Once upon a time there was a man named Malthus. Women's lives have been hell ever since.
You either have too many babies or too few; if they are born perfect, you must be interfering with the genetic hand you were dealt; if they are born imperfect you have been overeducated, drinking, smoking, taking dope, sniffing glue, using fertility drugs , and acting as if lifestyle didn't matter. Nowadays, a girl can go to jail for this. Nowadays a girl can go to jail for this even before the baby is born. Especially if she is poor, aboriginal, and unmarried.

Anonymous

There should be no contest at all between a mother's desire to smoke, drink or
consume drugs excessively and the unborn's right to be (legally) protected against
the serious risk of resulting disability to it.

Edward Keyserlingk, Professor of Law, McGill and
Co-ordinator of Protection of Life Project of Law Reform Commission

Last summer a Manitoba judge ordered a young woman to be confined to a drug-treatment centre until the birth of her child in December. Her 'crime' was solvent sniffing, not unusual among women on reserves; indeed, not unusual among pregnant women anywhere who often develop bizarre addictions during pregnancy.

But what was extraordinary about this case was the rush to judgment. Margaret Somerville, a bioethicist at McGill and frequent CBC broadcaster, was quick to defend the judge who, she said, acted properly even if it was debatable legally, a view she has ta ken on other reproductive issues. A spokesperson for the Child and Family Services asked, "How many badly damaged children does a person have the right to bring into the world?"1

In the days following the court decision we began to hear more about 'fetal glue syndrome.' In this case, the woman's three older children had been removed from her care, implying she was unable to look after them because of her addiction, and further we read that the older children had suffered some brain damage as a result of her habit. Maclean's was careful to point out that only two of her older children suffered neurological damage as a result of the addiction, but had no doubt that it was a r eal phenomenon.

Nevertheless, the Manitoba Court of Appeal overturned the judgement. Pro-choice advocates rejoiced; anti-choice groups who believe that fetal rights supersede those of the woman were angry while The Globe and Mail urged the Department of Justice to waste no time in drafting a law that "allows the courts to intervene in cases where a pregnant woman who had decided to bring an unborn child to term is doing serious damage to that child."2 Abort ­ or don't drink.

The speed with which the Winnipeg glue-sniffing case developed, the widespread approval of the coercive intervention by the state, and the chorus of bioethicists and other experts who accepted the fetal damage story as true could not have occurred without the widespread belief in Fetal Alcohol Syndrome (FAS). The glue syndrome was another version of this basic gestational prototype, and part of the larger scenario on addiction to substances that are normatively debateable.

The FAS narrative began in 1973 when a group of doctors noticed that some infants born to women who had regularly consumed large amounts of alcohol were smaller, born prematurely, often with some irreversible bodily impairment and mental retardation. They called this 'fetal alcohol syndrome.' Eight years later a child abuse suit was brought against a First Nations woman in Kenora, Ontario whose drinking habits were well known. The Children's Aid Society, alerted by the woman's physician, was present in th e delivery room and with the help of the physician who diagnosed FAS, the agency immediately took the child away.3

The pattern, then, was set although the number of cases that met the medical criteria remained small, even after the definition was broadened. A study conducted in 1990 of the records of 40 babies born to women who had been alcohol abusers found a 100% fa ilure by hospital staff to diagnose the syndrome.4 At best the frequency is low ­ five cases in a population of 12,000. Many FAS symptoms were found in mice exposed to other substances. As well, many of the women who gave birth to FAS children had mu ltiple problems, alcoholism being only one. Undernourished and under-age, they were often suffering from anaemia and/or hepatitis, compounded by poverty, sub-standard housing, and little education. Some were heavy smokers, often combined with caffeine; th ey might even be on a Methadone maintenance program. In addition, many of the symptoms attributed to alcohol consumption were found among women who had histories of epileptic seizures and used anticonvulsant drugs.

Because investigators were using a biomedical model of addiction, very little attempt has been made to determine the demographic profile of mothers whose children were found to have FAS. The incidence of diagnosed FAS was far greater in low socio-economic groups than high; more lower socio-economic women had alcoholic spouses and more of these women started drinking at an earlier age; they also began childbearing earlier. On a measure like attention deficit disorder, the differences were 21% for upper mid dle-class children and 71% for lower socio-economic groups.

Fetal alcohol syndrome, then, is problematic. The politics of research, however, are not. Attention shifted from alcoholism to 'crack' addiction and the 'war on drugs.' Meanwhile there was little interest in or resources for studies of fetal anomalies as a result of aspirin, tranquillizers, nasal sprays, laxatives and other over-the-counter medications. Hence, nearly a quarter of a century later, we know less about the nature of fetal anomalies than we do about the uses of street drugs.

Both in Canada and the U.S. there is a growing health establishment convinced that the lifestyles of women can destroy or damage the life of the newborn, creating problems that cannot be reversed through our high-tech neonatal nurseries and that continue throughout life. Popular books for pregnant women, signs in the women's washrooms of bars, and other media promote this anxiety-creating message. Pregnancy has become a form of 'worldly asceticism.' One way or another women are being guilted in a scenario where their voice is missing and through a bio-medical model of addiction. In addition, their own health is ignored. Excessive alcohol consumption is bad for women, pregnant or not. Deaths from cirrhosis of the liver among women are almost as great as th e number of male deaths but public policy is concerned with his health (ability to work) and her obligation to serve the family (domestic space).

In the larger context of reproductive rights, what Canadian women gained in the abortion decisions, the right to terminate a pregnancy, they may lose to the old Church doctrine that since a fetus is a person to risk its well-being is to incur sanctions.

In short, Fetal Alcohol Syndrome and its spin-offs like Fetal Glue Syndrome are more of a political issue than a scientific one, more of a research issue than a clinical one; they show the helping professions sustaining their own status on the backs of vu lnerable women ­ a classic case of having a solution without a problem.

Endnotes

1"A sad Manitoba case reopens the debate," Maclean's. Aug. 19, 1996, p.17.

2Globe and Mail. Sept. 13, 1996. Editorial p. D6.

3Children's Aid Society for the District of Kenora vs. J.L. 134, D.I.R.(3d).

4Rovner, Sandy (1980) "Hospital fails to identify alcohol-affected newborns," Washington Post, Health Magazine, Nov. 6.