Fetal Alcohol Syndrome and Pregnancy

C. Ward Kischer
June 20, 2006
Reproduced with Permission

There is a plague upon us. It is constant and unrelenting, and its victims are dispersed from coast to coast (a lesser number world-wide). Through no fault of their own, they are permanently disabled. They never can be cured. These are the victims of Fetal Alcohol Syndrome (FAS). This is one of the most unforgiving tragedies of our time. Lesser effects of alcohol poisoning are grouped into Fetal Alcohol Effects (FAE). Those suffering from FAS constitute a subclass of human beings who can never function as normal. But, the greater tragedy is that their condition is 100% preventable. FAS is a social problem, to be sure; but, scientifically, it presents a major problem in Human Embryology.

The Effects

The characteristics of FAS include: alterations in growth and morphogenesis, mental retardation and other anomalies. These are usually manifest in facial deformities, but, also in joint anomalies, and congenital heart disease. The clinical features may vary from subtle to severe [Moore, K.L. and T.V.N. Persaud. 1998. The Developing Human, 6th ed., p. 186. W.B. Saunders, Philadelphia]

Even moderate alcohol consumption (e.g. 1 to 2 ounces per day) may produce FAE. Binge drinking is also known to produce either FAS or FAE.

The effects are most pronounced in mental retardation and behaviors, which usually includes Attention Deficit Disorder (ADD) or Attention Deficit Hyperactive Disorder (ADHD). This begs the question: could those diagnosed with ADD or ADHD include a hidden history or denial of alcohol use by the mother? The susceptible period of nervous system development (e.g. brain) spans most of the gestational period. But, there is a precise element about the relationship between an alcoholic mother and the developing embryo.

Pregnancy and FAS

First, let's get something straight: pregnancy begins with fusion of the sperm and egg, in other words, at conception.

Second, for about the first two weeks of development the embryo gets its maintenance from the fluids in the fallopian tubes and the uterus. Thereafter, the placenta and blood vascular system develop so that nutrition and survival are provided via those two sources.

Third, fertilization occurs approximately 13 days after the onset of the last menstrual period. If the woman happens to "miss" her next period, she likely will not consult her physician, or have a pregnancy test, until sometime after the "miss". That puts the time element about 5 to 6 weeks after pregnancy has begun. This is the vulnerable time during which alcohol begins to kill neuronal cells.

In other words the killing has begun before the woman knows she is pregnant.

Critical Timing

Larsen's textbook of Human Embryology states: "Few women are fully aware that although it is important to avoid alcohol throughout pregnancy, it is crucial to abstain from drinking during the early weeks following any act of intercourse that might have resulted in pregnancy -- whether or not the woman knows herself to be pregnant [Larsen, W.J. 2001. 3rd ed., pp. 398-399, in Human Embryology, Churchill Livingston, New York].

The claim cannot be made that every woman who imbibes or is alcohol addicted during pregnancy will produce a FAS or FAE child. But, it can be said that every FAS child is delivered from a mother who poisoned her child with alcohol. The incidence is as many as 2 in every 1000 live-born infants.


Clearly, counseling is in order. One place to start is the nation-wide Crisis Pregnancy Centers (CPC). A significant number of their patients are young girls who party and "booze it up" on a given weekend, then show up the following Monday at a CPC asking for a pregnancy test. Such a test at that time could well be a false negative because the test is for human chorionic gonadotropin (HCG). HCG is not sufficiently detectable until about two weeks after fertilization. By the time pregnancy is diagnosed the damage has already been done by the imbibing mom, even from binge drinking.

What's So Offensive With The Phrase "risking pregnancy"?

In Arizona, bars and restaurants display a sign reading: "Drinking alcoholic beverages, including distilled spirits, beer, coolers and wine during pregnancy can cause birth defects."

In early 2004, and again in 2005, I proposed and initiated a change in the wording to Arizona State Senator Linda Gray to read: "Drinking any alcoholic beverage can cause permanent birth defects in an embryo and fetus in women risking pregnancy before the woman knows she is pregnant." In both cases a bill was introduced but with the words "risking pregnancy" deleted. There were objections to this phrase and the bills died due to inaction and non support from Arizona Representative Phil Hanson, who chaired the State Health Committee. In fact, Rep. Hanson, on the first attempt, said what was already stated was "sufficient". My questions as to why the phrase "risking pregnancy" was offensive went unanswered. So, I am left to my own conclusions.

Obstacles To Public Awareness

The catalyst for women's issues is the word "choice". Even women who are not adamant feminists enjoy the comfort of "choice". Thus, to inform women that they, and they alone, are responsible for FAS, and that if they "risk pregnancy" while drinking, and happen to get pregnant, their "choice" has been compromised. In effect, their "choice" for recreational intercourse, no matter what might happen, has been challenged. The extreme feminist position can be seen by the following quote attributed to Norah Vincent, a columnist for the Village Voice, which appeared in The Los Angeles Times, 29 March, 2001:

"Those babies are ours, and we can do with them what we like. We can smoke three packs a day. We can drink motor oil. And if that baby comes out with a brain that doesn't quite work or that doesn't work at all, if it has an imposed mortal dependency on a narcotic, or it comes out with expensive special needs, well, the government will pay for it. That's what government is for: to safeguard my right to do what I like and pick up the tab when I've done it. I can do anything, consequences be damned. Let freedom ring, because, by God, I am a woman, and this is America."

Compounding the problem with the feminist view is the liberal passion of blurring the distinctions between male and female. Thus, we have the one view of the nurturing, caring female with the goal-driven, independent female. These competing perspectives, in essence, deny the very biology of male vs. female. Even though the female of our specie is the only one to bear children, and is the gender with all the machinery to do it, we have seen movies and tabloids claiming the male to have been "pregnant". This literary license attempts to fog the difference between male and female in favor of deemphasizing the biological role of the woman, and, in the case of the tabloids, actually is a case of "parasitic twins" and is not in any way a case of "pregnancy" in the male.

Cloning is a current popular notion in the public media, and this procedure, also, has been touted as a way to relieve the burden of pregnancy in the female.

Biology And Responsibility

The biological facts are that the female conceives and cares for the embryo and fetus from day one of pregnancy. Fluids from the fallopian tubes and uterus provide sustenance until about 6 days post-fertilization, after which the placenta develops. This organ, then, becomes the lifeline for the new individual and transfers of oxygen, carbon dioxide, nutrients and metabolites are made, mom to embryo and fetus, embryo and fetus to mom. The placenta is no barrier to most noxious elements, not to viruses, and certainly not to alcohol. It is the mother's responsibility to care for the new individual human being from the moment of conception to birth and beyond. That's just how it is.

Therefore, there is one overriding message needed for every prospective mom, and that is: If one is "risking pregnancy", that is, having sexual intercourse, DO NOT DRINK ALCOHOL!

We have a subset of the human population which is permanently damaged due to irresponsible women. There is no excuse for it.

C. Ward Kischer, Ph.D. is an emeritus professor of Anatomy And Cell Biology, specialty in Human Embryology, University Of Arizona, College of Medicine, Tucson, Arizona, 85724. E mail: wardkischer@yahoo.com