The ‘early’ in early intervention means during pregnancy: The research that is a killjoy for pregnant mums

by Mar 5, 2012Substance abuse0 comments

Approx. Reading Time: 4 minutes
One of the difficulties with so much of the developmental research is that it can be used to bash parents, and especially mothers. This is a real shame. A difficulty is that we cannot ignore some of the research findings either, or else we are storing up serious problems. Typical is the research continually coming out about just how fragile the developing foetus is and how vulnerable it is to insults of various kinds. One of the latest studies has shown that taking ecstasy (MDMA)  in pregnancy can be surprisingly damaging to the unborn baby. The study, published in Neurotoxicology and Teratology by researchers from the University of East London,  suggested that babies exposed to ecstasy in utero had poorer co-ordination and reached other developmental milestones later, such as delays in hand-eye coordination and sitting up, and there is a suggestion that the baby’s nervous system is negatively affected. One issue that is known about is how ecstasy depletes the levels of the hormone serotonin that is so vital in many ways.

We did not know about MDMA until now but we do know about the dangers of other substances that are toxic and have a very serious effect. The worst culprit, we know, is unfortunately alcohol. That might seem like a very cruel finding. Binge drinking in pregnancy can be the precursor of very serious issues, in its most extreme form full-blown Foetal Alcohol Syndrome (FAS) which can give rise to a range of dysmorphic facial features, and worse, very serious problems such as a lack of emotional regulation and executive functioning, very poor memory and a host of other nervous system issues. The brains of FAS babies are very badly affected, for example with very small corpus callosum, which joins our left and right hemispheres. Such kids are often condemned to a life of serious disability and can be incredibly difficult to care for. We often see learning difficulties, poor relationship skills, low birth-weight, small head circumference, serious behavioural problems, hyperactivity, poor concentration and much more. Drinking alcohol can have a powerful effect even without the result being full-blown FAS, and clinicians are increasingly seeing a range of what are called Foetal Alcohol Spectrum Disorders. The worrying thing is that we don’t actually know what a safe amount to drink is, and many working in the field of FAS argue that it is safest to not drink alcohol at all. One of the awful facts is that it is quite possible to go on an innocent night on the town and have several drinks  too many without knowing at all that one is pregnant. The chances of problems increase considerably more with serious ongoing drinking, and those of us working with children who have been in the care system have been shocked by the damage we often see. We too often do not take a full enough history to be able to speculate properly about causative factors, but we know that a very large proportion of children in care have had at least one parent with a drug or alcohol issue.

Other drugs, such as crack and heroin can also have an awful impact, as substances will cross the placenta, enter the bloodstream and affect the developing foetus’ nervous system. Indeed we also know that if a mother is highly stressed, then the stress hormone cortisol will also cross the placental barrier and does its own serious kind of damage, leading to a form of hormonal programming whereby when the foetus is born it will already have a higher predisposition for stress. As well as the really bad effect on the baby’s developing nervous systems anyone who has witnessed a drug addicted baby going through cold turkey can be in no doubt about the potential psychological impact. It seems tough to potentially be pointing the finger at pregnant mums, and indeed we certainly should not do so, this is not about blame or fault. Many mums drink innocently for pleasure or fun, and most mums who abuse alcohol or drugs do so as an attempt to cope, because life has not treated them well, whether due to an abusive history, poor relationships, frightening neighbourhoods or a variety of other reasons, and indeed very few mums are aware of the effects on the developing baby. What we do urgently need though is a better way of screening so that we can offer help and direct therapeutic and practical support as well as ensuring that proper information is out there for parents and professionals, including GP’s. It seems very tough on women though that during what can be a very stressful period the relief of substances should be off-limits but the research findings do make frightening reading. Early intervention has generally been thought about as the first few years of life, but intervening before birth can in many cases be crucial

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