INFORMATION OF EARTH-SHATTERING IMPORTANCE (REALLY!) & HOW THINGS WOULD BE DIFFERENT IF I RAN THE WORLD TERATOGENS

There are not a whole lot of occasions when I can promise students that what I cover in a particular lesson will be of great importance to their personal lives and those of the people they care about. This is one of them. Unless you lead a very sad, isolated existence, at some point, either you, your spouse or someone you care about, such as a sister, good friend, aunt, cousin, etc. will become pregnant and have a child. At this point, it would be a very good thing if you knew what a teratogen was. TERATOGEN: Any chemical or infectious agent which causes birth defects.

Any time you read that a drug is "teratogenic", you should know that means it causes birth defects. Here is a clear case of where what you don't know CAN hurt you, or, worse, can hurt your unborn child. Your textbook does mention the most common teratogens, but I want to cover these in more depth and emphasize these because this information is SO important and (in my opinion) cannot be stressed enough.

HOW THE WORLD WOULD BE DIFFERENT IF I RAN IT - # 1

First of all, I would legalize marijuana and ban alcohol. Although marijuana does cross the placenta, and there is some possibility of harm to the fetus, the effects of alcohol are undeniable and pervasive.

ALCOHOL & FETAL ALCOHOL SYNDROME

Alcohol consumption during pregnancy can cause mental retardation, deficits in height and weight (below the third percentile), facial anomalies and other congenital problems.

In utero exposure to alcohol has severe mental and physical effects.

The more a pregnant woman drinks, the more her baby is at risk.

There is no cure for fetal alcohol damage. Good parenting and teaching may help a child's behavior or academics improve, but no amount of nurturing, love or tutoring will ever make the child normal.

There is no safe period for drinking during pregnancy. The central nervous system develops throughout pregnancy, beginning in the first month. Drinking during pregnancy at any time can affect brain development. Because women who are chronic alcoholics, by definition, drink consistently, the child of an alcoholic woman is exposed to alcohol in utero for the entire nine months, with severe, permanent effects on the developing brain. Children with Fetal Alcohol Syndrome not only are mentally retarded, but have significant behavioral problems as well, showing extreme impulsiveness, poor self-control and limited social skills.

Fetal Alcohol Effect is not necessarily any less severe "better" than Fetal Alcohol Syndrome. A child diagnosed with FAE does not have all of the symptoms of Fetal Alcohol Syndrome. So, the child may not have the facial characteristics generally associated with FAS or be average in size, but still have the intellectual and behavioral deficits associated with Fetal Alchol Syndrome.

There are many, many links on the Internet related to Fetal Alcohol Syndrome, unfortunately, some give no more information than what is presented above, and the information carried on numerous sites is pretty much the same. Below are two that I think are worth checking out. The first site gives parents' descriptions of their biological or adopted children with Fetal Alchol Syndrome. The parent who had been an alcoholic and gave birth to two children with FAS talks about the profound guilt she felt when she realized that she had caused her child's problems. This is one major difficulty work with parents of children who have Fetal Alcohol Syndrome presents. While most parents of children with disabilities feel some guilt regarding their child's handicap, professionals can reassure them that it is not their fault, that they did nothing to cause their child's disability. In the case of Fetal Alcohol Syndrome, the parent DID cause the child's disability and it IS their fault.

Click here to read parents' descriptions of raising children with Fetal Alcohol Syndrome.

As a professional, you will frequently be called upon to provide information on FAS. The national prevalence is estimated at somewhere between one in 750 and one in 900 births. However, there are some estimates which are considerably higher, suggesting that many cases of FAS go undiagnosed, either due to lack of knowledge on the part of health care providers, or unwillingness to accuse the parents of alcoholism. Fetal Alcohol Syndrome is more common on reservations, and in the upper midwest states, two areas with higher rates of alcoholism than the national average. Despite more attention to FAS lately, misconceptions are still rampant. When I lived in North Dakota, I made it a point to ask teenage girls what they thought would happen if they drank during pregnancy. Some of the answers revealed an astonishing degree of ignorances, such as "Your baby would be smaller when it was born, but after a while, it would be okay." or "There's something called Fetal Alcohol Syndrome, but that only happens to Indians."
A good resource, with a comprehensive listing of fact sheets, newsletters and a wealth of other information is available at the web site below.

Click here to go the Wisconsin web site on Fetal Alcohol Syndrome.

HOW THE WORLD WOULD BE DIFFERENT IF I RAN IT - # 2

    The most critical period for teratogenic effects is in the first trimester, often before a woman even knows she is pregnant. If I were God, I would change this. As you can see by the chart on page 75, during the first three months, the nervous system, eyes, ears and all major organs develop. Before vaccinations became widespread in this country, it was not uncommon to see 'post-rubella babies'. Rubella (also called German measles), could cause babies to be born blind, deaf and mentally retarded. However, sometimes, the babies were born deaf and mentally retarded, but not blind. In other cases, children might be mentally retarded but have no hearing or visual impairment, and, in still other cases, be born normal. I am old enough to have heard about the last German measles epidemic , and the many babies born disabled, and I wondered why there would be such a difference in effects.
    What I learned about prenatal development allowed me to make some sense out of the widely different outcomes. Babies who were affected in the first trimester, when their eyes and ears were developing, were born blind and deaf. Babies whose mothers were infected slightly later in pregnancy, after their visual organs had developed, were deaf, but not blind. Because the brain develops throughout pregnancy, children could be mentally retarded due to rubella, even if they were neither deaf nor blind,because their mothers had contracted the infection after their eyes and ears had already developed.
    Due to a great increase in immunizations (rubella is the "R" in the MMR that young children receive, rubella is much less common now in the United States, and, generally, post-rubella syndrome is only seen in children of immigrants from less developed countries where vaccinations are not nearly as readily available.

Moral: Get vaccinated. If you are female and have even the remotest possibility of ever becoming pregnant, make sure you have been vaccinated. Even if you are decades past menopause, or male, get vaccinated anyway to prevent the possibility of spreading rubella. It goes without saying that young children should be vaccinated. Unfortunately, it is a national shame the extent to which children, particularly poor children, in the United States are NOT receiving timely immunization (but more on that in a later section of the course).

HOW THE WORLD WOULD BE DIFFERENT IF I RAN IT - # 3

I CAN TELL YOU THIS BECAUSE THE STATUTE OF LIMITATIONS HAS EXPIRED...

About twenty years ago, before I had any children of my own, I was at a party in east Los Angeles and there was a very pregnant woman there freebasing cocaine. (Okay, yes, I admit it, I did not have the typical middle class upbringing of the average college professor.) Crack cocaine hadn't been invented yet, so this was how people smoked cocaine. I think I will skip an elaborate description of just how this was done. Anyway, I was curious about this, and asked the woman whether she was afraid that the cocaine would affect her baby. She replied, "Oh no, I am past eight months pregnant, the baby is fully formed by now. Nothing will have an effect on him."

Being a young person, who had never had a baby of her own, I accepted this answer. After all, she was pregnant, and she should know, right?

WRONG! The brain develops throughout pregnancy and after. There is no 'safe period' when your baby is fully formed and 'nothing' can affect it. While there is mounting evidence that children prenatally exposed to cocaine may have a better chance for normal development, in the long run, than was originally thought, studies with these positive findings are based on cases where children are subsequently raised in a stimulating, nurturing environment. Unfortunately, the type of mother who would abuse drugs during her pregnancy is often NOT the type of person who can provide a positive environment for her child, and so these infants are exposed to poverty, neglect and drug abuse in the home on top of their poor initial development. An important fact for those in early childhood education to be aware of is that these babies DO show short-term effects, of hypersensitivity, irritability, hyperactivity and being difficult to soothe. A couple of acquaintances who work in an early intervention (birth to three) program for 'crack babies' describe their little children as "hell on wheels". Regardless of their long-term outcomes, it is clear that, as young children, babies exposed to cocaine present significant challenges to their caregivers and have significantly more problems than young children not exposed to drugs.

HOW THE WORLD WOULD BE DIFFERENT IF I RAN IT - # 4

The final way in which the world would be different if I ran it is that any idiot who spoke out against prenatal care and nutritional assistance for pregnant and nursing women would be taken outside by a group of volunteer grandmothers who would slap them around until they had some sense.

Babies whose mothers are malnourished are more likely to be low birthweight, die in infancy and have physical and neurological problems. Proper nutrition does not mean simply enough food, but the right kinds of food, including milk, fruits, vegetables and protein. Not surprisingly, the women least likely to have proper nutrition in this country are those who are poor, who are disproportionately Native American, African-American and Latina women. Poorer nutrition, less prenatal care and higher incidence of alcoholism might explain why the infant mortality rate reported by the Indian Health Service for the Aberdeen area (which includes all of the reservations in North and South Dakota) was 2%. The first time I read this statistic, I thought it was a mistake, that someone had left out a decimal point. A student from Fort Berthold happened to come into my office while I was reading this report, and I asked his opinion. He said, "That sounds about right." I still couldn't believe it and said, "Come on, how many people do you know who have had babies die in their first year." He stood there and named enough people to make me depressed for the next couple of weeks.

Lately, in my home state of California, there has been a push to restrict these types of programs, and to deny prenatal care and nutrition assistance to pregnant women who are illegal aliens. Of course, according to the U.S. constitution, these children will be U.S. citizens when they are born, and according to all of the research reviewed in your text, they are more likely to have medical complications, physical and mental impairments. Personally, I am usually the first, loudest and longest to complain about how high my taxes are and how much of it is wasted. However, I have to agree with Winston Churchill, who stated that "A nation can make no better investment than putting milk into babies."

Click here to go to assignment #4

Well, there is ONE more change I would make if I ran the world - labor would be painless!

Click here to go on to fascinating information about birth, which, I do not CARE what our Lamaze instructor said last week, is not painless no matter how many hours a week you practice those breathing exercises!