CanFASD: Emily Oster’s ‘Expecting Better’ Puts Countless Unborn Children at Risk

urlOTTAWA, Canada, August 29, 2013 – The book entitled “Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong-and What You Really Need to Know” was released by the Penguin Press on August 20, 2013.  In it, the book’s author, Emily Oster, makes recommendations regarding a number of popular pregnancy ‘myths’ and her interpretation of the specific studies surrounding them based on her knowledge of statistics as an associate professor of economics at the Booth School of Business at the University of Chicago.  Oster presents her conclusion that women can safely consume alcohol during pregnancy, if they do so in moderation, which she defined in an interview as “a couple of drinks a week in the first trimester, no more than a drink or so a day after that”.

The claims in Oster’s book, particularly regarding alcohol consumption, have led to a great deal of media interest, and medical professionals fear not in a good way.  Irresponsible claims like Oster’s can give women the impression that a small amount of alcohol while pregnant will not cause Fetal Alcohol Spectrum Disorder (FASD). FASD is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol.  Effects associated with FASD are lifelong and can include physical, mental, behavioural and learning disabilities. Depending on the amount and timing of alcohol exposure, some individuals exposed will also develop a characteristic pattern of facial features, and some will have a growth deficiency.  All those with FASD will exhibit some degree of neurological dysfunction, as a result of damage to the developing brain.  Most individuals with FASD are not visibly different, although their brain is permanently damaged. While FASD is 100% preventable, this book gives women the dangerous impression that occasional drinking while pregnant will not harm the child she is carrying.  Medical professionals and associations alike are aligned in their disagreement of this statement.

Dr. Jocelynn Cook, Executive Director of the Canada Fetal Alcohol Spectrum Disorder Research Network (CanFASD), Canada’s first comprehensive national research network on Fetal Alcohol Spectrum Disorder strongly encourages readers to base their decisions on scientific evidence and not on Oster’s advice: “It is well known that FASD is the most common type of developmental disability worldwide, but some of the most important unanswered questions in the field are ‘how much alcohol in pregnancy is too much?’ or what is a ‘safe’ amount of alcohol to drink in pregnancy?”.  Oster, who is not a medical professional, has not considered a number of important factors that members of the medical community have considered when making their recommendation not to consume alcohol during pregnancy.  Dr. Cook continues “We know the timing of prenatal alcohol exposure during fetal development is a very important issue. There are a number of critical periods of development when growing tissues and structures can be impacted. Data from animal studies, and some research in humans, show that organs and tissues that are developing at the time of exposure are particularly susceptible to the effects of alcohol, and, most importantly, the brain is vulnerable at ALL points during the nine months.  The only way to ensure that the developing fetus is safe from the effects of alcohol is not to drink during pregnancy.”

Dr. Sterling Clarren, Scientific Director of CanFASD agrees “we know that people may misinterpret messages like Oster’s and inadvertently place their fetuses at higher risk.” Canada’s Low Risk Alcohol Drinking Guidelines identify when no alcohol is the best choice; like during pregnancy. These guidelines recommend that “Zero is limit when you are pregnant or planning to become pregnant, or about to breastfeed.” The safest choice is no alcohol. Cook says, “CanFASD fully supports these recommendations.”

CanFASD is in good company disagreeing with Oster’s recommendations.  Both the American Congress of Obstetricians and Gynecologists (ACOG) and the Canadian Society of Obstetricians and Gynecologists (SOGC) ideas coincide in their own respective sets of recommendations and guidelines.  The SOGC’s summary statements in their Alcohol Use and Pregnancy Consensus Clinical Guidelines read as follows: 1-There is evidence that alcohol consumption in pregnancy can cause fetal harm. There is insufficient evidence regarding fetal safety or harm at low levels of alcohol consumption in pregnancy; 2-There is insufficient evidence to define any threshold for low-level drinking in pregnancy; and 3-Abstinence is the prudent choice for a woman who is or might become pregnant.

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