The following guest blog was written by Stephanie Fade, an accredited dietician and mother of two children with suspected FASD. The original blog post can be viewed on Medium here.
Sex, alcohol and lockdown
Might we be making misery not love?
When we were initially told that we would only be allowed to shop for “essentials” the nation took a sharp intake of breath. Food and drink are essential for life but would snacks, fizzy drinks and alcohol be allowed? When we discovered then these things were still very much on sale panic buying ensued. As UK supermarkets struggled to maintain adequate stocks of alcohol, off-licences (smaller shops licensed to sell alcohol) had to be given a new status as “essential” in order to cope with the demand. Alcohol was officially classified as an “essential” and a good proportion of the nation breathed a sigh of relief.
Enjoy alcohol responsibly
Those of you who know me understand that I am perfectly happy for food and alcohol (drunk responsibly) to play a part in the average adult’s self-care. I am very much enjoying my carefully chosen lockdown wine. Despite the complex chore of shopping in lockdown I still make sure I actually select our wine with our weekend menu in mind, rather than just grabbing the first thing I come to.
However as it has become clear that the nation’s alcohol consumption is on the rise I have started to think more about an issue close to my heart. Of course if lockdown habits become permanent habits, people’s risk of alcohol related disease in the long term will rise. That’s a worry for sure but there is one health concern where the risk is immediate and potentially catastrophic.
Combine regular drinking with sex and far from making love we could be making misery.
For some people anxiety will reduce libido and obviously for those who live alone sex is not currently a possibility. That brings issues of its own. But for many couples living together in lockdown, sex is something positive amidst all the bad news. On the face of it this seems like a good thing, a helpful coping strategy. However we’re risking something that many people know nothing about and it’s called Fetal Alcohol Spectrum Disorder (FASD).
FASD is the overarching term for a range of birth defects associated with drinking alcohol in pregnancy. FASD is not only seen in children of heavy drinkers and alcoholics but others who drink more socially.
There is no treatment and the impact is lifelong and can be devastating.
FASD: what we do know
FASD causes a range of physical, behavioural and cognitive problems. Children with FASD may experience significant problems with maintaining attention, hyperactivity, impulsiveness, coordination, language, understanding cause and effect, learning from experience and learning generally. Some have low IQs and so are diagnosed as having an intellectual disability. Many are diagnosed with dyslexia and dyscalculia and have poor working memories. Our working memory is where we hold information temporarily in order to use it to make decisions. Children with FASD can become very frustrated by the challenges they face and often exhibit significant behavioural problems, with some displaying violence towards other children, their parents and care givers.
We know that young people and adults with FASD are also overrepresented in the criminal justice system. FASD can be devastating.
FASD: what we don’t know
Science is yet to provide enough information to tell us if there is such a thing as a safe amount of alcohol to drink during pregnancy. In the USA, the Centers for Disease Control and Prevention (CDC) recommend that women of reproductive age should avoid alcohol entirely when they are pregnant, attempting to become pregnant, or if they could become pregnant. Given that no form of contraception is 100% effective that’s basically saying that all women of child-bearing age who have sex should avoid alcohol completely.
This is a “no risk” approach, and given the devastation of FASD I can sympathise. I am mum to two children who might have been exposed to alcohol in utero. I don’t really know because I wasn’t there, as they are both adopted. However they struggle every day with significant learning difficulties, making sense of the world, hyperactivity, concentration and managing their impulses. It’s a huge challenge for them and for us as their parents. You can’t get a diagnosis without confirmation of drinking in pregnancy from the birth mother, but their symptoms indicate that my children probably have FASD.
It’s an acquired brain injury and all they, and we, can do is learn to cope with it over time.
Whether or not alcohol is a reason for our children’s struggles, I bear no grudge towards their birth mother. When I think about what I know of our children’s story I am amazed by their birth mother’s strength in the face of huge challenges. The fact is that FASD could impact any family where the mother drinks alcohol. Despite this, it’s not something people are very aware of. In the UK we have been cautious not to make women feel guilty or afraid and this feels important too. Drinking alcohol at any time during pregnancy is a risk, but the magnitude of the risk is unknown and the risk increases the more you drink. Of course we don’t know what the lowest level of risk is, so it’s hard to decide if the risk is acceptable to you. In the UK the advice from our Chief Medical Officer is that pregnant women, or those planning to become pregnant, should avoid drinking any alcohol at all to keep risks to a minimum and parents should be aware that long-term health risks for the baby are greater the more alcohol you drink.
Reality check
I think we need to be realistic as I doubt that women who do drink alcohol are going to stop drinking just because they are in a sexual relationship. Most will accept some risk and many do stop drinking when they start trying for a baby or as soon as they know they are pregnant. Given that it seems couples are drinking more and having more sex in lockdown all I ask is that people are aware of what FASD is like to live with because I could never have imagined what that reality would feel like.
My husband and I have never looked at parenting through rose tinted glasses. When we imagined being birth parents we imagined our children would throw tantrums, be stubborn, slam doors, say “I hate you”, struggle with some subjects at school and need our help to get through. We imagined they would fall out with friends and need our help to repair relationships and find better ones. We imagined they would take daft risks and get hurt and need us to put them back together. We imagined they would be ungrateful and difficult. We also imagined that a couple of times a week they might say “love you,” sometimes they would be really quite fun to be with. We thought that a few times a year they would do well at something and we would feel proud and celebrate. We imagined that we would do things as a family and that they would develop with our nurture.
When we thought about being adoptive parents we imagined all of that but also fighting for their trust and only winning it after years of effort, finding the right words to say to explain what happened in their early years whilst holding in mind compassion for the birth family. We were clear we would be coping with the quagmire of social media and all the particular risks that would bring for our children over and above the usual. We knew we would be helping them with school work in the context of their complex needs and fighting for appropriate therapies to help them heal.
However we could never have imagined what we actually have. It’s nothing like we imagined. We could never have imagined the weight our home would carry every single day and how hard it would be for us and our children to make so much effort without experiencing the joy of progress that should come along with it. We love our children and they are amazing. We are committed to them and progress does come, but it’s very slow and hard won and there are long periods of time where progress is so small as to be undetectable. This is hard-core parenting.
So if you are a woman in a sexual relationship, or the man who cares about her, before you have a drink just think.
If you have comments or questions for Stephanie please post them here on her blog. Read more of Stephanie Fade’s blogs here
The NOFASD Australia Helpline is available 7 days a week on 1800 860 613. If you are parenting a child with FASD, have questions about how to seek a diagnosis, or if you’re pregnant and looking for more information please feel free to give us a call or contact us here.
The Australian National Health and Medical Research Council’s guidelines to reduce health risks from drinking alcohol recommend that:
To reduce the risk of harm to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol. For women who are breastfeeding, not drinking alcohol is safest for their baby.
Being the parent or caregiver of someone with FASD can be challenging and exhausting. View Eileen Devine’s webinars on Building Carer Resilience here.
September 9th is FASD Awareness Day, an opportunity to start conversations and raise awareness about this important topic. NOFASD is acknowledging #FASDawareness through the Red Shoes Rock campaign, an opportunity to be creative and have fun starting conversations. Please join us this International FASD Awareness Day!
You may wish to host an event (please contact us to request your free FASD Awareness Month resources), share a message online (such as this Red Shoes Rock video or a photo of yourself in red shoes), or send electronic resources to your friends and colleagues. If we all support healthy pregnancies we reduce the risk of babies being impacted by Fetal Alcohol Spectrum Disorder.
Read more NOFASD Australia blogs