Sarah Lawton-Speert, a 27-year-old social worker, is in the seventh month of her pregnancy. Standing at a busy Vancouver intersection, she unconsciously holds her breath until the light turns green. She has read an article about the dangers of auto fumes on fetal development. Across town, obstetrician Lori Kanke tells about a pregnant woman who wanted to take vitamin supplements but then learned that the pills she had bought were tinted with suspect red dye. “How peculiar it is,” writes Yvonne Davie, a pregnant woman, to the Vancouver Sun, “that in this day of scientific awareness the pregnant mother is almost afraid to eat, drink or breathe .... Perhaps someone should do some research on the ways in which scientific ‘discoveries’ manipulate people’s anxieties.”
The pressures on pregnant women, custodians of the fertilized ovum for nine months, sometimes seem overwhelming. Where once simple moderation was the watchword, now total abstinence is the rallying cry—resulting from both a plethora of new studies and the inability to fix acceptable minimum levels of suspect food and drugs. This July, the U.S. Surgeon General recommended that pregnant women give up alcohol entirely. Six months earlier, the commissioner of the U.S. Food and Drug Administration (FDA) stated that pregnant women would be wise to curtail their intake of caffeine, which rules out cola as well as coffee and tea.
The old belief that the mother protects the fetus at the risk of her own life, that nothing crosses the placental barrier, has been known to be untrue for some time. However, the extent of fetal vulnerability is only now being fully explored. For example, the halflife of caffeine is one hour in a man, as long as 20 hours in a pregnant woman, and 80 hours in a newborn. “The only safe level is none,” says Dr. Patricia Baird, head of medical genetics at the University of British Columbia. “Would you give a baby a cup of coffee before it was six months old? A rum and coke?” The socially acceptable levels of any substance are no longer perceived as moderate when absorbed by the fetus. Carleton University psychologist Peter Fried has studied 600 women to ascertain the effects of “social” levels of marijuana, cigarettes and alcohol. The babies of women who smoked fewer than five marijuana cigarettes a week dis-
played normal nervous system development at birth. However, the offspring of mothers who drank approximately one ounce of liquor a day—a couple of highballs or beers—showed irregularities in muscle tone. Fried is still researching long-term effects, but his examination of commonly accepted doses lends new and strict meaning to the word caution.
Modern inquiry into the mother’s effect on life “in utero” dates back to 1947, when researchers reported that babies of smokers weighed less at full term. The momentum picked up when the deleterious influence of alcoholic mothers came to the fore in 1973 and was named Fetal Alcohol Syndrome. Within two years, research shifted to analysing the “social drinker,” and in short order, the
possible negative influences of saunas, jogging, kitty litter, spermicidal foams, sex and an assortment of prescription and over-the-counter drugs. But unless research is interpreted carefully and reported responsibly, warnings can boomerang. “It’s an overload: there’s been so much in the media that mothers are overwhelmed and have difficulty determining what’s true and what’s nonsense,” notes Dr. David F. Smith of the outpatient department at Vancouver’s Health Centre for Children.
The hammer of guilt is being used to knock pregnant women into line. Television ads linking infant mental retardation with maternal drinking or smoking conclude, “Most mental retardation can be prevented.” Carleton’s Peter Fried, author of Smoking for Two, demurs: “This implied one-to-one connection is innuendo. It is simply too strong a statement to make on the basis of scientific evidence.” Dr. Patrick MacLeod,
associate professor of medical genetics at UBC, engaged in clinical studies of Fetal Alcohol Syndrome, says that in fact most birth defects are not preventable. Approximately three per cent of babies have some type of abnormality. “In about 90 per cent of cases of birth defects we can’t come up with a clear cause and effect.”
To warn or not to warn is the dilemma. Sanford Miller, director of the FDA’S Bureau of Foods, admits, “If we don’t say anything, we’re accused of trying to hide information, and if we do, we’re accused of raising false fears.” Dr. Henry Rosett thinks authorities are crying wolf too often. As head of the Fetal Alcohol Education Program at Boston University, Rosett charges that the Surgeon General overstated the possible effects of a mother’s moderate drinking on her fetus. “Doctors won’t believe it [this advisory]. It runs against their common sense approach.” But Miller argues, “I’d rather make it known to people and let them make up
their own minds.”
Ironically, the most hopeful result of this upsurge in cautionaries is that information is just what the patient ordered. This holds true particularly for women who are taking a more active role in their own pregnancies. In addition, they are having fewer children— 1.7 on average—literally putting all their eggs in one basket. So along with more careful planning and having babies later, there’s a heightened concern for infant health and vitality.
Instead of feeling victimized or “guilted out,” then, most women are coping, adapting—they want to know. A Vancouver 33-year-old, Leigh Bowie, stopped long-distance running in order to become pregnant. To be safe, she also quit jazz dancing and alcohol and cut down on tennis and coffee. “For nine months, it’s just not worth taking a risk.” But what happens when they warn us about pickles and ice cream? c£>
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