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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FASD Awareness Day 2014 “Bring on the Beer and Pass Out the Condoms”

Our Better Safe than Sorry Project effort with Planned Parenthood of Metropolitan Washington in recognition of FASD Awareness Day was a success.  Six volunteers distributed condoms at a booth outside The Barking Dog bar in Bethesda, Maryland on Saturday evening (before the party crowd).  Our aim was to test the idea as a pilot project, to gather reactions from pedestrians and patrons, and to learn more for future campaign events.

Booth

Our display booth with free condoms was visited by a number of pedestrians and bar patrons.

Table with condoms

Informational condom cards made a nice display with the U.S. Surgeon General’s warning cards by the bathroom door.

 Bathroom stalls

We posted posters behind the bathroom stalls where customers could read over the information in privacy.

Top 10 BSTS Lessons Learned about Condom Distribution:

  1.  Female bartenders felt passing a condom with the first drink of the evening would seem like a proposition. Duh! Why didn’t we think of that???

  1.  50 and 60-somethings agreed to share the informational condom pocket cards with their 20 and 30-somethings (who were partying elsewhere) – men seemed more open than women.

  1.  A scientist from the Environmental Protection Agency now knows that prenatal alcohol exposure affects 2-6% of American children – a bigger problem than environmental chemicals!

  1.  Most people thought that the CDC rate of 1 in 8 (13%) underestimated true numbers of college women binge drinking and were shocked that 50% of U.S. pregnancies are unplanned.

  2.  When passing a condom to a pedestrian, do so discretely (i.e., whisper, don’t shout – “Use a condom if you drink alcohol!”).

Pass it on –  Contracept if you drink alcohol to prevent FASD!!!!

Free Condoms at the Barking Dog Bar and Grill for FASD Awareness Day

In recognition of FASD Awareness Day, on September 6th, the Better Safe than Sorry Project Team will be at the Barking Dog pub in Bethesda, MD distributing 999 condoms and informational materials about FASD.

The condoms were donated by the Planned Parenthood of Metropolitan Washington.  For each first drink of the evening purchased, patrons of the bar will receive a condom with a bookmark cover to promote contraception for alcohol consumers.  BSTS project volunteers will provide information and a brief discussion about FASD for those who express interest in learning more.

 front of condom cover  inside of condom cover Back of condom cover

Our project concept was developed by our interns after the idea was suggested during one of our summer talk show segments.  From a primary prevention perspective, It’s a little further “upstream” approach than the pregnancy test kits in bars – another extraordinarily innovative project implemented in Minnesota and Alaska.

STOP our social drug of choice from affecting 2-6% of school aged children with preventable brain damage.  Just like HIV/AIDS & STD prevention, help spread the word to “contracept if you use alcohol!” 

Special thanks to BSTS volunteers Melissa Blair and Nick Muzic, BSTS interns Sydnie Butin, Juliana Pietri, Carlye Hillman, Kaitlyn Gularson, and Nathalie Pollack, and our fabulous BSTS Blog Master, Daniela Mielke for creating and implementing the innovative FASD Awareness Day prevention project. We are also thankful to the Barking Dog bar and grill for letting us promote our project there and to Robert Ridley of Planned Parenthood of Metropolitan Washington for donating the condoms.

BSTS Talk Show Episode 4: Ideas for Raising Awareness About the Dangers of Prenatal Alcohol Exposure”

Our fourth episode of “Better Safe Than Sorry – Alcohol and Unprotected Sex Don’t Mix!” sheds light on the recent Alaska initiative to prevent FASD by placing pregnancy test dispensers in the women’s bathrooms of bars. This campaign is designed to help women know whether they are pregnant to avoid prenatal exposure from that point on.  While it is a novel approach to FASD prevention, what happens when the woman finds out she’s already pregnant and she had already been drinking?

[For more information on Alaska’s recent campaign, read the article Alaska to offer free pregnancy tests in bars to curb fetal alcohol syndrome on foxnews.http://www.foxnews.com/health/2014/06/16/alaska-to-offer-free-pregnancy-tests-in-bars-to-curb-fetal-alcohol-syndrome/?intcmp=obnetwork]

In our show, we discuss the idea of passing out a condom to customers at bars along with their first alcoholic beverage purchased for the night. If a person is drinking alcohol, they will hopefully stop and think about preventing pregnancy when they see the condom and read the large print warning message placed strategically on the wrapper.

Our motto is: “If you’re pregnant or planning a pregnancy, avoid alcohol. If you’re using alcohol, avoid pregnancy.” Use contraceptives!

There are plenty of methods that we discussed such as condoms, the spermicide sponge, birth control pills, implanted contraception, etc.  Sadly, since just after the development of oral contraceptives in the 1970s, the rates of unplanned pregnancy have stayed relatively the same – at about 50% for all socioeconomic groups.

We believe that the FASD epidemic causing brain damage to children before women know they are pregnant is as much a public health crisis as the AIDS epidemic.  Just like with HIV/STD prevention, make conscious decisions when talking about alcohol and sex potentially leading to a pregnancy.

In this episode, we also discuss the man’s role in preventing (or causing) FASD. A man who drinks heavily causes “epigenetic” changes in his sperm. This means that the alcohol causes molecular changes in the DNA of the sperm.  There are also some studies showing low birth weight and prematurity as outcomes of alcoholic fathers even when the mother abstains. Since it takes 3 months for sperm to develop prior to being able to fertilize an egg, men have a responsibility along with women to avoid alcohol when planning pregnancy – both for the safety of their child and out of respect and support for their partner.  We like to point out that alcohol may boost libido, but heavy use can cause “faulty plumbing” and lowers a man’s fertility. It’s better to be safe than sorry!

– This week’s BSTS Ghost Writer:  Sydnie Butin from Salisbury University, Maryland.

Talk Show Episode #2: FASD and the Responsibility of Men

Better Safe Than Sorry – Alcohol and Unprotected Sex Don’t Mix… during our second filming we focus on the responsibility of men when it comes to alcohol use and contraception. Being safe is the responsibility of both men AND women. Our guest Nick Bruni is providing us with insights on the male point of view.

Watch us on YouTube https://www.youtube.com/watch?v=ro8DjNX8vSY&feature=youtu.be

The male responsibility in dating: “If a girl is inebriated, YOU AS A GUY should NOT approach that girl and take her home. Find her friends and let them know that their friend is “blacked out”. As good samaritans they should take her home to avoid the chances of her getting taken advantage of.”

Talking about FASD and the responsibility of men brought us back to the recently uploaded blog post “A fathers fight for appropriate diagnosis and treatment” about Charlie Sheen advocating to have his twin sons evaluated for Fetal Alcohol Syndrom. A father and a mother have the same responsibility for the well being of their children. Raising children is a partnership, both should be an advocate for the best interest of their children. So what makes Brooke Mueller refuse having the twins evaluated? Our guess since they are a profile couple, she might be afraid of her image as well as being afraid that she is not going to retain custody as a result of their ongoing divorce. But also there is another important point: the female’s guilt… that she was the one drinking and either knowingly or unknowingly causing brain damage to the developing fetus. But hold on…isn’t that the man’s problem as well?! HE COULD HAVE USED CONTRACEPTION OR ENCOURAGED HER TO STAY ABSTINENT WHEN PLANNING A PREGNANCY! 

Think about it, if he is drinking, isn’t it more likely that she is drinking as well? The Washington Post published an interesting advice column “It’s not fair for my husband to drink while I am pregnant”

Why do we let “our social drug of choice” harm our future generation?

Kick Off For The “Better Safe Than Sorry – Alcohol and Unprotected Sex Don’t Mix!” Talk Show

We are delighted to introduce you to the “Better Safe Than Sorry – Alcohol and Unprotected Sex Don’t Mix!” talk show – our newest blog addition. Our talk show is hosted by Dr. Susan Rich, a Child and Adolescent psychiatrist who specializes in the evaluation and treatment of Fetal Alcohol Spectrum Disorder (FASD). Dr. Rich moderates a young adult “coffee table” discussion about alcohol use and problems caused by alcohol exposure in the womb.
Watch our first episode on our BSTS YouTube channel : http://youtu.be/ymF_JV5Q9Uk
Each week we invite different guests to discuss recent postings on our blogwww.bettersafethansorryproject.wordpress.com. Our first session focuses on the high prevalence rates of drinking on college campuses and the potential for FASD in babies exposed inadvertently during unprotected sex.
Dr. Rich is joined by her team of “change agents”:
Daniele Mielke, a 25 year old graduate of a social work degree from Germany, currently looking to attend George Washington University’s graduate program in forensic psychology.
Sarah Roberts, a 23 year old recent graduate of UMBC’s department of psychology, also with an interest in attending graduate school in psychology.
Juliana Pietri, a 20 year old rising junior at Loyola University in New Orleans studying criminal justice, with an interest in forensic psychology.
Sydnie Butin, a 20 year old rising junior at Salisbury University studying psychology with an interest in graduate school as well.
Carlye Hillman, an 18 year old rising freshman at High Point University with an interest in psychology and pre-med.
Remember – if you are sexually active and using alcohol – contracept (i.e., avoid pregnancy!).  If you are pregnant, could be, or planning to be – avoid alcohol

Kick off for the Better Safe Than Sorry – Alcohol and Unprotected Sex Don’t Mix! Campaign at the Winston Churchill High School in Montgomery County, Maryland

We launched the Better Safe Than Sorry Project with a kickoff today at Churchill High School. Our project aims to empower young adults to make informed decisions about alcohol and other drug use, including it’s consequences. Our focus on prenatal alcohol exposure and the reproductive health consequences of alcohol use is incorporated into broader messages, presented in a format that is both light-hearted and serious. This “train the trainer” approach attempts to engage adolescent “change agents” in the program development to tailor each school-based project according to each school’s interests.

Dr. Joan Benz, the principal of Churchill High School (#1 public high school in Maryland for 2013), requested our leadership to develop a Churchill BSTS campaign after she heard Dr. Rich present in Baltimore at the FASD and the Law Summit (read former article). Over the past several weeks, BSTS volunteers collaborated with Churchill students and staff in a series of 4 focus groups designed to train students as change agents while getting their direction, feedback and perspectives about the campaign.  Together, we developed the BSTS Project’s kick off presentation for Churchill seniors that we held on April 2nd.

The multimedia presentation (developed during the focus groups) was designed to prepare seniors for prom, graduation, beach week, college and beyond. The Safety Tips evolved out of Dr. Rich’s desire to catch the students’ attention while sharing important information for healthy transitioning. Her father, a retired police officer, helped start the original MADD (Mothers against Drunk Driving) programs in Randolph and Guilford County, NC and has been an inspiration in her prevention efforts.  As a child psychiatrist, she always appreciates the simple approach of children’s books to get serious points across. “Officer Buckle and Gloria” by Peggy Rathmann is the inspiration for the safety tips, with David Letterman’s “Top Ten reasons” lists providing additional humor.  To get an idea on how Officer Buckle and Gloria presented their Safety Tips watch the book reading on YouTube: https://www.youtube.com/watch?v=pmViPSWwbPY

Our aim with this first presentation is:

1) To empower High School students to make informed personal decisions about alcohol use;

2) To kickoff our student led blog and internship program;

3) To inspire Churchill students and faculty to begin incorporating messages about reproductive health consequences of alcohol use into their curriculum, and

4) To help develop and empower student leadership toward prevention initiatives on a broader scale by posting the presentation to our blog, which has the potential to reach a global audience.

Our Safety Tips are:

Safety Tip #10: Be Smart – Beware of Prom Gaming

 

Safety Tip #9: Fashion Tip. Don’t Vomit on your Favorite Clothes

 

Safety Tip #8: Use Common Sense. Limo drivers are smart.

Safety Tip #7: Catch 22

EtOH (til21) & Mj r illegal – 18 y.o.’s go to jAIL not juvie.

 

Safety Tip #6: Be Self-conscious. Beware of Black Outs & Booty Calls

 

Safety Tip #5: Have Self-respect. Avoid Social Media Frights!

 

Safety Tip #4: Be a good Samaritan. Take care of friends

 

Safety Tip # 3: Know your limit. We are NOT all EQUAL

 

Safety Tip #2: Be safe. Learn Self-Defense

 

Safety Tip #1: If you use alcohol, CONTRACEPT. If pregnant or might be, AVOID alcohol.

  Copyright by Dr. Susan D. Rich Better Safe Than Sorry Campaign

In upcoming posts, more details on each safety tip will be provided along with information, useful web links and resources.

Feel free to spread the word or to get in touch with our team for further questions on our Better Safe Than Sorry Campaign.