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Once again a major news media outlet has produced a segment that reinforces broadly held misconceptions about alcohol consumption during pregnancy and deepens the stigmatization of Fetal Alcohol Spectrum Disorders (FASD). Most recently it was ABC’s Good Morning America (GMA) Weekend. NOFAS is deeply concerned about the misinformation reported on GMA Weekend and has responded to ABC, speaking with one of the reporters responsible for the story to challenge the information presented by ABC and to request continuing coverage of the issue to set the record straight.
Unfortunately, a review of print and electronic news and editorial coverage from the past few years on the topic finds that the same myths and flawed assumptions are repeated over and over again in most national and local stories on the topic. The few feature stories that are covered tend to be more accurate largely because they include first-person interviews with FASD parents and caregivers, but this type of coverage also often contains inaccuracies and assertions that misrepresent the facts.
There are several false premises often repeated in the media that come from and appear to reflect the views of some segments of the general population and some professionals. Although it may appear as if producers and editors develop inaccurate stories using the same flawed template, sadly it likely confirms that the misconceptions about alcohol and pregnancy are real and more pervasive then we might imagine.
MYTHS AND FACTS
The following are some of the most common myths regularly reported in the media.
The science is incomplete and unclear. FALSE
There are over 3,000 articles since 1973 in the medical literature describing the risks of alcohol during pregnancy. The conclusion is so overwhelming and clear that since 1982 the United States Surgeon General has advised women to abstain from alcohol when pregnancy due to the risk of birth defects. Since 1989 an advisory about alcohol and pregnancy has appeared on every container of alcohol distributed in the U.S. Whatever your view of the federal government there is no more independent, credible or authoritative voice on health-related issues. More importantly, we know that alcohol is a teratogen, or neurotoxin like lead or mercury, that can interfere with human development at any stage of gestation. It is also understood that alcohol crosses into the blood supply of the embryo or fetus. Understanding the facts, why would anyone advise others to play Russian roulette with their pregnancy?
The science only shows that heavy or binge drinking can harm a pregnancy and that “moderate” use is harmless. FALSE
The effects of prenatal alcohol exposure occur on a continuum. Rather than an issue of a threshold, an amount that women can safely consume with zero risk, alcohol during pregnancy is an issue of dose-response. The more you drink the greater the risk of effects and the greater the potential range and severity. Heavy drinking throughout the pregnancy is linked to the most serious risk and the full Fetal Alcohol Syndrome. Research has also clearly found that moderate consumption can also be harmful. Occasional drinking has been linked to more subtle effects such as learning and behavior problems like attention and hyperactivity disorders and problems with judgment and understanding cause and effect. Who has the right to tell the public that a low dose amount of a toxic substance is completely risk free? Is a little harm acceptable as long as the birth defects are subtle?
It is also important to understand that heavy and binge drinking during pregnancy is not an issue that society can dismiss. More than 125,000 newborns in 2004 in the United States were exposed to heavy and binge drinking--One Hundred and Twenty Five Thousand children born in America in one year affected by heavy and binge alcohol. Does it further the cause of preventing alcohol-related birth defects when the media minimizing or dismisses the issue?
It is alright to drink beer and wine. Only distilled spirits or liquor is harmful. FALSE
Beer, wine and distilled spirits all contain alcohol, and all pose a risk depending on the amount consumed. The inference that wine or beer is okay because it may be more socially acceptable than distilled spirits demonstrates that the resistance may not be about the facts, but interfering with the traditions and customs regarding alcohol in society.
Women are overwhelmed with information on what they should not consume or be exposed to during pregnancy. Alcohol is just like some foods or cosmetics or household products that paranoid health officials believe could pose a risk. FALSE
Alcohol is a teratogen, a neurotoxin that can cause subtle developmental disabilities to profound brain damage. The alcohol risk far exceeds prenatal exposure to tobacco, most illicit drugs, or any noncontaminated foods. To even compare the effect of alcohol to the possible effects of foods and most other products, other than specific pharmaceuticals, is a false argument.
Marijuana, cocaine and heroin are more harmful to a pregnancy then alcohol. FALSE
Alcohol is a teratogen. The most common illicit drugs of abuse, marijuana, cocaine and heroin are not. Research has shown that children exposed to crack cocaine and not alcohol do not suffer the permanent physical or cognitive effects found in alcohol exposed children.
If a woman is celebrating a birthday or special occasion it is alright to have a drink. FASLE
Why is it more important not to upset the sensibilities of women wanting an alcoholic drink with their favorite meal or at a holiday celebration then to disseminate the facts in the surgeon general’s advisory? That has a devastating influence on women with a growing or chronic alcohol problem seeking license to drink. Advising a woman that there is no harm in one drink turns the advisory about prenatal alcohol on its head. An advisory is intended to warn the public about the use of a substance, not to promote its use. There is no need for further interpretation of the Surgeon General’s advisory: “A pregnant woman should not drink alcohol during pregnancy. Health professionals should inquire routinely about alcohol consumption during pregnancy, inform them of the risks of alcohol consumption during pregnancy, and advise them not to drink alcoholic beverages during pregnancy.”
The endorsement of special occasion or one time only drinking are code words for telling a women that she is exempt from the risk, usually because of ethnicity, status or education. The endorsement of moderate or light drinking demonstrates that professionals, and others, do not understand the dose-response relationship of alcohol exposure and are likely not comfortable talking with women about alcohol use, as research suggests. Regardless, the effect of this behavior is to strengthen the stigmatization for women who do use alcohol especially those who misuse alcohol.
Many professionals say that they have never seen a Fetal Alcohol Syndrome baby and therefore they conclude alcohol during pregnancy is not a significant concern. FALSE
As of 2008, only approximately six medical schools of the more than 125 in the United States offer coursework on Fetal Alcohol Spectrum Disorder. Unfortunately, many practitioners have not been educated on FASD or addiction medicine or trained to screen women for alcohol use disorders or diagnose children or adults with FASD.
CONCLUSION
False premises lead to false conclusions and when those assumptions are reported by the media that leads to misinformation. Reporters like to say, “Don’t shoot the messenger.” They assert that they are just conveying the prevailing attitudes and beliefs of the public and professionals. Perpetuating myths and stigmatization may be reporting, but it is not journalism and it is a missed opportunity to conquer the myths and stigmatization.
The so called controversy that the media often reports is really the false controversy of myth vs. fact. On one side are the myths produced by the repeated dissemination of incorrect or conflicting information; myths that are often reinforced because they are convenient and people want to believe them. On the other side are the facts; science complemented by a common sense understanding of the advisory to abstain from alcohol when pregnant or thinking about pregnancy. Alcohol-related birth defects are the leading known cause of mental retardation, birth defects and learning disabilities. Fortunately they are completely preventable. A media that reports the facts would go a long way toward fulfilling that promise.
NOFAS MEDIA OUTREACH
Media education and outreach is an important part of the NOFAS mission. Whenever possible, NOFAS responds to inaccurate media reports about FASD and alcohol and pregnancy. NOFAS also responds as appropriate with criticism or praise to portrayals of the issue in television, movies and other media. NOFAS is currently seeking additional funding to launch a comprehensive media outreach initiative to not only respond to the media, but to also brief producers and editors about the latest information on FASD and pitch story ideas on a regular basis.
It is imperative that all FASD advocates respond to erroneous media reports with a clear, rational and firm reply that sets the record straight. As with the need to educate policymakers if we want effective policy, NOFAS and all FASD organizations and advocates must educate the media if we expect them to report accurately, given the many misconceptions and shame associated with alcohol and pregnancy. In addition to training professionals about FASD, educating the media and policymakers should be our most important objectives.
For more information about NOFAS media outreach contact Erin Bailey, bailey@nofas.org or Tom Donaldson at donaldson@nofas.org.
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