Messages from physicians differ

Dr. Christopher Cunniff is studying the rate of FAS in the state.

More than a few pregnant women have come into Dr. Walter Brewer's office in a panic.
"Many women come in and tell me they didn't know they were pregnant and they've had a few drinks, and they're so afraid of what they've done to their baby," Brewer said.
Brewer, a Tucson obstetrician and gynecologist, tries to reassure them. But he also tells them pregnancy is not a time to drink.
But experts say other obstetricians are telling their patients it's OK to drink socially during pregnancy.
"As late as 1983, doctors were being trained that drinking is safe in pregnancy," said Dr. Terry Cullen, clinical director at Sells Hospital.
"There are tons of doctors in their 40s and older who are still giving this advice to their patients."
Cullen teaches a course at the University of Arizona College of Medicine, and she advises doctors on the ill-effects of social drinking on a fetus.
Debbie Thomas, who runs a fetal alcohol syndrome prevention program on the Tohono O'odham reservation, said "a lot of providers drink themselves, and they don't want to tell patients to stop."
Cullen and Thomas said there are few plans in place for doctors to help pregnant women stop drinking.
Thomas, who worked as a public health nurse for six years, said when she was pregnant five years ago, she went to health care provider in Tucson for a prenatal checkup.
A nurse mistakenly thought she had no health insurance, and asked her about drinking and drug use. When the nurse realized she had insurance, she apologized, saying she wouldn't have asked those questions.
"I said, 'Don't apologize. You should be asking everyone those questions.'"
Thomas said drinking in pregnancy is like domestic violence. "People just don't ask. They aren't very comfortable asking, and then they don't know what to do with it."
Sharon Davis, director of research and program services for The Arc, a national organization on mental retardation, said it is "simply not OK for doctors to tell their pregnant patients that a drink now and then is OK."
"Since we do not know what level of drinking is safe, it's best not to drink at all. It really is something you have to abstain from throughout pregnancy."
Ann Streissguth, an FAS expert known throughout the world, said health care workers must be clear about the potential damage.
"The more clear doctors can be, the easier it is for women," Streissguth said. "Doctors, nurses and everyone else need to simply say, 'Don't drink.'
"At every prenatal visit, doctors should be asking their patients what they've been drinking. They need to repeatedly tell them of the consequences, and let them know if they can't stop, they will help them work out a plan to help them stop drinking."
Streissguth said some physicians "don't seem to believe in FAS." One study found that more women believe in abstaining from alcohol during pregnancy than do doctors, she said.
Gail Harris, who has worked with children with FAS in Arizona for 20 years, said doctors shouldn't be "preachy."
"But if we know alcohol is poison to the system of the developing fetus, our hardline position should be that no amount of alcohol is safe and none should be consumed."
"It's not a judgment about alcohol or lifestyles. It's not saying alcohol is bad. It's not a moral issue. It's an issue of health and education and prevention of a lifetime of misery for an innocent child."