Texas To Seek Universal Fetal Alcohol Syndrome Screening: Will It Be Used to Further Shame Women?

Last week state health officials in Texas announced they’re aiming to have “universal screening” of all pregnant Texans to determine their alcohol use, in an attempt at curbing instances of Fetal Alcohol Syndrome, which they report affects one in 100 children in the state and can cause developmental delays and physical or behavioral disorders.

I talked to Janet Sharkis, Executive Director at Texas Office for the Prevention of Developmental Disabilities, about the initiative, which includes five questions and an “intervention” that basically amounts to handing a woman an information pamphlet. Sharkis says the quick conversation between a woman and her doctor (or other medical provider) is proven to help reduce alcohol use and FAS.

“They’ll ask her a few questions, and from that they’ll determine whether she’s at higher risk or not,” explains Sharkis. “The beauty of it is in a very short amount of time you can have a huge impact on a child’s life.”

Research from Washington State suggests that screening does reduce FAS, but we couldn’t help feeling apprehensive about a potentially embarrassing and shaming conversation. Too often, pregnant women’s behavior is analyzed, shamed and criticized, leaving women feeling helpless and attacked.

Listen to our own Amanda Marcotte when she talks about a study that links FAS to male infertility: “My concern isn’t with this study or the reporting so much as the hyper-focus on pregnant women’s behavior and choices over all other influences on fetal health, particularly environmental ones pregnant women have no control over.” Even though state health officials in Texas clearly mean well, I can’t help but think of potentially creepy implications related to the anti-choice personhood movement, which in part aims to analyze every move a pregnant woman makes in hopes of catching her in a criminal act for endangering her fetus.

But Sharkis says, “This is not about getting women in trouble.” The screening questions, which include inquiries about “other people the person knows,” are “designed to really make women comfortable talking about it.” If a woman is thought to be at risk, she gets a booklet which includes information about the dangers of using a number of drugs while pregnant. “For a total time of four minutes, wow, what results you get.”

In Texas, however, we have a huge uninsured population, and with rapidly and dramatically shrinking public health funds here, it may be harder than ever to reach pregnant women for even basic prenatal care, let alone FAS screening. Fifty percent of births in Texas happen on Medicaid, notes Sharkis, and she says it’s more important than ever to pass health care reform so pregnant women can have the health care they need. “If that is implemented fully, more people will have access to health care,” she says. Even Lousiana didn’t cut funds the way Texas has, she says, because “this is saving money.”

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  • carmarhal67

    It amazes me that anyone would be more concerned about “embarrassing” the mother than ensuring the healthy future of the unborn child. As an adoptive mother of a child with Fetal Alcohol Syndrome, I can tell you that it is a physically and mentally debilitating condition. My child will never be normal, and is expected to achieve a mental age of 10-12 at most. This is the case with mose FAS children. Now 4 1/2 years old, he is mentally and physically at a 2-year-old level. Along with severe physical problems, the brain damage is permanent and causes so many problems. FAS is one of few completely preventable birth defects, so why shouldn’t we do everything we can to prevent it? If the mother truly cares about the health and future of her child, she will be glad to get any information to help her achieve it!

  • carmarhal67


  • crowepps

    Isn’t this too late?  We have a LOT of FAS in Alaska.  In most cases, the binges that caused the damage happened way before the women goes in for prenatal care.  It would make more sense to me to reduce FAS by addressing alcoholism in hopes reducing the overall number of alcoholics (male alcoholics have damage to their sperm).

    This comes across as ‘nobody cares if YOU drink yourself to death, but now that you’re pregnant we want to make sure it’s adoptable.’

    I cannot lay my Google on the link right this second, but I remember reading that there is far more prenatal damage from pollution and industrial chemicals than there is from FAS, and yet they have recently LOWERED the standards on that.  How come it’s a big deal if Mommy had a drink but not a problem at all if the power plant in Mommy’s town is dumping massive amounts of pollutants into the air she is breathing? 

  • andrea-grimes

    I think the stats that show that women, once they find out about the dangers, dramatically reduce or stop drinking altogether. Screening appears to work. However, if women feel threatened or ashamed, they may not be receptive to having these conversations in the first place, and end up lying to their doctors to hide their behavior. Then, no one gets the information or help they need. No one’s arguing that embarrassing conversations shouldn’t happen when kids’ lives are affected, just that it needs to be done sensitively.

  • carmarhal67

    may cause prenatal damage, but it hasn’t been proven to cause retardation and physical handicaps. Please do some research on FAS. Alcoholics are not the only ones having babies with FAS! There is NO known safe amount of alcohol during pregnancy at ANY time! So much misinformation is floating around out there about “safe” amounts of drinking during pregnancy.

  • forced-birth-rape

    Maybe we should have sex education that teaches drinking while pregnant is bad for fetuses.



    I have a cousin who gave birth at sixteen, she claimed she did not know she was pregnant, I believe her. She had severe emotional issues and was raised by lunatics.

  • crowepps

    Cannot Google it up right now, but remember reading that a pattern of heavy drinking by men resulted in deformed sperm.  In addition, my guess would be that a woman heavy drinker might have several binges before missing that first period, which would expose the fetus before she even knew it existed.

    It would be great if we could convince both men and women if there was any chance at all of their creating a pregnancy, they shouldn’t drink.  But then, if they weren’t drinking, maybe they’d think better of the sex altogether?

  • crowepps

    Correlation is not causation, but there seems to be something there that should be investigated

    In the early 1990’s, a rash of anencephaly cases (babies born with partially-formed brains or skulls) in Brownsville, Texas – across the border from Matamoros – attracted national attention to the region’s environmental contamination



    Researchers analyzed all 30.1 million births in the United States between 1996 and 2002. They found a strong association between higher rates of birth defects among women whose last menstrual period was in April, May, June or July and elevated levels of nitrates, atrazine and other pesticides in surface water during those same months.

    The data showed a statistically significant correlation between the last menstrual period and higher rates of birth defects for half of 22 categories of birth defects, including spina bifida, cleft lip, clubfoot and Down’s syndrome.


    I would note that there sometimes seems to be an unconscious assumption that ALL ‘birth defects’ are caused by the mother, that they are likely cause by her ‘immoral’ behavior such as alcohol or drug use, and that stigma on mothers who already burdened with dealing with the defect needs to recognized and gotten rid of.  Just as an example, my husband’s family got a long history of heritable dyslexia, and yet when I tried to deal with the school to get my daughter’s learning diability recognized and accomodated, I was told by two different teachers something along the lines of “it’s a shame you didn’t stop drinking while you were pregnant”, which I didn’t need to do, because I don’t drink alcohol.

  • ashley-herzog

    Actually, there’s a lot of evidence that fetal alcohol syndrome barely exists, and even alcoholic women who guzzle tons of alcohol only have a 5% chance of having a baby with genuine FAS. The research on this condition is all over the place, but 1 out of 100 sounds like a ridiculous number. I read it’s more like 1 in 10,000. Other research puts it all over the map–but these myths about how one drink a day will harm your baby have no basis in fact. The people who have really sat down to study this–like the author of the book “Bearing Risk, Conceiving Responsibility” question its existence and see it more as a socially constructed condition that was invented in the 70s, when America not only got more strict about alcohol, but women had gained reproductive rights to birth control and abortion. The sight of a pregnant woman drinking just invokes people to engage in “bad mommy shaming,” even if there is no risk. There’s also an article called “How Real is Fetal Alcohol Syndrome?” that says genuinely alcoholic women (we’re talking bottles) have about a 4% chance of giving birth to a child with it.

    I only say this because I drank in my first trimester and was worried about this. The doctor has repeatedly assured me there is nothing wrong with the baby. I don’t drink now, because of the social stigma and who knows? Maybe there are some small risks there. (Plus, I can’t imagine how gross it would feel to be pregnant and hung over.) Not to mention fear of serious trouble if any medical professional found out I drank, given the hysteria around it.

  • ljean8080

    of FAS on any reservation.

  • elburto

    As a not-American, I have to agree. We Europeans love our booze. We start early, we drink often, and going by American standards we should have catastrophic levels of FAS.

  • freetobe

    but i smoked when I was pregnant the whole time and drank some hard whiskey.( Before all this info came out) I also lifted a car up and held it before it fell on my ex-husbands head! I was pregnant when I did all those things and had a blue ribbon baby. She was 8 lbs 13 oz’s and the doctor told me if I had not smoked she probably would have been 10 lbs!( Ouch I am kind of glad she was not that big)

    Any way I was young and physically fit at the time so maybe that had something to do with her being healthy and normal. i do not think they have done enough studies on any of this fetal alchohol syndrome. I know many women who drank and smoked and even took aspirin back when we knew not much of these dangers and all their children were born healthy!

    I think it has more to do with inferior genes in the gene pool. After all we are saving EVERYONE now adays. Back then it was survival of the fittest.

  • incompetent-housewife

    I am raising two little boys with fetal alcohol spectrum disorders. It really hurts to hear someone say their permanent brain damage is a myth. These are two beautiful little people whose lives are severely affected because their mothers drank alcohol during pregnancy. So honestly, I’d take shame and embarrassment any day over brain damaged babies.

    Each time I visit my doctor, I’m asked if I feel unsafe or if anyone hurts me. It’s clearly a domestic violence screening. Fortunately I am not being hurt, so I answer the questions and move on. Each time I took my children to their former pediatrician I was asked a litany of questions from if I kept loaded weapons in the house to whether I kept household poisons out of reach and if I used carseats every time. None of this shamed or embarrassed me as a woman or as a mother. If I were keeping a loaded gun under my pillow, maybe I would feel ashamed. So maybe I’d do something about it. Even if I lied to the doctor, maybe I’d still go home and make a potentially life-saving change. Frankly, I’m surprised to hear the fetal alcohol screening does work. If it works, let’s use this tool. If a woman isn’t drinking, she will feel no shame. If she is, help her.

    Thank you, Andrea, for clarifying in your comment that the screening works and you’re only saying it should be done sensitively. I agree. I just wish that was in the original article.

  • incompetent-housewife

    Um, you do.

  • halli620


  • colleen


    Perhaps she was refering to the odd fact that the incidence of FAS is 20 times higher in the US.  http://www.ncbi.nlm.nih.gov/pubmed/7565490

    I am not endorsing drinking alcohol while pregnant. (or, for that matter, when not pregnant.) but it appears that the causes are more complex.