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‘Alcohol, Pregnancy and Harm Reduction: A Review of the American Experience’


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In this paper I will briefly review the evolution of policies promoting alcohol abstinence in pregnancy in the United States. I then focus on the battle to place warning labels on alcoholic beverages sold in the United States, on the statements of medical organisations regarding abstinence, and on the material found on the FASD website of the Centers for Disease Control and Prevention of the US government.

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‘Alcohol, Pregnancy and Harm Reduction: A Review of the American Experience’

  1. 1. Message in a Bottle: The Making of Fetal Alcohol Syndrome Janet Golden, Ph.D. Rutgers University
  2. 2. National Organization on Fetal Alcohol Syndrome poster, c. 1992
  3. 3. Phase I: 1973-1977 Discovering the Offspring of Alcoholic Women
  4. 4. Discovering FAS <ul><li>Dr. David Smith and Dr. Kenneth Lyons Jones </li></ul><ul><li>“ Pattern of Malformation in the Offspring of Chronic Alcoholic Mothers,” LANCET 1 (1973): 1267-1271 </li></ul><ul><li>“ Recognition of the Fetal Alcohol Syndrome in Early Infancy,” LANCET 2 (1973): 999-1001 </li></ul>
  5. 5. Cigarette Warning
  6. 6. American Lung Association Poster, c. 1988
  7. 7. Phase 2: 1977-1986 The Crusade to Warn
  8. 8. 1977 Warning from the NIAAA <ul><li>Pregnant women who consume more than six drinks a day incur a significant risk of producing a child with birth defects </li></ul><ul><li>Limit drinking to two drinks per day </li></ul><ul><li>Consult doctor </li></ul>
  9. 9. 1981 Advisory on Alcohol and Pregnancy: <ul><li>Pregnant women and those considering pregnancy should not drink alcoholic beverages </li></ul>
  10. 10. FAS Costs
  11. 11. Warning from the NIAAA
  12. 12. NIAAA Pamphlet
  13. 13. Rate of FAS
  14. 14. Phase 3: 1986-1990 The Discourse of Law and Responsibility
  15. 15. Warning Label
  16. 16. Michael Thorp
  17. 17. The Broken Cord
  18. 18. National Organization on Fetal Alcohol Syndrome poster, 1991
  19. 19. Arizona Department of Behavioral Health Services poster, c. 1992
  20. 20. Crack Mothers
  21. 21. AMA Report <ul><li>&quot;Pregnant women will be likely to avoid seeking prenatal of other medical care for fear that their physicians’ knowledge of substance abuse or other potentially harmful behavior could result in a jail sentence rather than proper medical treatment.&quot; </li></ul><ul><li>Board of Trustees Report, Legal Interventions During Pregnancy, 264 JAMA 2663, 2667 (1990) </li></ul>
  22. 22. Phase 4: the 1990’s From Victim to Victimizer— the Death Row Debates
  23. 23. Robert Alton Harris
  24. 24. Charles Krauthammer, M.D. : <ul><li>“ We can either do nothing, or we can pass laws saying that any pregnant woman who takes cocaine will be sent until delivery to some not uncomfortable, secure location (boot camp, county jail, house arrest--the details are purely a technical matter) where she can do anything except leave or take drugs.” </li></ul>
  25. 25. Alaska Department of Health and Social Services poster, c. 2001
  26. 26. Phase 5 An Imagined Response
  27. 27. Substance Use in Pregnancy