Women Physician’s Voices Count in Prenatal Alcohol Exposure Awareness

The first female physician in the United States, Dr. Elizabeth Blackwell, would turn 196 today.  In her honor, a group of physicians established February 3 as National Women Physician’s Day.  Inspired by her maverick spirit (after all, how dare a woman in the mid-19th century think she could be a doctor?!) and participation in the recent Women’s March, I envision a paradigm shift when we female doctors are going to end the ignorance surrounding prenatal alcohol exposure.

As a pioneer in medicine who graduated medical school in 1849, Dr. Blackwell may well have been at the forefront of the Temperance Movement, which occurred in the late 1800’s to early 1900’s.  At that time, medical doctors understood the devastating effects of alcohol on reproductive outcomes, low birth weight, prematurity, child/family mental health, and infant/child morbidity and mortality.  Public health statistics abounded, fueling the fire for Prohibition in 1920.  What a pity we lost all that knowledge after its repeal in 1933.

At that time in history, mostly men called the shots in society because they were the main holders of wisdom in science.  Professional papers were written, published in high brow journals, read by a handful of intellectuals and scientists, then put on shelves to collect dust.  There was no Internet for information sharing.  If one did not make it to college, medical school, or professional school (i.e., law school, doctorate programs, etc.), then most scientific advancements and knowledge about medical matters were hidden within academic institutions.

Today, only those of us motivated, bright, and resourceful can endure the rigors of 4 years of college, another 4 years of medical school, and another 3-6 years of residency in our desired field.  In many ways, our knowledge is as hidden from plain site as ever.  One of the key areas of my interest has been in raising awareness about the leading known and preventable cause of neurodevelopmental disorders, birth defects, and developmental delays – which can occur as early as the third week after conception.  Since this time frame is often before a woman may know she is pregnant, our society can and must do more to encourage sexually active alcohol consumers to contracept  to avoid unintentional exposure of their offspring.

It is my hope to help childbearing age alcohol consumers understand that they should stop using alcohol if pregnant or planning a pregnancy and to use contraception until they have stopped using alcohol.  Their partners should support them in this effort – after all, it takes sperm 3 months to develop, and alcohol methylates the sperm DNA.  These methylation effects last for several generations, passing silently through the genome into unsuspecting offspring.

Theodore Geisel, also known as Dr. Seuss, once wrote – “Unless someone like you cares a whole awful lot, nothing’s going to get better, it’s not!”  Unless we speak up about what we know about prenatal alcohol exposure happening early in pregnancy so the lay public understands, people will not hear our message.  As a change agent and spirit sister of Dr. Elizabeth Blackwell, I am determined to get this message across.

Susan D. Rich, MD, MPH, DFAPA

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