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Vernellia R. Randall, Taking a Community Approach to Preventing the Creation of a Biological Underclass, Chapter Four, Families and Communities in Partnership, edited by Patricia Voydanoff, 43-68 (University Press of America 1996)
Notes: This paper is limited to fetal alcohol syndrome because alcohol abuse provides a good paradigm for analyzing all substance abuse. Furthermore, the problem is not complicated by the illegality of its use. This paper is limited to a discussion of the impact of maternal drinking during pregnancy on the unborn child. This is not to minimize the potential impact that paternal alcohol abuse may have o the unborn child. Paternal drinking is known to reduce sperm counts and sperm motility and to produce other sperm abnormalities. However, this does not directly affect the unborn child. While paternal drinking may also contribute to fetal abnormalities, the limited studies that have been done have not found such an effect.
Each year, thousands of children are born severely damaged by maternal alcohol abuse) Fetal Alcohol Syndrome' is the leading known cause of mental retardation (ranking ahead of Down's syndrome and spina bifida).
This problem is not new. Since the beginning of recorded history, women have consumed alcoholic beverages in religious ceremony, in celebration, for medicinal therapy, and in recreation. Historians have recognized and reported the impact of problem drinking on the fetus.' Hippocrates warned pregnant women not to take drugs before the fourth month and after the seventh month.' Soranus of Ephesus warned women not to take drugs especially during the first trimester:
Let no one assume that the fetus has not been injured at all. For it has been harmed: It is weakened, becomes retarded in growth, less well nourished, and in general, more easily injured and susceptible to harmful agents; it becomes misshapen and of ignoble sou1.
Without minimizing the general oppression of women, it is no surprise that society has generally disapproved of women drinking alcohol. In ancient Rome, women were strictly prohibited from drinking alcohol and were punished by stoning or starvation for breaking the prohibition." In Philistines, according to chapter 13 of the Book of Judges, an angel appeared to the wife of Manoah and told her: "Behold . . . you shall conceive and bear a son. Therefore beware, and drink no wine or strong drink, and eat nothing unclean." She followed the injunction and bore the hero Samson. Because of that biblical story, alcohol drinking by pregnant women has been taboo for many people.
Centuries later, Kant attributed the sobriety of women of his time to their special place." While Kant's observation may reflect the sexism that historically has oppressed women, his observations also support, indirectly, what social scientists have documented. Whenever the cultural bars to female drinking fall, the incidence of prenatal alcohol injury rises and the harm to communities and society escalates.' "Whatever the root of the ancient restrictions, they have for millennia had the effect of promoting healthy births."'
The lifting of the prohibition against women drinking in our society can, in part, be traced to the 1940's when the country repealed national prohibition, the depression was ending, and the country was reluctantly preparing for war.-There was little national interest in alcohol-related problems. Alcoholics were heavily stigmatized, assumed to be of little worth, and usually blamed for their condition. While the society was concerned about intoxication, there was a widespread reluctance to enforce anti-drunkenness controls'
Society dismissed as a myth the association between women's alcohol use and birth defects." This change in attitude toward the impact of women's drinking coupled with less patriarchal oppression resulted in a significant increase in drinking and alcohol problems in women.7 For instance, women born during the 1950's and 60's show a higher rate of heavy-frequent drinking than the generations of women before them.7 Furthermore, the risk of alcoholism in the present generation of women closely approximates that of men in their fathers' generation." Today, it is as acceptable for women to drink alcohol as men. In fact, 3.5 million American women use alcohol inappropriately and suffer from
One of the tragedies of the twentieth century is Fetal Alcohol Syndrome (FAS). As a result of FAS, three babies out of every thousand are born mentally, emotionally, and behaviorally retarded. The tragedy goes beyond the impact on the individual. FAS individuals form a self- generating, renewable, biological underclass (bio-underclass). Such an underclass has significant impact on the community and can potentially destroy it. Although FAS is completely preventable, efforts to prevent FAS break down over the debate about individual rights, that is, maternal rights and fetal rights. Individual rights' discussion in this context demonstrates the inadequacy of the rights language in an age of pluralism and diversity. FAS is a prime example of the need for a revised analytical structure. Such a revised structure would include the languages of interdependency, responsibility, and commitment to communities.