes required to break down alcohol. Added to this, the blood-brain barrier is underdeveloped thus the alcohol directly damages the brain. Depending on the stage in pregnancy, and thus the part of the brain developing at the time dictates the nature of the brain damage caused. In some cases there are physical features to this, such as a shortened nose and railroad ears. However, often these are not present, hence it can be seen as an invisible disability.

FASD can cause primary characteristics such as dysmaturity (often present as a mental/social age that is lower than the person's actual age), impulsivity, slower processing pace, memory problems, difficulty forming links and association (cause and consequence), and an inability to think in an abstract sense. Often FASD goes undiagnosed (with symptoms often being attributed instead to conditions such as ADHD), thus the primary symptoms go unsupported. These can lead to the development of secondary characteristics, such as frustration, low self-esteem (or self-aggrandisement), aggression, depression, and isolation, which, like the primary symptoms, are often irreversible once they have materialised.

Frequently, children with FASD end up in the social care system, and adoptive families often do not know of the child's alcohol exposure in-utero. This puts a huge amount of strain on the adoptive and foster families when the primary and secondary characteristics of FASD begin to materialise. In the UK, there are only two places for FASD suffers to get a diagnosis on the NHS (Exeter and Surrey), whereas in any other areas the person will have to pay privately to get a diagnosis ~ a fee which many people cannot afford. Unless a proper diagnosis has been obtained, access to the anyway-limited support systems is almost impossible.

Due to the nature of FASD, people with the disorder are far more likely to struggle functioning in day-to-day life. 60% of FASD sufferers will contend with the criminal justice system at least once in their life. It is believed that 23% of the prison population of North America have FASD, however this is widely considered to be an underestimate. 12.8 years old is the average age for FASD suffered to have their first contention with the law. Those are children who are just starting senior school; Year 7s.  The number of people in the criminal justice system at any given time whose FASD has been a significant factor in their unlawful activity is impossible to estimate, however the cost of this is inescapable. Not only is this a potentially productive and healthy life now spent locked away behind bars, but also the cost to the taxpayer. It costs £40,000 per prisoner per year to be incarcerated. Over £2.8bn is spent annually simply on prisons. Imagine how that money could be spent elsewhere if just a fraction of the yearly total cost was spent on effective preventative measures.

Not only this, but people with FASD are more prone to substance abuse / addiction themselves, due to their in-utero exposure to the addictive substance of alcohol. Often, alcohol and drug addictions go hand in hand, so many of the mothers who drank during their pregnancy may also have taken illicit substances, which, like alcohol, may have had teratogenic effects (an agent that can disturb the development of an embryo or foetus), thus further adding to the brain damage already caused by the alcohol. The costs of this to society are huge. Alcohol-related crime in England costs an average of £11bn. Lost productivity costs £7bn annually. Alcohol-related illnesses cost the NHS £3.5bn per year. The total cost to society is over £21bn per year, a significant proportion of which is due to the secondary effects of FASD.

FASD is an entirely preventable condition, however there is still a massive issue of under-reporting on the topic, and a comparatively tiny amount of research into the condition's causes and effects when taking into account the widespread effect it has on today's society. Even just social drinking during a pregnancy can lead to lifetime-long effects for the child, however in equal measure the child can be born without any of the effects of the alcohol on the foetus. With the present research and understanding, the probability of a child born with FASD when the mother has drunk during the pregnancy is still unknown, however a fail-safe method of preventing FASD is to simply not drink alcohol for the duration of the pregnancy. 

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