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rate of FAS higher than thought

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I thought this is interesting because for years I've been thinking that women are drinking way too much and that excessive alcohol consumption is normalized and almost glorified in our culture. 

 

Far More U.S. Children Than Previously Thought May Have Fetal Alcohol Disorders

 

"The study, published Tuesday in the journal JAMA, estimates that fetal alcohol syndrome and other alcohol-related disorders among American children are at least as common as autism. ...

 

Based on their findings, they estimated conservatively that fetal alcohol spectrum disorders affect 1.1 to 5 percent of children in the country, up to five times previous estimates. About 1.5 percent of children are currently diagnosed with autism."

 

https://www.nytimes.com/2018/02/06/health/pregnancy-drinking-fetal-alcohol.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront&utm_source=Global+Health+NOW+Main+List&utm_campaign=8392bfeeb5-EMAIL_CAMPAIGN_2018_02_06&utm_medium=email&utm_term=0_8d0d062dbd-8392bfeeb5-889579

 

 

What do you think? Do you know women who you suspect didn't/couldn't stop drinking when pregnant?  Is the endless pinteresting of wine for mommy normalizing alcoholism? 

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Based on my experience drinking heavily is the expected norm. I find it disturbing and have for 8+ years since I first saw it as a huge issue.

 

I must run in completely different circles, because I do not know anybody, woman or man, who is drinking heavily. All my female friends abstained during pregnancy.

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I must run in completely different circles, because I do not know anybody, woman or man, who is drinking heavily. All my female friends abstained during pregnancy.

Interesting. I gather from your posts you’re an academic. Dh is also, and has some harrowing tales of hard-drinking faculty/ grad student events in various departments in his area. Sometimes with serious negative outcomes. I suppose different fields and departments have different cultures; but I’ve been left with the impression that alcohol is a real problem in academia.

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My experience is that most people I know drink less than my parents generation (my parents are 78 and 80). I saw a lot of drinking when I was a kid. My parents didn't drink to excess, but they did drink. 

 

In my age group (50s) there was binge drinking in college, but not among everyone. After we moved on to careers that kind of drinking stopped and was replaced with the occassional beer or wine with dinner. 

 

No one I know of drank while pregnant. No one. 

 

So, I would have to say I see less alcohol consumption than during my growing up years, when people smoked and drank through pregnancy. 

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I read the article (not that one, but one about the same study) and it seemed a little questionable on several counts.

 

That said, while I don't know anyone who drank heavily while pregnant, almost every woman I know drank some alcohol while pregnant (and there doesn't seem to be a lot of evidence that the occasional beer isn't okay during pregnancy - in fact, there's not a ton of evidence either way).  My mom says she had a beer every evening while pregnant with me :)

 

What I can believe is that a lot of women are drinking at least moderately when they become pregnant, and don't know they're pregnant for the first few weeks.  

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I know moms who drink daily before finding out they were pregnant, they won’t trying to conceive but not preventing either. Their children are not suffering from FAS though as far as we know, their kids are around my DS13’s age. My childhood home is in a drug gang neighborhood so I know babies born with birth defects and suffering cold turkey due to moms being drug addicts.

 

My husband’s office lunch parties do have alcohol being served. It’s at the office and no one is driving. His face gets very red if he drinks even a half glass of wine or a can of beer so he brings home the alcohol for me to use for cooking or baking. One of his colleagues was under 21 so they have to be careful not to offer the young adult any alcohol.

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Most of the mothers that I know did have an occasional glass of wine or beer while pg, especially during the 3rd trimester, myself included.  And I know several that did drink more than a single drink in one sitting before they knew they were pg, myself included.  But I do not know of anyone that drank more than a single occasional drink once they knew they were pg.  I do know several women who were not able to completely quit smoking while pg though.  Some of my close friends are still expanding their families and I have noticed that they are more likely to 100% abstain now than they were in during prior pregnancies.  So, anecdotally, in my circles, drinking while pg seems to be less common recently.

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I must run in completely different circles, because I do not know anybody, woman or man, who is drinking heavily. All my female friends abstained during pregnancy.

 

This is my experience as well. 

 

I also have to say, as much as I have worked with kids and been around kids, FAS is not a diagnosis I can recall having encountered.  I have lots of experience with kids. Everything from the basic minor interactions with kids we meet at the park, all the way up through teaching for a time frame.  I have encountered autism plenty of times, I have a kid with that diagnosis.  Downs, CP, CF, and many others. 

 

So.....are the kids going undiagnosed?  Are they being misdiagnosed?

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Interesting. I gather from your posts you’re an academic. Dh is also, and has some harrowing tales of hard-drinking faculty/ grad student events in various departments in his area. Sometimes with serious negative outcomes. I suppose different fields and departments have different cultures; but I’ve been left with the impression that alcohol is a real problem in academia.

 

I am not discounting your DH's experience, but it does not match mine. I have hosted and attended countless department parties where wine is served, and have never seen a colleague drunk or noticeably impaired (i.e. no inappropriate behavior or talk.)

I remember one single incident at a party where a colleague from another department was intoxicated, and that was noticed and talked about because it was so completely outside the norm.

 

I am also not aware of any incidents with grad students and alcohol; many of our grad students abstain completely because their religion forbids alcohol.

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My inner circle does not drink but sitting at youngest son's baseball games all i hear are the plans for the moms getting together and drinking. A lot of them have young kids & I've often wondered if they abstain while pregnant.

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I am surprised by the findings. I know that in Canada there is a huge stigma to drinking at all during pregnancy. I don't know anyone who drank during their pregnancies. 

 

However, in the UK, my midwife told me to drink Guinness to help with my iron levels. I may have had a beer once a week. I'm pretty sure I was encouraged to drink the occasional beer while breastfeeding, too. 

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This is my experience as well. 

 

I also have to say, as much as I have worked with kids and been around kids, FAS is not a diagnosis I can recall having encountered.  I have lots of experience with kids. Everything from the basic minor interactions with kids we meet at the park, all the way up through teaching for a time frame.  I have encountered autism plenty of times, I have a kid with that diagnosis.  Downs, CP, CF, and many others. 

 

So.....are the kids going undiagnosed?  Are they being misdiagnosed?

 

I've had friends who were foster parents and FAS was definitely an issue with a number of kids they fostered.

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I’m in my 20s, and I don’t know any women who drank when they knew they were pregnant. Some may have drank before finding out, but it stopped then.

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Yes, I think drinking is more normalized now among young mothers.  The 20 something neices certainly don't play the designated driver roles...everyone in their circle goes camping, which is really a drinking weekend.  Most can be classified as heavy drinkers..and they don't plan pregnancies, so drinking doesn't stop until they notice they are pregnant.  In my circle, wine is the norm for ladies... it will a party or a party to sell something once a week. I"ve been dropped because I can't drink...interferes with my meds.  

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Drinking while being a mom to living, breathing, outside the womb children is, as far as I know, not an issue in this study. Maybe I'm missing the connection/correlation between that an FAS?

Edited by Sneezyone
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I am not discounting your DH's experience, but it does not match mine. I have hosted and attended countless department parties where wine is served, and have never seen a colleague drunk or noticeably impaired (i.e. no inappropriate behavior or talk.) 

 

This is not a good indicator. 

 

In fact, just the opposite. Functioning alcoholics can down incredible amounts of alcohol with little obvious impairment. 

 

 

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I am already viewed under FAS suspicion by medical professionals because I have a child with unexplained mental retardation. Not a drop of alcohol the entire pregnancy, but I can detect their skepticism when I tell them that. But now, with this study, I'm sure I will be scrutinized and doubted even more. Joy.

Edited by Kinsa
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This is not a good indicator.

In fact, just the opposite. Functioning alcoholics can down incredible amounts of alcohol with little obvious impairment.

 

I have also no other reason to believe that any of them is an alcoholic.

 

The question was about a culture of heavy drinking. I can positively say that there is no heavy drinking at social functions in my department because I am the hostess for the majority of departmental socializing and place the empty bottles in my recycling bin afterwards. The amount of alcohol collectively consumed is insufficient for anybody to be drinking heavily at these events. (And I know it is not an issue of supply, because I carry the unopened bottles down to the basement after the party.)

 

ETA: maybe they are still all alcoholics who just choose to control their consumption in public? not sure that is possible though.

Edited by regentrude

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Definitely relative to the group of folks you hang out with.   I know of a number of women who continued to drink - some quite heavily - during pregnancy.  Last I read, Alaska had the highest rates of FASD in the nation, so maybe that is not so surprising.   

 

Women who need to drink find it very difficult or impossible to stop.  Being pregnant may not be enough motivation, even when they know it's not a good idea.

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My ex DIL's mom drank with many of her pregnancies. Apparently she only drank when she didn't want the child. My ex DIL is one of those children. She has FAS. She didn't drink when she was pregnant with my grandchildren. She's FN if that makes a difference.

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I drank during my first pregnancy.  We thought we were infertile, had been together for 8 years without pregnancy, and had no reason to expect me to be pregnant.  I had irregular periods anyway.  

 

Once I knew I was pregnant, I stopped drinking, but I did drink while pregnant.

 

I really can't remember exactly how much I was drinking - maybe  two or three glasses of wine.

 

These days I drink a little at weekends - I don't have a young person's stamina for drinking every night.

Edited by Laura Corin

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I know one person who drank heavily throughout her pregnancies. She lives in the US but is from Ireland and claims that it is normal to drink during pregnancy there. I don't know how true that is because one of her Irish friends was concerned and trying to get her to stop. Her husband, who is American, is intelligent and well-educated enough to know about the dangers. They both would just laugh it off whenever anyone expressed concern - it was very sad. Their kids have numerous health and learning difficulties. 

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As a school teacher I see many children that most probably have FAS

 

My twins were exposed to other nasties in-utero leaving a huge impact on their brain - extremely poor brain wiring that has resulted in Intellectual disabilities, vision problems, gross and fine motor problems, language problems.

 

 

 

Once you start working with the results of poor parenting while pregnant you start to wish that there was mandatory sterilization for some people who continue to do these things

Edited by Melissa in Australia
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This is my experience as well. 

 

I also have to say, as much as I have worked with kids and been around kids, FAS is not a diagnosis I can recall having encountered.  I have lots of experience with kids. Everything from the basic minor interactions with kids we meet at the park, all the way up through teaching for a time frame.  I have encountered autism plenty of times, I have a kid with that diagnosis.  Downs, CP, CF, and many others. 

 

So.....are the kids going undiagnosed?  Are they being misdiagnosed?

 

I think it's a combination of things. 

 

One is that parents of kids with alcohol related disabilities aren't generally going around discussing it.  While the parent you meet at the park might say "Oh, he has autism", the parent of a child with FAS is much less likely to use that label in casual conversation, because they'd be opening themselves up to blame and judgement.  Even adoptive parents may choose to keep that information quiet. 

 

In addition, FAS/FAE are umbrella terms that cover kids with a wide variety of symptoms.  Most kids with FAS/FAE are going to meet criteria for other conditions, whether that's ADHD, or ID, or Learning Disabilities or Language Impairment.  These are the conditions under which they'll qualify for special education services, and so these are the conditions that will be shared with a teacher.  These aren't misdiagnoses, they're accurate.  It's just that for these particular kids the ADHD/ID/SLD/SLI whatever was initially caused by prenatal exposure to alcohol.

 

 

A significant portion of kids who have alcohol related neurological deficits, also had other complications in pregnancy, at birth, or after birth.  They may have been prenatally exposed to cocaine, or they may have had a low birth weight, or they may have been born to a mother who was mentally ill, or experienced trauma, or been raised in poverty.  Sometimes, we overestimate the impact of those things, which can lead us to overlook the impact of the alcohol.  For example, crack cocaine is far less damaging neurologically than alcohol, and most kids who were exposed to crack in utero were also exposed to alcohol, but people are likely to attribute behavioral and learning differences to a child being a "crack baby " (a very offensive term), whereas there isn't even an equivalent term for children damaged by alcohol.  

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I am already viewed under FAS suspicion by medical professionals because I have a child with unexplained mental retardation. Not a drop of alcohol the entire pregnancy, but I can detect their skepticism when I tell them that. But now, with this study, I'm sure I will be scrutinized and doubted even more. Joy.

Oh I wonder with #5 if anyone thinks that. Nothing to drink, but he has global delays. Who knows?

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I read the article (not that one, but one about the same study) and it seemed a little questionable on several counts.

 

That said, while I don't know anyone who drank heavily while pregnant, almost every woman I know drank some alcohol while pregnant (and there doesn't seem to be a lot of evidence that the occasional beer isn't okay during pregnancy - in fact, there's not a ton of evidence either way).  My mom says she had a beer every evening while pregnant with me :)

 

What I can believe is that a lot of women are drinking at least moderately when they become pregnant, and don't know they're pregnant for the first few weeks.  

 

 

I tried to get pregnant for almost a year so I was at first constantly worried for 2 weeks of every month....but my doctor told me that the baby is almost indestructible for those first two weeks.  And to stop worrying about it.  And late in my pregnancy he told me to enjoy a half of glass of wine to relax.  I did a few times.

 

But generally most women I know abstain completely while pregnant.  

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This.

 

I must run in regentude's circles.  I know a few people who talk about drinking, and may even take a glass at a fancy dinner. But I can't really think of the last time I was around them when they actually drank that glass and I don't personally know any lady who drank while pregnant.

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I must run in regentude's circles.  I know a few people who talk about drinking, and may even take a glass at a fancy dinner. But I can't really think of the last time I was around them when they actually drank that glass ..

 

oh, no - all my friends actually do drink wine. No teetotalers. Just in moderation, and no drinking while pregnant.

 

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oh, no - all my friends actually do drink wine. No teetotalers. Just in moderation, and no drinking while pregnant.

 

That you know of.

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ETA: maybe they are still all alcoholics who just choose to control their consumption in public? not sure that is possible though.

My alcoholic cousins (now in their 40s to 60s) would drink at home because they have enough embarrassment from their alcoholic dads or uncles since young to refrain from drinking in public. Luckily social media wasn’t around then. If they drink in public, they know they are likely to binge and embarass themselves and someone might just post their drunk photos on Facebook or Instagram.

 

My FIL only likes Guinness and would only binge on beer. He doesn’t drink wine at all.

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

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That you know of.

 

Yes, that's my experience..they won't drink much when I'm around or an under 18 is around, but there will be drinking before the party and after the party.  I know one that passes it off as hypoglycemia.  

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There is exactly 1 person in my life that I've suspected.  She has a well known history of substance abuse.  While I know another mom with a history of substance abuse issues, I don't actually suspect her of imbibing while knowingly pregnant.

 

I happen to be in the "wine for mommy" category, but I had maybe 3 drinks across 5 pregnancies, and one of those was a sip of champagne at a wedding.  The others were (midwife recommended) beers at term.  I've never flirted with alcoholism unless you count my first semester of college. I don't.

 

 

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

 

People can hide it very well and do fine drinking responsibly in front of others. It doesn't mean when they get home from the party you had they don't keep drinking to excess. It also doesn't mean they didn't start drinking before the party. Some can be very high functioning alcoholics. They're still alcoholics, though. 

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

Yes. My mom was an alcoholic and most people never knew. She rarely drank in public and never to excess. But every night at home, she was drunk.

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If I were to guess there are likely significant clusters of this if you tease out the numbers.

 

My extended family has a fairly broad range and there are sections of it that are very heavy drinkers, as are their friends.  These are people my age.  I don't think most knowingly drink during pregnancy but they might well do so before realizing they are pregnant.

 

Other parts of my family, and my social circle, are't like this.  They don't necessarily abstain totally during pregnancy but they also are pretty light drinkers anyway.

 

I also see a lot of student culture since there are five universities in town, and there are also a lot of young sailors.  The level of drinking that goes on in those groups is pretty extreme both for men and women.

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What are the symptoms of FAS?  I wouldn't know it if I saw it since I don't know what to look for.  I know a couple of kids where something is 'off' with them but probably not autism, so maybe I do know some.   

 

I don't know anyone that drank while knowingly PG.   Well, since I was in college and the dingbat I worked with who was having a married mans baby talked about having wine with him and was shocked when I said that was a bad idea.  

 

I suspect that many women drink between ovulation and their period, though.  We saw a fertility doctor and he asked about alcohol.  He was pleasantly surprised when I told him I avoided that time.  So, I must have been someone unusual.  Although, maybe most just stopped entirely.  

 

Weirdly, I did crave wine while pregnant.   WIth cravings I tried to think of what my body was really asking for.   I drank a large wine glass of 100% juice - a Cranberry blend.    I'l never forget the first time I did that, and he walked in on me  apparently drinking a 10 oz. glass of Merlot while cooking.  

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

 

Alcoholism is a lot more varied than that.  And there are also people who could probably be classed as abusers rather than "classic" alcoholics.

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A very close friend of mine is a pediatrician in Alaska who works extensively with families affected by alcoholism and FAS. I don’t know if she’s seen more cases, though.

 

Having grown up on a reservation, I saw kids with FAS often enough and also mothers who drank excessively throughout their pregnancy. Our young neighbors would drink until they passed out and were not aware their toddlers were roaming alone outside. It also had the highest number of adolescent deaths due to drunk driving in the US, at least back then.

 

Personally, I don’t see alcoholism as a character flaw but an illness that often arises from untreated mental and emotional issues. I think many mothers feel stressed, isolated and unsupported. Booze is socially acceptable, touted as healthy (even though it can seriously damage health) and offers a temporary break.

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

 

Yes, someone can moderate consumption in public and still be unable to moderate consumption throughout the course of a day or a week.

 

The difference is they can't have one glass a month.  They've learned to deal with negative emotions by numbing them with alcohol and that is their go-to whenever they are stressed.

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I’m pretty extreme by choosing not a sip of caffeine or alcohol during pregnancy and no medication during pregnancy or birth.

 

But my infertility doctor told me there was absolutely no reason to abstain during the “two week waitâ€.

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I see a lot of daily drinking but not a lot of drunkenness. We live in a huge wine consumption area.

 

I don’t know anyone who drinks throughout pregnancy. But if daily consumption is your norm and you have an oops pregnancy, I can see how there would be some overlap.

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I don't know anyone who knowingly drank alcohol while pregnant. I drank with both of my dc before I knew I was pregnant. Neither of them were planned and I was on BC pills for both. Neither of them were affected by and neither doctor I saw was concerned at all. 

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Interesting. I gather from your posts you’re an academic. Dh is also, and has some harrowing tales of hard-drinking faculty/ grad student events in various departments in his area. Sometimes with serious negative outcomes. I suppose different fields and departments have different cultures; but I’ve been left with the impression that alcohol is a real problem in academia.

DH and I are both academics.  Neither of us have experienced any more of an alcohol problem among our colleagues in academia than in our general lives.  Over 30+ years in academia, I have known a few colleagues who have had serious alcohol issues, but I have known a few friends, neighbors, relatives, etc. with serious issues with alcohol.  I have worked at a school where there was an on-campus pub and faculty were encouraged to have a beer with their students, I have worked at a school that did not allow faculty to drink in the presence of students, and everything in between--so a variety of cultures when it comes to alcohol.   

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Maybe this is a stupid question: is an alcoholic able to moderate his consumption in public? I thought that once they begin to drink, they can't stop,and they cannot choose to drink just one glass?

The alcoholics I know are totally able to control consumption in public. I think this is part the problem - people don't know what alcoholism looks like & don't recognize it in colleagues, friends or themselves.   I know actively drinking alcoholics who have full time prestigious occupations & are functioning well.    

 

Some of them finally stopped functioning but it's often not a big dramatic bender, drunk all the time thing.  It's just a decline. Often they finally get caught in a roadside test, forced into treatment, employers put them on leave etc. Some take early retirement or 'time to start a new chapter'/start businesses etc. They're alcoholics whose careers quietly imploded. 

Many alcoholics can choose to have just one or a few, or they can even choose to skip. It's just that they can't go on for long without drinking. But many can do a couple days dry here & there. They know that they shouldn't drink tons in public so they drink before coming, or drink after going home. 

 

I also know alcoholics  who go dry for months and years & then start again. A glass here, a glass there, a beer or two every couple weeks. Then it's weekly.  Then it's daily.  The alcoholic I know best, I have not seen them drunk in many decades but they're currently still drinking - slow, steady & regular.   They'd absolutely fail a roadside test but unless you know how a functioning alcoholic looks, you might easily not see how buzzed they are and how much they actually drink. 

 

 I think once you know one and realize what it looks like, it's like a kaleidoscope shifting - suddenly you are able to see alcoholics in other places.  

 

 

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I do know one child who I suspect has it--he has the look and, when I taught him, also seemed to have learning issues (I only taught him once a week at co-op, though). I've been to parties where his mom drinks--she's somewhat of a "party girl."  However, it's not something I could say.  She talks about how brilliant and advanced he is and maybe he is.  I could be completely wrong and I never, ever would say anything, bc there is nothing really to do about it now.  And, I feel for folks like Kinsa.  No one needs someone judging them when dealing with a child with learning issues.  For goodness sakes, why not just take the mom's word for it and move on.

 

In terms of the culture now, the young moms I know still abstain.  I don't see harder drinking among kids now than at college in the 80s and as a young single in a big city in my 20s.  None of my close friends drank while pregnant (other then an occasional wine, maybe, at the very end).  I was told by a doctor it was okay to have wine the last few weeks of pregnancy, but I never did.  I did have an occasional drink while nursing, though--but made sure it was after I'd nursed when there would be at least 2-3 hours before the next nursing session.

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my sister was having issues with her pregnancy - so her dr ordered progesterone shots once a week.  started late first trimester.  she didn't think they were safe, but if she went much longer than a week - would go get one as she starting having contractions.  I say this for context.

 

she though drinking a SHOT of whisky every day would be better to prevent contractions.   Her dd was born by emergency c-sec at 30 weeks.

I wouldn't be surprised if some of the child's issues were alcohol related.

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