A S K T H E E X P E R T S
VOL 181,
No.2. Text and photographs by GEORGE
STEINMETZ
THE WORLD AS THEY SEE IT

“When Malcolm was born, I thought my heart
would break,” she said. “And, oh my God, the
guilt…”
Ellen O’Donovan (pseudonym) was losing her fight
against alcoholism when she discovered she was pregnant. Months
later her son was born with fetal alcohol syndrome, and his battles
began.
I met them both in Dublin, where my photographic
coverage had brought me. Ellen and her three-year-old son,
Malcolm (left), live in a small town on Ireland’s north coast; they
had ridden a bus for six hours to visit Malcom’s doctor, a
specialist who is treating the boy for severely defective vision,
one of his many alcohol-related disabilities.
First identified about 1970, fetal alcohol
syndrome (FAS) is a term used to describe the damage some unborn
children suffer when their mothers drink during
pregnancy. Alcohol in the mother’s bloodstream can be toxic to
the developing fetus depending on the stage of pregnancy and how
much she drinks. Damage can range from subtle to severe,
causing clumsiness, behavioural problems, stunted growth,
disfigurement, mental retardation.
Ellen’s doctor had told her that an American
journalist wanted to photograph her with her son. She consented
in hopes that others could learn from her mistake, but when I began
unpacking my cameras, she hesitated. Then she took a deep
breath and began to talk.
“I was drinking a bottle of vodka a day that
December,” she said grimly, “so out of touch that I didn’t even know
I was two months pregnant. When I found out, I quit there and
then, but the damage was done.”
The O’Donovans are not alone. Thousands of
babies are born with alcohol-related defects each year, ranking FAS
as one of the leading known causes of mental
retardation.
According to his doctors, Malcolm was undersized
at birth, with kidneys and a stomach that didn’t work properly; he
had to be tube-fed until he was 14 months old.
His head is smaller than normal, and he also has
facial abnormalities typical of FAS children – small wide-set eyes,
a thin upper lip, a short upturned nose, and a receding
chin. He was born with damaged corneas, and his eyelids
drooped. Surgery later gave him limited sight in his right
eye.
FAS is irreversible, and during our session it
became clear to me that Ellen has dedicated her life to caring for
her son. “He doesn’t seem retarded, thank God,” she
said. “He’s even starting to talk a little. I’m working
with him every day, helping him learn to do the things normal kids
do.”
I was moved by the way she held him and comforted
him in Gaelic when he started to cry. “If this little boy
hadn’t come along, I might have drunk myself to death,” she said
quietly. She hasn’t taken a drink, she added, in three and half
years.
Still, it isn’t going to be easy. Unemployed
and living with her mother, Ellen plans each day around Malcolm and
the frequent trips they make to his doctors in Dublin. When I
offered to reimburse her for the bus fare, she declined. “Just
tell women out there that if they want to have a baby, leave the
drink out of it,” she said. Then she kissed her son on the top
of his head and they were gone.
A large dose of
alcohol given to a pregnant mouse produced severe abnormalities in
the developing fetus (bottom), according to doctors at the
University of North Carolina studying effects of alcohol in early
pregnancy.
Compared with a normal fetus (top), the one exposed to
alcohol suffered eye damage, a stunted brain, and facial
deformities similar to human babies with FAS, particularly those
affected during the first trimester, when bones and organs are
forming.
Blood-alcohol levels reached during
the experiment approximate those that could occur in a woman of
average size if she drank a quart of vodka within a 24-hour
period.
I met them in every
country I visited – some with tiny, twisted bodies, others with
faces tragically skewed. Some were agitated, while others
seemed quite normal. Each encounter was disturbing, for few
things compare to the sadness of a child stunted by FAS, or made
miserable by a group of more subtle abnormalities known as fetal
alcohol effect (FAE).
“What’s really sad is how many FAS and FAE kids go
through life undetected,” says Ann Streissguth of the University of
Washington, a specialist in FAS behaviour. “It takes a trained
eye to spot FAS, even in the severely retarded. And in FAE,
mildly retarded kids are often misjudged because they tend to be
talkative and outgoing. No one dreams their nervous systems are
impaired.”
As the FAE child grows, such positive traits are
often muted by alcohol-related shortcomings – impaired memory, brief
attention span, poor judgement and capacity to learn from
experience. Some victims drop out of school in frustration or
wind up on the margins of society.
Fetal alcohol damage shows itself differently in
every child. In the Soviet Union I met a boy, a teenager, who
was continually trying to stab his playmates with scissors; in
Sweden I met a wonderful little girl who was so sweet and beautiful
that I felt I was photographing an angel. 
Little is known
about the thresholds of alcohol that cause FAS. Genetics may
also be a factor. Even with fraternal twins one might have
severe FAS, while the other is mildly affected. Not all mothers
who drink have FAS babies. Some doctors believe that any
alcohol puts the baby at risk, while nearly all agree that binge
drinking is perilous, especially during the first 12 weeks, when
signs of pregnancy are few. As Ellen O’Donovan lamented, “I
didn’t even know I was pregnant. That’s the tragedy of
it.”

Reduce the measure of your
alcoholic drinks to nil when you are
pregnant |