It’s been 45 years since researchers revealed the risks of drinking during pregnancy. But as Vanessa Hrvatin reports, rates of Fetal Alcohol Spectrum Disorder are three times higher than previously believed — just as more women are drinking, and drinking more, than ever before. In the first of a three-part series, Postmedia’s Michelle Lang Fellow explores the challenges of eradicating one of the most common — preventable — developmental disorders and what’s at stake if we fail.

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Photography by Jason Franson for Postmedia

The hangover wasn’t a surprise.

It was the first day of 1986 and Tracey Knowlton had been to a big New Year’s Eve party the night before.

Then 24, she was already the mother of a baby girl. But she knew she didn’t want more children, so she was back on birth control and back on the job in North Bay, Ont., as a supply technician with the military. She also made time to be with friends from work — which often included drinks.

“Alcohol was just part of the environment,” she recalls. “It was nothing for us to go out for lunch and have a couple beers and a sandwich. On Friday nights everybody went out, so there was lots of drinking.”

But this hangover was different. “I felt this thing in my belly,” says Knowlton.

“By then, I was already 18 weeks pregnant.”

Knowlton considered giving up the baby, a second daughter. She even pursued a private adoption. “But once she was born and I saw her I thought, ‘I can’t do this, I need to take this baby home.’”

Right away, though, Knowlton knew something was wrong. “She was fussy, she didn’t feed properly. Just little things that kind of added up to something different,” she says.

At first, no one else seemed to notice. The family moved to Cold Lake, Alta., without incident. But by Grade 1, Knowlton’s daughter was clearly falling behind in school. In her early teens, she started lying, stealing and running away from home. Finally, at 14, she was diagnosed with Fetal Alcohol Spectrum Disorder.

There were few supports, however, and at 20 Knowlton’s daughter had her own child. She had also been drinking early in her pregnancy. Knowlton is now raising her 13-year-old granddaughter, who has developmental challenges associated with prenatal exposure to alcohol.



Programs for FASD have improved since her daughter was born, says Knowlton. But the blaming and shaming that often come with talking openly about drinking during pregnancy (wittingly or otherwise) have continued to have a profound impact: there is no national strategy for research and treatment, and provincial funding is a fraction of that for other brain-based disorders.

Both birth mothers and adoptive parents who spoke to Postmedia about living with FASD — more than 50 across the country — talked about marriages falling apart, families pulling away, losing friends, losing jobs.

Meanwhile, the stigma around FASD may have obscured how big a problem it really is, with women drinking more than ever before.



The first large-scale study on FASD in Canada — a survey of more than 2,500 seven- to nine-year-olds in the Greater Toronto Area released last spring — suggests up to three per cent of the general population could have the disorder.

That’s triple previously reported rates, and means that FASD could affect more Canadians than autism and cerebral palsy combined.

In her last annual report, tellingly released just after the legalization of cannabis, Canada’s Chief Public Health Officer, Dr. Theresa Tam, warned that “because of its social acceptance, we have lost sight of the fact that continued high rates of problematic alcohol consumption are leading to a wide-range of harms.”

Accidents like Knowlton’s are one concern: In the most recent national survey from the Society of Obstetricians and Gynecologists of Canada, an estimated 61 per cent of women between the ages of 15 and 50 reported an unplanned pregnancy. But drinking has also become a symbol of empowerment for women — including, for some, during pregnancy.

A flash survey of Canadian physicians conducted by Postmedia on Figure 1, an online medical community, suggests that doctors may be normalizing this behaviour: A fifth of respondents agreed that — in stark contrast to Health Canada’s official message — the occasional drink during pregnancy is safe.

All of which raises urgent questions: We’ve known for more than 45 years that drinking during pregnancy is harmful — more harmful to a fetus than cannabis, crack or cocaine. Why haven’t we succeeded in eradicating FASD? And what needs to change if we can’t?

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