ETOH - CHILD ABUSE IN THE WOMB

Once upon a time, there was a beautiful young girl. She had rich blue eyes, blonde hair, a petite frame well proportioned by nature. As she grew up, she was blessed by many talents. She was an accomplished gymnast and cheer leader in her high school. She became a concert pianist and cellist and was an Ontario Scholar. She graduated from medical school as one of their top students. As an emergency room physician she excelled and when she went into private practice, her practice built up quickly. She had a soft and gentle demeanour and always a smile. Her patients and friends loved her dearly.

Something happened to this fairy tale princess. She discovered alcohol, and liked its effects. For several years no one knew what she did behind closed doors after work, not even her husband. She was a "hidden" drinker. When she tired easily and went to bed early it was because of the long strenuous day at work. The next morning she would be back to her normal perky self. As time went on, the alcohol cost her a marriage and a son.

When she became involved again, she kept the alcohol problem well hidden. Her new spouse had never been involved with alcohol problems before and was rather naive. However, alcoholism is a progressive illness and the problems began to surface. At her husband's insistence and encouragement, she joined the DOC (Doctors On Chemicals) group and began to attend Alcoholics Anonymous meetings. Yet she would come home after the meetings and pass out, drunk. She began supplementing the alcohol with barbiturates and diuretics. As a physician, she could write prescriptions for patients and pick them up herself.

She became pregnant and her alcohol problem burst into the open. She lost her medical practice, and was voluntarily institutionalized in an alcohol treatment program. She left, against medical advice, after three weeks. She subsequently went to a program in the U.S.A. for treatment and left, against medical advice, after three days. She returned to the former program in Canada, but was expelled after two weeks for being drunk in the hospital. She returned to the U.S. program, but left after two weeks, against medical advice. Had she been an American citizen, she would have been involuntarily committed for the duration of the pregnancy. Over the following months of pregnancy, the horrors continued. Outrageous drunken behaviour at home and in public. Many trips for detoxification at hospitals. Several stays at hospital were involuntary under the Mental Health Act, Form 1. This only works for a maximum of 72 hours. The medical profession does not believe they can really help an alcoholic.

An addict cares about absolutely nothing except where their next "hit" is coming from. They will do anything and sacrifice anybody to get it.

No one can say that she drank out of ignorance, not knowing what harm could come to the baby. She was a bright, well educated, knowledgable physician. There was no excuse. And yet she would consume 12 to 40 ounces of vodka, 1000 mg Tuinol barbiturates and 200 mg Furosemide diuretics, daily.

Finally, she gave birth to a baby boy. He was tiny, only 4 pounds 12 ounces. Within days of being released from hospital after the birth, she was again drinking heavily. Finally, her husband, unable to legally bar her from the house when she became drunk and dangerous to the baby, had to pack a few belongings and move out, with the baby. The nightmare continued with false charges, legal battles and financial destruction. When the immediate dust cleared, the family assets were gone, two businesses destroyed and the baby boy was adopted by the father. While the husband was the natural father, the adoption transferred all parental rights to the husband. This avoids future legal battles.

That baby boy is my son. He was diagnosed at the Motherrisk Clinic at Sick Children's Hospital, Toronto, as suffering from Fetal Alcohol Effects. Hair sampling also detected traces of amphetamines. Subsequently, he was further diagnosed by his paediatrician and McMaster-Chedoke Hospital (Chedoke Division) with Fetal Alcohol Effects. Up until his second birthday, he participated in the Chedoke Infant/Parent Program. This involves regular home therapy visits and frequent testing assessments. He began day care at age 2 and received special attention by a resource teacher. He had to be withdrawn from day care 90 days later. Of the 90 days in day care, he was ill 87 days. His immune system could not handle bacteria and viri carried by the other children.

He is a beautiful, blue eyed, blonde, loving little boy. At his second birthday, he was 6 months delayed in his expressive language. He cannot concentrate for any length of time on a single item. He is extremely active. He has an extremely high pain tolerance level. The level is so high that it is dangerous to his safety. He is very impulsive.

He has tremors when awakened and frequently during the day. He runs anywhere he goes and often trips over his own feet. His head size has not kept pace with his body growth. He is still a tiny child. He has frequent "Night Terrors" where he screams as if he is in extreme pain or fear for up to twenty minutes, without waking up.

He has an extremely short memory span. After 2 minutes of "time-out" for misbehaviour, he may not even remember what he was punished for and proceed to do exactly the same thing again. Negative reinforcement through spanking is of no use, both because of his high pain tolerance and his short memory span. Redirection does not correct negative behaviour but only delays its repetition. His impulsiveness does not provide for cause and effect caution development.

I have remarried and we have a daughter by that marriage. At 10 ½ months she weighed two pounds more than her brother did at two years old. While I am my son's biological father, my wife and I have also legally adopted my son. Looking after a hyperactive child with fetal alcohol effects or syndrome is a full time, exhausting, job. The extra time and energy required to deal with my son unfairly competes with the time available for my daughter.

Throughout the pregnancy saga, everything that could legally be done to protect my fetal son, was done. I still bear great frustration and resentment that the law does not recognize a baby as being human until it passes fully from the body of the mother. If an addict did to her child after birth what she did during pregnancy, she would be charged with criminal negligence, reckless endangerment and more, and likely spend time incarcerated in the penal system.

Your right to swing your fist ends at my nose. A mother's right to consume alcohol or other harmful substances ends at the placental wall. If the baby is going to be carried to term, then the rights of the baby exceed those of the mother.

It has been well acknowledged that about 10% of the adult population has an alcohol problem and that the problem is fairly evenly distributed between men and women. The medical profession's addiction rate is estimated at about 20% of doctors. If this is the case then it is likely that in excess of 10% of children born have been exposed to alcohol in the womb. I say "in excess" in that many women consume alcohol at a level which "society" does not consider to be a problem. Many more will have consumed alcohol during the first two or three months before they discovered they were pregnant. The baby may have already been damaged. Continued drinking would exacerbate the problem.

Research shows that alcohol damage to the fetus occurs over a wide continuum. Damage varies due to volume ingested, timing during pregnancy, peak blood alcohol levels, genetics and environmental factors. At the mild end, damage may be the loss of some intellectual functioning (IQ), visual problems and higher than normal pain tolerance. At the severe end, damage may be severe loss of intellectual potential, severe vision problems, dyslexia, serious maxilo-facial deformities, dental abnormalities, heart defects, immune system malfunctioning, behavioral problems, attention deficit disorders, hyper-activity, extreme impulsiveness, poor judgement, little or no retained memory, deafness, little or no capacity for moral judgement or interpersonal empathy, sociopathic behaviour, epilepsy, tremors, cerebral palsy, renal failure, heart failure, death.

Consider the future for a victim of fetal alcohol. The child may have an "attention deficit disorder" or be hyper-active. The child may be rather bright but not be able to retain information. There may be other learning disabilities. The child may only be able to learn in a highly structured one-on-one teaching environment.

Children and some teachers can be very cruel. Children who do not physically appear different from the others, will be punished for poor behaviour, reviled for poor academic performance and otherwise dumped on consistently while they are growing up. They may be "expelled" from school or drop out early. The child physically grows into the body of an adult but may have an negative attitude problem from being dumped on for the previous 18+ years. The child/adult may act impulsively, to an unacceptable degree. He, or she, may not be able to get a job, or remember to go to work if they do get one. They may not be retarded and, in fact, can be quite bright. How will society deal with this child/adult? If he cannot survive in an unstructured environment, he may be placed in a highly structured environment, in the prison system. Society will pay over $70,000 per year to sweep this child under the carpet. However, as the law only permits incarceration for limited periods, society will periodically throw this child/adult out of his structured environment. He no longer has housing, clothes, meals, entertainment or companionship. The only way to escape back to the safety of incarceration is to inflict pain on society, and get caught. Once again the victim is victimized by a blind, stupid and negligent system.

Negligence is the recognition of a hazardous condition and the failure to attempt to correct that hazardous condition.

There is absolutely no question but that alcohol damages the fetus during pregnancy. There is absolutely no question that an addict will not voluntarily refrain from substance abuse during pregnancy. In the U.S.A., they have legislation which permits involuntary committal of a substance abusing pregnant woman for the duration of the pregnancy. We need similar legislation in Canada.

Society must express its extreme revulsion at the deliberate deformation and crippling of infants by substance abusers. The sanctions must be exceptionally high and the tools for the medical and legal professions must be strong enough to protect the most vulnerable of society's children.

Many physicians have recognized the problem and need clear legal power to deal with it. The devastation caused by alcohol abuse is well documented. If alcohol were being introduced as a new drug, it would not be tolerated. In North America alone, tens of thousands die annually in alcohol related traffic accidents. Hundreds of thousands of families are destroyed by alcohol and other substance abuse. Tens of thousands of children are born with alcohol induced disabilities which will plague them for the rest of their lives, and cost society dearly.

Fetal Alcohol Syndrome and Fetal Alcohol Effects and the lesser degrees of disability caused by maternal alcohol ingestion during pregnancy are entirely preventable. This problem crosses all racial and socio-economic groups.

There is a perception among some that FAS and FAE are primarily found in aboriginal, black or poor groups. This may seem to be the case because these groups are more frequently under the microscope of various agencies. Upper and middle income white anglo-saxon's are in a better financial position to hide "the problem" and will never admit to a parent being an alcoholic, particularly the mother. Yet one has only to attend various Alcoholics Anonymous, Alanon, Alateen, or Adult Children of Alcoholics meetings to see the full cross-section of society, from rich to poor and predominantly white, both male and female, from all age groups.

The devastation caused by alcohol makes tobacco smoking almost healthy by comparison. Yet for some strange reason it is popular to attack smoking tobacco. No one beats his wife or children after smoking. No one commits motor manslaughter because of smoking too much. No one causes fetal alcohol syndrome or fetal alcohol effects by smoking, although smoking can contribute to low birth weight.

While equality of the sexes is in many areas a justifiable social goal, the fact is that by definition only females in our species can bear children. We all have the right and freedom to do whatever we want, providing it does not negatively affect anyone else. When our actions or perceived rights clash with the rights of another, society develops guidelines and sanctions governing that conflict. This intolerable situation cries out for clear legislation protecting our children.

A dead human body has more legal rights than a child in utero. One can be imprisoned for "offering an indignity" to a dead human body. The Last Will and Testament of a dead person can determine the distribution of his assets. Under the law, the child has no rights whatsoever. It can be tortured, maimed, poisoned and crippled for life while still in the womb, with absolute impunity.

I strongly recommend the following:

1. Legislation providing severe sanctions against alcohol or substance abuse during pregnancy. Involuntary committal of a pregnant substance abuser to a medical treatment facility should be available through the medical profession or through the courts. Committal should be able to continue for the duration of the pregnancy.

2. If a child is born addicted to or withdrawing from substance abuse, the abuser should suffer severe sanctions including incarceration (where they may get treatment) and the child should be removed and placed in protection. The abused child should not be returned to the abuser.

3. Legislation providing severe penalties against those providing alcohol or other abusable substances to a pregnant woman. This would include bars, beer, liquor and wine stores and taxi drivers who act as bootleggers, among others. Sanctions could match those in existence against providers of cocaine, crack, heroin, etc. The effects of alcohol abuse are certainly as great as or greater than these substances.

4. A tax of $5.00 per litre of ethyl alcohol (of all types at all dilutions) for human consumption. It would allow at least partial cost recovery of the damage caused by alcohol. The entire proceeds of the tax to go to addiction research and treatment, Fetal Alcohol diagnosis and support facilities and appropriate housing and care for victims of maternal substance abuse. This is a reasonable alternative to incarceration in penal facilities for an adult FAS victim. It is time to begin protecting the tiniest victims of alcohol.

5. A ban on any alcohol advertising in any media.

6. Warning labels on all containers of alcohol, with statements at least as strong as those already required on alcohol sold in the U.S.A. This represents little or no additional cost to Canadian manufacturers.

6(a) An end to fancy packaging of alcoholic beverages. Labels should all be black print (Helvetica style) on yellow background only. As a "controlled substance" alcohol should not be glamorized.

7. Criminal and civil remedies should be available to the victims of substance abusers and their suppliers. When you don't want someone to do something, you make it worth their while not to do it. A clear and unmistakable message must be given that this society will not tolerate inflicting substance abuse on a child in the womb any more than it will tolerate substance abuse inflicted on an already born child. Not only will the abuser be punished, but also any one who contributes to that abuse.

8. A major screening and assessment of offenders in penal institutions to identify those suffering from fetal alcohol syndrome or fetal alcohol effects. Development of special programs and facilities more appropriate to dealing with the identified victims of maternal alcohol abuse. These facilities may include long term structured care facilities more appropriate to medical disabilities than to penal punishment. An FAS offender may not even remember why he is being punished. For many of them, every day is a new day, with few, if any, memories of yesterday.

A cynic might note that the fetal alcohol victim of maternal alcohol abuse may ultimately spend his or her life incarcerated in prisons or other institutions, while those who caused the problem in the first place carry on with impunity. It is a sad commentary on our society.

Some of these recommendations will undoubtedly incur the wrath of the alcohol lobby. Tough! They are little different from traffickers in narcotics. I am not a "teetotaller" but my son and I have been the victims of alcohol abuse and a negligent medical/legal system which could not protect him from the ravages of his birth mother's drinking. I have no sympathy for the purveyors of death and disability.

I will do everything I can to help my son through the disabilities created by his birth mother's substance abuse. But I won't live forever. At some point, society may well have to pay the price.

A measure of the level of civilization is society's willingness to protect and care for its children. After all, they are the future of society. They pay the price for their parents' mistakes. If we, as a society, will not tolerate an adult deliberately maiming, visually impairing or mentally crippling a child after it has been born, how can we continue to tolerate such behaviour while the child is in utero. Failure to act would be negligence in the greatest degree.