Alcohol and sex: A tragic cocktail

Monday, July 15, 2002 | 10:07 a.m.

Results of a survey on Nevada women, babies and alcohol :

Sources: State Health Division, the Governor's Maternal and Child Health Advisory Board Fetal Alcohol Syndrome subcommittee, the Division of Child and Family Services.

It's a tough message to bring to a society that mixes alcohol and romance, but a little-known governor's advisory board feels it has no choice, given the dangers of alcohol to unborn children.

The Governor's Maternal and Child Health Advisory Board is advising sexually active women of child-bearing age to either stop drinking or do whatever it takes to keep from getting pregnant, up to and including sterilization, in an effort to prevent fetal alcohol syndrome.

It has produced placards it hopes to get placed in bars warning of the dangers of mixing alcohol and sex, and wants bartenders and other servers as well as health officials to get training on the subject.

The reason: Research, while incomplete, shows that as little as one drink can trigger fetal alcohol syndrome in an unborn baby as early as the first weeks after conception -- before a woman may know she is pregnant.

"In the environment in which most of the population lives it can be tough," said Dr. Terrence McGaw, chairman of the group's subcommittee on the subject and an OB/GYN for the Washoe Pregnancy Center. "(Drinking and sexual activity) is the norm, but we are trying to change the norm, the Sin City complex."

Fetal alcohol syndrome is an irreversible birth disorder that often results in facial deformities, stunted growth and central nervous system dysfunction. The syndrome -- which national statistics say occurs in 1 of 1,000 babies but some state health officials believe could affect as many as 1 of 100 babies -- leads to secondary conditions such as learning disabilities, mental health issues and behavioral problems.

It's also 100 percent preventable, which is why the advisory board has unanimously agreed to make fighting the syndrome a top priority in its legislative agenda for 2003.

"Fetal alcohol syndrome essentially impacts the brain," said Laurel Swetnam, program manager for Early Child Services for the Clark County Division of Child and Family Services. "You can make the best of it and you can use strategies which build on the child's strengths and the parent's strengths, but you can never undo the fact that the child is born with a disability."

The advisory board wants to go further than just getting the word out about the dangers of drinking while pregnant. It also wants to help substance-abusing women get treatment or long-term or permanent birth control, and to improve efforts to diagnose and treat children with the syndrome.

The board notes the high costs of raising these children -- both to the individuals and society as a whole.

More than 60 percent of children with fetal alcohol syndrome end up in trouble with the law, said geneticist Dr. Colleen Morris, professor of pediatrics at the University of Nevada School of Medicine. Others abuse alcohol and drugs, become disruptive in school, have trouble holding jobs and have alcohol-damaged children themselves, she said.

The dangers have been known since at least 1989, when the surgeon general warned that drinking by pregnant women or women who want to get pregnant could cause birth defects.

Research has found no safe level of alcohol consumption of any type -- from beer and wine coolers to hard liquor and mixed drinks -- for pregnant women, according to reports prepared for the advisory board.

Part of the problem is that the development of fetuses is so individual that a single drink at the wrong time can have a terrible effect, the board noted. On the other hand, several drinks at a different time may have no effect. A woman just can't know when it's safe.

"We still have to say no to alcohol," said McGaw, who chairs the subcommittee that wrote the reports. "What if they take that one drink at a critical time in their nine-month course that did affect growth or development?"

The advisory board hopes to get this point across with the warning placards featuring a National Geographic photo of a mother with an infant suffering from the syndrome.

About 1,600 of the placards, which will be displayed voluntarily, have been mailed to drinking establishments registered with the Nevada Division of Taxation. Another 3,500 will be mailed this year to convenience stores, beauty salons and other locations through money provided by the March of Dimes.

The advisory board wants the Legislature to mandate that the placards be displayed in all drinking establishments and places where alcohol is sold. State Sen. Valerie Wiener, D-Las Vegas, already has requested legislation be written.

Board member T.J. Rosenberg wishes she had had such a warning when she was a pregnant alcoholic.

"I told my doctor I was an alcoholic, and he said it won't hurt if you have one glass of wine," Rosenberg said. "What he didn't understand is that alcoholics can't really have one drink."

Her son suffers from developmental effects of fetal alcohol syndrome. He doesn't have many social boundaries, and can get angry and violent, especially around other kids, she said.

"It's really hard," Rosenberg said. "He doesn't have any of the facial features, so he looks normal and is expected to act normal. But because of the brain damage, he doesn't connect or process information like other kids do."

But health officials don't want to alarm women who have already consumed alcohol during their pregnancy into thinking all is lost, or deter them from seeking prenatal care for the unborn child.

"Ceasing alcohol consumption can improve the outcome of having a healthy baby at any time during the pregnancy," McGaw said.

They hope that the phone numbers they distribute with the placards will direct women into programs to treat their addictions.

The state has a policy of giving pregnant women first priority for state-funded drug and alcohol treatment programs.

One obstacle to getting women to take advantage of that is some women may fear that they will go to jail or lose their babies if they come forward.

Rosenberg said she didn't get treatment for her alcoholism during her pregnancy because of such fears.

"Every day when I was pregnant I woke up and said I wasn't going to do that, but I didn't know any way not to," said Rosenberg, who has been sober for 13 years. "With these programs women can have hope."

For substance-abusing women who have difficulty remembering to use regular birth control methods, the board recommends long-term or permanent methods such as voluntary sterilization be offered if they refuse to get help for their substance abuse.

Arlene Poquiz, who gave birth to eight babies, four of whom are in foster care in Las Vegas, said she would have accepted an offer of sterilization.

"If someone would have said 'I would tie your tubes for free,' I would have jumped on it," said Poquiz, who denies having used alcohol or drugs during her pregnancies, though at least three of her children have been diagnosed with fetal alcohol syndrome.

McGaw said that while the law allows the state to take custody of children born obviously exposed to alcohol or drugs, prosecuting the women doesn't help.

"It's tough enough for someone to recognize they need help and come in anyway, so it doesn't help to have police there," he said.

Not everyone agrees. Allen and Betsy Goldbrener, the adoptive parents of Poquiz's 13-year-old twins, say mothers should be charged with child abuse and the children taken away if a second child is born with fetal alcohol syndrome.

"Why should this child be brought into and suffer for the rest of their lives when these women know they can't protect themselves?" Allen Goldbrener said. "Like these girls, they would be brilliant if not for (fetal alcohol syndrome). Why should they have to suffer?"

The state and county reach out to children who suffer from the syndrome, but more needs to be done to break the cycle, the advisory board said.

It's hard to tell exactly how many children are affected by the syndrome because many children, like Rosenberg's son and the Goldbrener twins, don't show the facial deformities at birth, said Morris, who is also a member of the board's subcommittee on the syndrome. Most of the indicators may not show up until the child is 7 years old, she said.

That delays a diagnosis and treatment that could improve a child's chances, Morris said.

"One of the problems is that if fetal alcohol syndrome is not diagnosed at an early age, you have a very high chance of having secondary disabilities," Morris said. "A disruptive school experience, drug or alcohol use, sexual abuse, all these occur more frequently in children who are not diagnosed early enough for children to receive proper treatment."

The county Division of Child and Family Services reaches out to children with developmental delays from birth on, offering classes and counseling. The school district steps in at age 3 with special education.

But family environment and positive support are the most important assets for children with fetal alcohol syndrome to be able to gain skills to their capacity, Swetnam said.

Determination helps too, the Goldbreners said.

When they adopted the twins, they were told the girls had IQs of 60 and 63, that they would never be able to write or even know their names. Despite that, both girls have done well in regular classes at their middle school. Dorinda is a published poet, and Melinda an accomplished musician.

"The state itself didn't give them a chance, but ever since they came home asking what their problem was and we sat them down and explained what fetal alcohol syndrome was, they've studied harder and really concentrated on what they are doing," Allen Goldbrener said. "That is why they are catching up, because with their IQs and their backgrounds, they are not supposed to be doing this good. But they are fighters."

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