"Fetal Alcohol Syndrome" is closely tied to a series of medical, social and cultural milestones in the last third of the 20th century. Until the feminist movement, virtually all studies - and public programs - on alcohol and substance abuse were concentrated on men. The Supreme Court's Roe v. Wade decision on abortion (1973) had secondary effects of encouraging doctors to focus on health issues affecting pregnancy, alcoholism included. Later the increased incidences of hard drug use by expectant mothers, and public reaction to it - 'crack babies' - also heightened concerns for all forms of substance abuse by pregnant women. Despite the growing public perception of Fetal Alcohol Syndrome, scientists and clinicians were at loggerheads on the issues. Since the level of individual tolerance for alcohol varied significantly, scientists tended to recommend complete abstinence during pregnancy. Clinicians generally considered moderate alcohol use during pregnancy acceptable.

Passage of the 1989 Alcoholic Beverages Labeling Act marked the beginning of a new era. Distillers welcomed the legislation because it seemed to promise limited liability for use of their products by pregnant women. Evidence suggested that despite the warning labels, the incidence of fetal alcohol syndrome was climbing. Recognition of Fetal Alcohol Syndrome was highly contested. America's post-Prohibition attitude was that alcohol problems resided in the drinker, not the drink. A growing public climate in which personal responsibility was emphasized also made the diagnosis suspect, especially when used as a legal defense. Residential treatment programs for women with fetal alcohol syndrome are neither readily available nor serviceable. Expectant mothers who enter such programs are generally forced to place their other children in foster care and they face serious obstacles when they try to get them back. The cultural history of Fetal Alcohol Syndrome is a mirror for the social and cultural forces of the recent decades.

Her book, Message in a Bottle: The Making of Fetal Alcohol Syndrome, is forthcoming from Harvard University Press.

For more information, please contact Janet Golden, Department of History, Rutgers University-Camden.

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