Pregnant women, alcohol, and bar staff

[Spoons]

If you were a bartender or a server in a bar, would you serve a pregnant woman alcohol?

I was talking with some friends the other day, among whom were K, a bartender in his mid-20s; and G, a woman in her early 30s. K was describing a time when a group of women--one of whom was visibly pregnant and looked close to her delivery date--came into his bar. They came in for lunch, and to start, they all ordered glasses of wine.

The server, while perfectly willing to serve wine to the other women, didn't think the pregnant woman should be drinking alcohol, and asked K what she should do. K replied that in his opinion, the pregnant woman could have one glass of wine, but he would cut her off after that.

G piped up. As a woman who had had a child, she noted that when she was pregnant, her doctor had said that an occasional glass of wine in the third trimester wouldn't hurt, although she had not had any. But it wasn't K's call to decide how many (if any) glasses of wine the woman could have, G said; it was between the woman and her doctor to decide what was appropriate.

What eventually happened, K told us, was that the group of women overheard his conversation with the server about whether the pregnant woman should be served, and confronted the manager. They didn't feel that their pregnant friend's drinking habits were any of the staff's business, and that they were leaving. Which they did.

Thankfully, our conversation drifted on to other matters before this discussion could develop into a confrontation between K and G, but I found myself sort of leaning towards G's side of things--if the woman was old enough to drink (she was), and was not intoxicated when she came in (she wasn't), then K really had no reason not to serve her, and the matter should not even have been questioned.

But K and his server seemed to feel that they had some responsibility for the pregnant woman's health. While it is true that under local laws, K can legally refuse to serve anybody who has just walked in (though such an occurrence rarely happens); it is equally true that he is not a guardian of a patron's personal health (with the sensible exception of cutting people off when they have had too much and calling them a taxi so they don't drive, of course).

Dopers, what say you? Is it K's job to serve up the drinks to any and all patrons--including pregnant ones--who are old enough and sober enough to drink? Or is it part of his job to decide how many drinks, if any, a pregnant woman should have?

[Grey]

Wait staff can’t serve patrons that are obviously drunk and they are legally responsible for drunken patron’s actions once the person leaves the bar. It is my understanding that this is to prevent the patron from harming others. Now if the law considers a fetus a person open to harm then K would have a responsibility to not enable harm to occur right?

A few problems here that I can see.

1. Status of the fetus as a person
2. Medical knowledge by the staff of the impact of drinking on a fetus
3. Lack of action taken by retailers selling tobacco products to pregnant women

Ultimately it is the mother’s responsibility to provide for her unborn child, though the bar can always choose not serve the person.

[alice_in_wonderland]

Well, from a FASD point of view, a single glass of wine in the third trimester isn't much of a threat at all. In fact, the substantive risk for FASD comes in the first trimester when most pregnancies aren't visable, so unless K was going to insist on pregnancy tests for all his female patrons, he really doesn't have a leg to stand on.

If the woman chose to get drunk, then the waiter or bartender should cut her off as they would any other patron, but policing everything that a visibly pregnant woman does is obnoxious.

[Phlosphr]

Though the intentions are noble, K is definitely wrong. The woman should be able to walk into any establishment, order what she pleases and enjoy an outing with her friends whenever she feels the need. It is not up to K, or G to make those decisions for her, plain and simple. As mentioned a glass of wine in the 3rd tri is doing no harm to the unborn child. Drinking until intoxication daily is harmful, but in the end, K was wrong and the ladies should not have been bothered.

[Anaamika]

Yeah, but maybe he was just trying to cover his ass? I mean, we've all heard of people getting drunk, in an accident, and suing the bar. WHat if the lady had a premature baby and sued the restaurant?

[Dangerosa]

If you were concerned about someone suing you because you served them, bartending is a bad field for you to choose to be in.

Rare beef is bad for pregnant women, would he have refused to serve her a rare steak? Caffeine isn't good, would he have refused to serve her coffee?

[Athena]

Yeah, but maybe he was just trying to cover his ass? I mean, we've all heard of people getting drunk, in an accident, and suing the bar. WHat if the lady had a premature baby and sued the restaurant?

I might be wrong, but I don't think alcohol causes premature babies. I thought the major issue was fetal alcohol syndrome.

I was in a situation like this many years ago. I was around 21, and had a roommate of about the same age. She was VERY pregnant, but she was still a fun-loving 21 year old. After spending many nights home alone, she decided pregnancy be damned, she needed a night on the town. She called a group of her friends and we all went out. She had no intention of drinking at all. She just wanted to get out of the house and do some socializing.

We walked into one of our favorite bars, and the bouncer stopped her, saying "I'll let you in, but if I see you drinking your ass is out of here."

We saved him the trouble and left immediately. I was highly offended - it was none of his business if she drank or not. She just wanted to hang out with her friends after not being out for many weeks, and anticipating she wouldn't be going out once the baby was born. IMO the guy was being an asshole.

[danceswithcats]

I'll buy a round of STFU for the bartender and the bouncer. Follow them with a MYFB chaser.

[Beadalin]

Funny timing. I just hosted a baby shower for a dear friend of mine, who is a pediatrician. All the guests were women from her hospital, and all (except one) also pediatricians of various stripes. Toward the end of the shower, my friend mentioned how much she's looking forward to eating all the soft cheese she wants, and having a glass of wine.

All the women there agreed that the occasional glass of wine while you're pregnant does no harm (although the soft cheese is still out). In fact, several of them related anecdotes of themselves or their friends "saving up" time to go and have a glass of wine with friends, snotty looks from servers and fellow patrons be damned. I figure that if a bunch of people whose profession is devoted to healthy children all agree it's OK, then it's OK.

K has no business choosing whether or not to serve the woman what she ordered.

[bouv]

All the women there agreed that the occasional glass of wine while you're pregnant does no harm (although the soft cheese is still out). In fact, several of them related anecdotes of themselves or their friends "saving up" time to go and have a glass of wine with friends, snotty looks from servers and fellow patrons be damned. I figure that if a bunch of people whose profession is devoted to healthy children all agree it's OK, then it's OK.

K has no business choosing whether or not to serve the woman what she ordered.

1) Soft cheese is bad during pregnancy?

2) Actually, it IS K's busines to decide whether or not to serve the woman. A server of alcohol, AFAIK, has the right to refuse to serve the alcohol to anyone they want. I'm not saying that refusing to serve a pregnant woman one glass of wine is the corect decision, but it is K's decision to make. A bar/restaurant is under no obligation to brign you food or alcohol just because you ask for it, they haev the right to refuse. Granted, sometimes the reasons for refusal are illegal (for instance, you cann't refuse to serve someone based on their race, religion, etc..) but you can just flat out say 'I don't like you jsut because' and they don't have to do squat.

Again, I'm not saying that someone refusing to serve one glass of wine to a pregnant woman is correct, but he has the right to do so.

[UrbanChic]

Some soft, runny cheeses (brie, camembert) are made from raw milk.

[lavenderviolet]

While I agree with the consensus that one glass of wine in the third trimester probably isn't going to hurt anything, I definitely think a bartender should have the right to refuse to serve drinks at his discretion.

[Dangerosa]

He does, but we all have the right never to grace his door again.

Bars are a tricky business. If I were managing one, I wouldn't risk alienating customers. K managed to alienate a whole group of women. Most who are telling the story to their friends. Some of whom won't patronize his bar.

I have every right to run a business where I give you lousy service, patronize you and insult your ability to care for yourself.

So there are three questions here:

Does he have a legal right not to serve her: sure.

Does he have an ethical responsibility to serve or not serve her? Trickier question. He was certainly well intentioned, but since he obviously knew little about FAS other than "pregnant women shouldn't drink....."

Does he have an employement obligation to serve her? Depends on the management and ownership of the bar. If it were my bar, I'd fire his ass. But I'm sure many bar owners would back him up.

[auntie em]

I worked in a restaurant where we had several "regulars" that we knew well--they came to our staff Christmas parties, etc.

One of them got knocked up, but continued to come and toss back a few with the boys on an almost daily basis. Finally, the bartender (also a woman) refused to serve MotherToBe, and gave her a little mini-lecture (from the POV of a friend) about drinking while pregnant. MTB told the owner (also a friend), and Bartender was instructed to shut her trap and give MTB whatever she wanted. Apparently MTB's story was that since she was an alcoholic, her doctor told her that quitting drinking would be too stressful on the unborn baby. I can't imagine that being true, or a doctor saying it, but what do I know?

At any rate, I don't know how the kid (who must be about 12 by now) is going to do on his SATs, but I can tell you that he was the sweetest, most beautiful, healthiest-looking baby I have ever seen. Just gorgeous.

[alice_in_wonderland]

Apparently MTB's story was that since she was an alcoholic, her doctor told her that quitting drinking would be too stressful on the unborn baby. I can't imagine that being true, or a doctor saying it, but what do I know?

Not unreasonable. I can imagine a Dr. saying this - however, they may advise her to cut down.

Regarding her healthy baby: Severe FASD is actually fairly difficult to cause in your fetus - it requires a lot of drinking, with very little nutrition.

However, it's impractcal to say "Cut down to a reasonable amount" because for an alcoholic who drinks 24 beers a day, perhaps 12 seems reasonable. Additionally, "healthy nutrition" is a bit hard to quantify for someone with diminished capacity (alcoholic) so generally the recomendation is "no alcohol" which will eliminate FASD as a possibility.

That being said, lots of women get pregnant when they're drunk. Their babies are fine. FASD is a horrible condition, but it's not quite as straightline causal as people are led to believe.

[Roberta Plant]

BEER is the answer. High in Folic Acid. Helps to prevent neural tube defects. BEER!!!!

[Fuji Kitakyusho]

I would have been really careful raising that issue as the bartender - what if the woman wasn't pregnant?

[Primaflora]

Soft cheeses and salamis and cold cuts and sushi are to be avoided in pregnancy because of the risk of listeria which can lead to stillbirth. Nothing to do with raw milk at all.

Bartender was in the wrong IMO.

[UrbanChic]

Thanks, Primaflora. A nurse told me about the raw milk thing a few years ago and I never bothered to check it out.

[Keapon Laffin]

Wait, wait, wait.

If she was inclined to drink a third glass, doesn't that mean that she would have been drinking many, many times before this?

Stopping her at her third glass so late would hardly have made a difference.

[China Guy]

No one has even considered that maybe the pregnant lady just wanted to have a filled wine glass in front of her (even though she wouldn't drink). Depending on the situation and company, it's polite to pour every one a full glass even if they have no intention of drinking it.

I've got a pregnant wife, and she would likely get incensed if a bartender or waiter said i can't pour a glass. She's had about 10 small single sips over the past 6 months og pregnancy.

[Dangerosa]

Not unreasonable. I can imagine a Dr. saying this - however, they may advise her to cut down.

Regarding her healthy baby: Severe FASD is actually fairly difficult to cause in your fetus - it requires a lot of drinking, with very little nutrition.
...

That being said, lots of women get pregnant when they're drunk. Their babies are fine. FASD is a horrible condition, but it's not quite as straightline causal as people are led to believe.

And its amazingly hard to pin whose child will get FAS and whose won't. Younger woman and first pregnancies are at lower risk for FAS - even when the alcohol consumption has been similar. Its been pointed out many times that most of Europe has been drinking a few glasses of wine a day for centuries - and Europeans may be a little strange, but it isn't a whole region of people with FAS. I have a lovely cousin and a lovely uncle whose mothers were both extreme lushes. Both are normal and bright individuals. My uncle even has two perfectly normal siblings (although one is an alcoholic himself).

One of my big rants is on the subject of "public pregnancies" - particularly the alcohol issue. So many women I know have spent nine months of their life under extreme stress because they had a glass of wine with dinner before they realized they were pregnant. They've denied themselves things like champagne toasts at their sister's wedding - or had those things denied to them. They've gotten dirty looks drinking near beer in bars. One of my girlfriends is on the heavy side and gets the "drinking while pregnant" backlash every time she goes out (in the six years I've known her, she has never dated and has always looked pregnant).

This isn't to say women should drink while pregnant, but there are a whole lot of things women should and shouldn't do while pregnant. I should have eaten far more green and yellow vegetables and whole grains than I did and I should have gotten more exercise early on. I should have disposed of all the cats in the house before getting pregnant - as neither was really good about litterbox behavior. I should have taken the prenatal vitamins (even though they made me barf). I should have given up caffiene completely - rather than just limited myself.

[SaxFace]

Heh, when I found out I was pregnant, my OB-GYN said that I could only have one glass of wine per day. Of course, I haven't had much of a yearning for something so syrupy but I have had a glass or two over the course of the pregnancy. Does that make me a horrible future mother? BTW, the only thing that really affected me was one small glass of champagne that gave me a HUGE hangover the next day and a raging headache for two more days. This was from three sips!!

I was told not to eat cheeses made from unpasteurized milk (not a problem in the US, though, I think they're illegal there), yes, because of the threat of listeria.

I think it's really awful for someone to dictate what another person can or can't do. My cousin was refused a glass of wine while she was visibly pregnant (this was in Wisconsin). What's preventing the future mother from buying a bottle of vodka and chugging it in her home at 2 am? In my opinion, one can't and shouldn't police pregnant women, hasn't anyone heard of the hormones??

[alice_in_wonderland]

One of my big rants is on the subject of "public pregnancies" - particularly the alcohol issue. So many women I know have spent nine months of their life under extreme stress because they had a glass of wine with dinner before they realized they were pregnant. They've denied themselves things like champagne toasts at their sister's wedding - or had those things denied to them. They've gotten dirty looks drinking near beer in bars. One of my girlfriends is on the heavy side and gets the "drinking while pregnant" backlash every time she goes out (in the six years I've known her, she has never dated and has always looked pregnant).

A friend of a friend was absolutely tied in knots because one of her "well meaning"1 "friends"2 told her that she should abort her baby because she'd had a glass of wine before she even knew the pregnancy existed and therefore her baby was going to have FASD.

'Cus clearly, being totally stressed out about how you've rendered your baby 'horribly retarded' is better than having a glass of wine before you even know you're pregnant.

1: nosy, jealous
2: bitch

[Velma]

I agree that one should not dictate to a pregnant woman in this case, although I sympathize with the bartender. Even if the bartender has a legal right to deny her, I would stay out of it. Should clerks refuse to sell cigarettes to pregnant women? There are many things that are harmful or risky for a pregnant woman to do and it should be between her and her doctor what she decides to participate in.

I chose not to drink during my pregnancy but I did eat cold cuts a few times and took a few over the counter medicines that were not in the "100% proven safe" category. There's a lot of grey area, some choose to do one thing but would never do another. The majority of women are very protective of their own health and their baby's and know very well that excess drinking is risky, the bartender is not educating her or saving her baby by not serving her.

[WhyNot]

Oh, my, word.

Yeah, another MYOB vote here. A. None of his business and B. He was obviously underinformed and C. None of his business!

Several years ago, a dear friend contacted me after an eight month disappearance. She told me she was pregnant, she needed help, etc. So I took her to the doctor, and as the nurse is filling out the paperwork, she starts reading down the list of recreational drugs, asking mom-to-be if she's used any of them in the last year.
"Tobacco?" "Yes"
"Alcohol?" "Yes"
"Marijuana?" "Yes"
"Cocaine?" "Yes"
"Heroin?" Yes"
"LSD?" "Yes"
"Ecstacy?" "Yes"
(The nurse is turning white at this point. ) All the way down the list, there's not a single thing that MTB hasn't been using. Finally, the nurse staggered out to get the doctor. He came in and looked at the sheet, blanched and said, "How much of this are you still using, MTB?" "Only cigarettes," she said (truthfully). "As soon as I found out I was pregnant, I stopped everything else. Cold turkey. It was really hard." (She also didn't know she was pregnant until nearly 5 months.) "Don't stop smoking!" The doctor exclaimed. "It would be just too hard on your system, and I'd rather you smoke cigarettes than go back to all this!"

So she kept smoking, under doctor's orders. But the comments she would get if she smoked in public were truly horrifying. People are just too invasive for words. Four months later, she gave birth to a beautiful, healthy baby boy who's the smartest little whippet I've ever met. She's continued smoking through the years, including during two other pregnancies, producing another beautiful fat baby boy and a sweet, wonderful baby girl. The smallest of the three was 9 lbs, 3 oz. So much for low birth weight!

Two morals to this story. One, shut the heck up. You never know all of someone's medical history. Unless you're her doctor, what you think doesn't matter.

And two, cigarettes are more addictive than cocaine or heroin.



(This story is not meant to encourage or even condone smoking during pregnancy - just an anecdote of why sometimes it is recommended by doctors!)

[Indygrrl]

I'll buy a round of STFU for the bartender and the bouncer. Follow them with a MYFB chaser.

Yep.

[JustPlainBryan]

All these stories about women drinking, smoking, and still giving birth to perfectly healthy children has led me to wonder how much truth there really is to claims that these substances would truly harm a fetus.

I'm starting to think maybe the only way a pregnancy can be harmed is if you were a 2 pack-a-day smoker who binge drinks every night.

[Quartz]

I'd just like to draw attention to the point that they were discussing whether to serve this woman within earshot. It's this, I feel, that is the height of rudeness. Surely a simple, "I'm very sorry, madam, but I'm not sure I should be serving you alcohol; will you please accept (some soft drink) while I go and check?" would suffice. Or even simpler, "Are you sure you should be drinking?"

[alice_in_wonderland]

All these stories about women drinking, smoking, and still giving birth to perfectly healthy children has led me to wonder how much truth there really is to claims that these substances would truly harm a fetus.

I'm starting to think maybe the only way a pregnancy can be harmed is if you were a 2 pack-a-day smoker who binge drinks every night.

These things aren't well understood (actually, I'm not sure anything is well understood). However, what is known is that humans are very resilliant. Women who drink a glass of wine once in a blue moon, are healthy, and eat a good diet, don't have babies with FASD. In fact, functional alcoholics who are still eating generally don't have babies with severe impairment. In order to have a pronounced impairment, a woman has to work at it - binge drinking daily with zero food intake for a week, for instance - generally, I'd be willing to bet that babies concieved under those circumstances wern't planned.

Anyhow - ignorant, uninformed comments about any aspect of a stranger's pregnancy are pretty well always ill advised, IMHO.

[alice_in_wonderland]

Or even simpler, "Are you sure you should be drinking?"

Just as obnoxious, as far as I'm concerned. If she wasn't sure, she wouldn't have ordered the drink.

[WhyNot]

All these stories about women drinking, smoking, and still giving birth to perfectly healthy children has led me to wonder how much truth there really is to claims that these substances would truly harm a fetus.

I'm starting to think maybe the only way a pregnancy can be harmed is if you were a 2 pack-a-day smoker who binge drinks every night.
Well, yeah. Unless you hit just the right window when just the right chromosome is replicating or the right cell is dividing, and then who knows?

I think the problem is twofold:
American women, like all Americans, are not so good at "moderation" sometimes.
American doctors don't want to counsel moderation, have a woman become a binge drinker and then get sued for malpractice. (Or, for the less cynical, doctors don't want to counsel moderation, have a woman become a binge drinker and end up with a very sick baby.)

[Ashes, Ashes]

It does happen JustPlainBryan, but I wonder what the numbers are. In ten years of teaching, I've seen maybe a half dozen FAS affected kids, compared to maybe five times that many with Down's Syndrome. Thing is, it can be pretty awful when it does happen and I don't blame some parents for being a bit over-cautious.

[Sat on Cookie]

Surely a simple, "I'm very sorry, madam, but I'm not sure I should be serving you alcohol; will you please accept (some soft drink) while I go and check?" would suffice. Or even simpler, "Are you sure you should be drinking?"

You know in cartoons when a character gets so mad that steam comes out of his ears? In the event some idiot said the above to me, I would look exactly like that, except my head would probably pop off from irritation as well. I mean, seriously, WTF? Because some uninformed moron read a blurb about pregnancy and alcohol in TV Guide and decided they were educated on the subject, I'm supposed to humor their ignorance? No, I'd be having a talk with the manager, owner, regular barflys, the cleaning people, the local media, and I might even call their mother and tell her she raised an effing dolt.

[levdrakon]

My first instinct would be to mind my own business. But on reflection, I can see a problem. It's the bartender's responsibility to not serve anyone underage. If a woman is obviously pregnant, it's reasonable to assume she's not going to abort it, or that it's legally beyond the abort date. So now you're serving two people, one of whom is definitely underage.

If the bartender waited a month or two and this woman came in with her baby in a baby carriage and asked the bartender to fill it's baby bottle with wine or beer, and the bartender did, the bartender could very well go to jail.

It probably does no harm to have a drink during the 8th month of pregnancy. It also does no harm to give a ten month old some alcohol. It also does no harm to give a 19 year old alcohol. But that's your choice as a parent. The bartender doesn't have that choice. They are expected to butt into your business and make a judgment about you each and every time you ask for a drink.

What I'm saying is, if you want to give your baby some liquor at home, that's more or less your choice. But if you're going to ask a bartender to serve your baby liquor, don't be too offended if the bartender struggles with some moral ambiguities, if not legal ones.

[Dangerosa]

It does happen JustPlainBryan, but I wonder what the numbers are. In ten years of teaching, I've seen maybe a half dozen FAS affected kids, compared to maybe five times that many with Down's Syndrome. Thing is, it can be pretty awful when it does happen and I don't blame some parents for being a bit over-cautious.

Can I ask how you knew they were FAS affected?

I ask because my son is adopted. In adoption circles, its quite common for peditricians to tag our kids FAS for darn near anything. Once they find out you don't know much about the birthmom, they (and, unfortunately, a lot of adopted parents) are ready to blame the birthmom for every learning disability say it must have been booze.

Not that there isn't such a thing as FAS, but I sometimes wonder if it is - in adoptive children at least - overdiagnosed.

[GorillaMan]

Two morals to this story. One, shut the heck up. You never know all of someone's medical history. Unless you're her doctor, what you think doesn't matter.

And two, cigarettes are more addictive than cocaine or heroin.


I fully endorse these two statements. Slightly separatly, my gran was an obstinate smoker, and was allowed a packet a day, while in the advanced stages of lung cancer. Basically, the doctors said 'why stop her now?'.

[WhyNot]

It does happen JustPlainBryan, but I wonder what the numbers are. In ten years of teaching, I've seen maybe a half dozen FAS affected kids, compared to maybe five times that many with Down's Syndrome. Thing is, it can be pretty awful when it does happen and I don't blame some parents for being a bit over-cautious.
Would that same bartender say to a 36 year old woman, "Lady, advanced maternal age is linked with extremely high rates of Down's Syndrome. You shouldn't be pregnant at your age!"?

She'd kill him. And rightly so.

Dangerosa, according to the CDC (http://www.cdc.gov/ncbddd/fas/fasask.htm#character),

Children with FAS or ARND may have the following characteristics or exhibit the following behaviors:
small for gestational age or small in stature in relation to peers;
facial abnormalities such as small eye openings;
poor coordination;
hyperactive behavior;
learning disabilities;
developmental disabilities (e.g., speech and language delays);
mental retardation or low IQ;
problems with daily living;
poor reasoning and judgment skills;
sleep and sucking disturbances in infancy.

Generally, it's the small eye opening and tiny stature linked with behavior problems that clues most teachers in to the problem.

[calm kiwi]

So she kept smoking, under doctor's orders. But the comments she would get if she smoked in public were truly horrifying. People are just too invasive for words. Four months later, she gave birth to a beautiful, healthy baby boy who's the smartest little whippet I've ever met. She's continued smoking through the years, including during two other pregnancies, producing another beautiful fat baby boy and a sweet, wonderful baby girl. The smallest of the three was 9 lbs, 3 oz. So much for low birth weight!

Two morals to this story. One, shut the heck up. You never know all of someone's medical history. Unless you're her doctor, what you think doesn't matter.

And two, cigarettes are more addictive than cocaine or heroin.


I was a very heavy smoker before I got pregnant. I tried really hard to quit and got down to 2-3 a day but I just couldn't shake those last couple. I was in tears at the doctors one day because I was feeling so guilty about what those cigs might be doing and the doctor said, "If you repeat this I will deny it but the stress of giving up is more harmful to the baby. Don't smoke more then 3 a day". I have a very healthy son, who was born a month early (but not small for his gestation). His early birth was caused by something else.

[Dangerosa]

Yes, I'm well aware of what the CDC says are the clues for FAS. Are you saying you make the diagnosis as a teacher by what the child looks like and that they misbehave? Or do you have a medical history you are working from? And if you are working from a medical history, do you know the maternal history during pregnancy?

[WhyNot]

Yes, I'm well aware of what the CDC says are the clues for FAS. Are you saying you make the diagnosis as a teacher by what the child looks like and that they misbehave? Or do you have a medical history you are working from? And if you are working from a medical history, do you know the maternal history during pregnancy?
IANATeacher, although my mother is, and has had a few FAS students. It's in their records, from their doctors.

Sorry, I didn't mean to be condescending by posting information. Just trying to help.

[kung fu lola]

"There is no safe level of alcohol consumption during pregnancy." (http://www.aap.org/advocacy/chm98fet.htm)

"Avoid alcohol entirely for 3 months prior to getting pregnant and during the entire pregnancy." (http://www.lambtonhealth.on.ca/pregnancy/healthybeginnings/alcohol.asp)

"women should be counselled that a personal history of uneventful alcohol use during one pregnancy offers no guarantee for subsequent pregnancies." (http://www.lambtonhealth.on.ca/pregnancy/preconception/alcohol.asp)

"a doctor cannot advise the pregnant mother to have just one or two drinks if she wants to be sure she is protecting her baby." (http://www.medicalnewstoday.com/medicalnews.php?newsid=13332)

[Ashes, Ashes]

Dangerosa, as WhyNot mentioned, I knew they were FAS because it was in their files, because their special ed. teachers told me when we were going over their IEPs, etc. I had no idea people tried that stuff with adopted/foster kids. Sounds a bit like how folks love to slap ADHD labels on every excitable student.

WhyNot, I'm a bit confused; you don't think I meant that people over 35 shouldn't have kids, right? I was simply comparing one form of disability to another to give an idea of how many kids with FAS I've seen over the years.

[mks57]

"There is no safe level of alcohol consumption during pregnancy." (http://www.aap.org/advocacy/chm98fet.htm)

"Avoid alcohol entirely for 3 months prior to getting pregnant and during the entire pregnancy." (http://www.lambtonhealth.on.ca/pregnancy/healthybeginnings/alcohol.asp)

"women should be counselled that a personal history of uneventful alcohol use during one pregnancy offers no guarantee for subsequent pregnancies." (http://www.lambtonhealth.on.ca/pregnancy/preconception/alcohol.asp)

"a doctor cannot advise the pregnant mother to have just one or two drinks if she wants to be sure she is protecting her baby." (http://www.medicalnewstoday.com/medicalnews.php?newsid=13332)

I have to wonder if these zero-tolerance assertions do more harm than good. They remind me of the mindless anti-drug propaganda that has afflicted this country for decades. Why can't patient education be based on facts and scientific data, rather than unfounded speculation?

Don't live in Denver! It only takes one cosmic ray to turn your future child into a hideous monster!

[MinniePurl]

Ya know how ingrained in our culture this "pregnant women shouldn't drink" idea is? I got hassled about it by my four year old stepdaughter. I wasn't actually drinking alcohol, I was drinking an IBC root beer. It comes in a brown glass bottle, and if you're four and can't read, it looks just like a regular beer bottle. She saw me drinking one when I was 7 or 8 months pregnant, gasped, and exclaimed in an incredulous tone, "Can MOMMIES drink BEER?" If even a four year old feels like she must say something about it, any visibly pregnant woman who orders a drink and doesn't expect a hassle is pretty naive.

[PookahMacPhellimey]

It's a very curious thing to me how there is a tendency in Americans (there are of course numerous exceptions and plenty frequent this board) to fanatically defend personal freedom above any other good but throw that philosophy out the window the minute a foetus enters the scene.

Therefore, chiming in, waiter please mind own business.

[DantesTenth]

I recall a case years ago (somewhere in the US - have no idea where/when, or how to find a site.

A 8.99 months-Pregnant women enter a bar and ordered a (gasp!) alcoholic beverage - both the barkeep and a waitress gave her tons of "You can't do that - think of the fetus" crap, even after the customer had said she was aware of the risks, and still wanted a drink. (excuse me folks, but if she can legally dring alcohol, it really not your concern- just poor the drink).

In one of the "justice is actually served" scenes, the manager was summoned to the bar - whereupon he immediately fired the barkeep and waitress.

Bravo for him! It is not up to the waitstaff to tell a customer what she can order - this is one of the of the examples which redeem (almost) faith in the species.

Dear waitrons - it is NOT your position to dictate your judgement to the customer - you are there to sell booze - just do it or resign, OK?

[WhyNot]

WhyNot, I'm a bit confused; you don't think I meant that people over 35 shouldn't have kids, right? I was simply comparing one form of disability to another to give an idea of how many kids with FAS I've seen over the years.
No, no, you're in the clear. Merely pointing out that if a person were to indicate public disapproval of a woman over 35 for being pregnant, he could rightly expect to get bitch-slapped. (When in fact, Down's Syndrome due to advanced maternal age is a far greater risk than FAS from a glass of wine late in pregnancy.) I was paralleling (is that even a word?) it to the situation in the OP.

Sorry if that wasn't clear. I don't, for the record, think women should be prevented from having babies later in life, nor should they be chastised for it. It does have its risks, however small, as does drinking alcohol. But those risks are up to each woman (and perhaps her doctor) to weigh and make an informed decision.

[Alessan]

I really shouldn't talk - my wife is approaching her third trimester and she hasn't had a drink since she stoped taking her birth control (not that she was ever much of a drinker to begin with). But if I were the bartender I would have refused, too. In all likelihood, nothing would happen, bit I just wouldn't want anything on my conscience. She has a right to do whatever she wants - but so would I.

[Dangerosa]

Alessan,

I'd make a poor bartender, too.

I don't want to contribute to anyone's alcoholism
I don't want someone I serve to go have a fatal car accident
I don't want someone to get drunk and abuse their spouse or children.

Why is pregnancy different? If you can't handle the downside of a job, maybe you are in the wrong career.

[Dangerosa]

to balance kung fu lola's cites:

http://www2.potsdam.edu/alcohol-info/FAS/FAS.html

This study is my favorite because its so counterintuitive to what we are taught:

A study of pregnancies in eight European countries found that consuming no more than one drink per day did not appear to have any effect on fetal growth. A follow-up of children at 18 months of age found that those from women who drank during pregnancy, even two drinks per day, scored higher in several areas of development.

As Alice has been saying, this is far from cut and dried

[Northern Piper]

2) Actually, it IS K's busines to decide whether or not to serve the woman. A server of alcohol, AFAIK, has the right to refuse to serve the alcohol to anyone they want. I'm not saying that refusing to serve a pregnant woman one glass of wine is the corect decision, but it is K's decision to make. A bar/restaurant is under no obligation to brign you food or alcohol just because you ask for it, they haev the right to refuse. Granted, sometimes the reasons for refusal are illegal (for instance, you cann't refuse to serve someone based on their race, religion, etc..) but you can just flat out say 'I don't like you jsut because' and they don't have to do squat.

Again, I'm not saying that someone refusing to serve one glass of wine to a pregnant woman is correct, but he has the right to do so.But in those jurisdictions where businesses are prohibited from discriminating on the basis of sex, there's a good argument that refusing to server the drink on the basis of pregnancy would be sex-based discrimination, since the ability to be pregnant is one of the key sexual traits of women. Also, the server's attitude assumes that the server knows better than the woman what's best for her, which treats her with considerably less dignity and autonomy than other persons - again, based on her sex and particular situation.

Would depend, of course, on the particular law of the jurisdiction in question.

[irishgirl]

We're told to tell pregnant women that they should avoid alcohol, but if having a glass of wine every day is going to make them less stressed and anxious than having one, they should drink the wine.

Getting a preganat woman (especially a very heavily pregnant woman) upset and anxious by not serving her a glass of wine is probably going to do more harm to her baby than the wine itself.

Since medical opinion (and research) says a glass of wine is OK, who is the bartender to say otherwise?

[alice_in_wonderland]

Dangerosa - I'm not saying that your child does or does not have FASD - I've never met either of you, so I have no idea. A couple of things I do know, however:

FASD (fetal alcohol spectrum disorder - it's no longer properly refered to as FAS because of the wide variance of symptoms and impairments) occurs along a spectrum - mild cases may never be diagnosed, or may be diagnosed as other learning diabilitys or conduct disorders. However, severe cases have a pronounced difference in brain arcitecture (see here (http://www.nofas.org/healthcare/identify.aspx) and here ()http://www.fas-region3.com/FASE.html) - scroll about half way down and click the "Brain of Normal Baby vs FASD baby link), as well as a well documented set of visual and behaviour cues for diagnosis.

How exactly a fetus gets it is kind of unclear - however, once the child is born with it, it's fairly straightforward to diagnose it.

[Dangerosa]

Mine doesn't, he is a perfectly healthy kid (well, except for cat allergies and a history of febrile seizures). I've just noticed in adoption circles that FAE and FAS is often diagnosed - without having any history of the pregnancy - in other words, they assume alcohol is the culprit without knowing. I've never heard of anyone having the brain scan done - diagnosis is often made by behavior and learning disabilities. Although a lot of adopted kids do have FAS (you can't control another woman's pregnancy - and not all birthmothers are paragons of the ideal pregnancy) - I think its being overdiagnosed. And I KNOW FAE diagnosis is problematic in adoption circle - because FAE doesn't have any physical traits. Somehow it seems unfair to me to blame drinking by the birthmother when you don't know if she drank or not - unless you can prove cause and effect.

Are there any other causes for similar loss of brain tissue? Or is this unique to fetal alcohol exposure?

[alice_in_wonderland]

Are there any other causes for similar loss of brain tissue? Or is this unique to fetal alcohol exposure?

Well, I'm not a neurologist (perhaps one will be along soon?) - however, my understanding is that FASD results in a unique set of brain annomilies which are easily identified on a PET scan or CT.

Regarding diagnosis - ADHD I can believe is overdiagnosed. Oppositional Defiant Disorder I can believe is overdiagnosed. FASD, on the other hand, has a rather exclusionary set of criteria - particularly facial anomilies that are not present in other conditions. That being said, I know that mild cases of FASD are often misdiagnosed as ADHD or ODD in the early stages of treatment, because of the similarity of behaviour problems. However, generally ADHD and ODD respond to certain types of therapies which are not effective in FASD cases (ritalin, for instance, would not help an FASD child, unless the child also had ADHD Yikes!)

In fact, I would be inclined to think that FASD was Under diagnosed, or misdiagnosed.

[Spoons]

Been following along, and I'm kind of glad to see that the general consensus seems to be that K was well-intentioned, but somewhat wrong. I may eventually point him in the direction of this thread to forestall future occurrences, but after that incident, I don't think too many pregnant women will be entering K's bar.

But it's also been educational, I must say. Thanks for the replies so far, and I'll look forward to reading more as they come.

[alice_in_wonderland]

Been following along, and I'm kind of glad to see that the general consensus seems to be that K was well-intentioned, but somewhat wrong.

Actually, I think I would amend that to "well-intentioned, but totally wrong."

Honestly, a woman who is drinking heavily and is visibally pregnant was probably drinking heavily when she wasn't visibally pregnant - that is, the damage is already done.

Further, I think most people would object less if the woman had drank 10 glasses of wine and he balked at serving her the 11th one - if you wanna get pissed, personally I think you should do it at home, pregnant or not. However, commenting on the woman's drink selection, within her earshot, based on eronious information, guesses and bad feelings was totally obnoxious and totally wrong.

IMHO. :)

[Dangerosa]

Well, I'm not a neurologist (perhaps one will be along soon?) - however, my understanding is that FASD results in a unique set of brain annomilies which are easily identified on a PET scan or CT.

Regarding diagnosis - ADHD I can believe is overdiagnosed. Oppositional Defiant Disorder I can believe is overdiagnosed. FASD, on the other hand, has a rather exclusionary set of criteria - particularly facial anomilies that are not present in other conditions. That being said, I know that mild cases of FASD are often misdiagnosed as ADHD or ODD in the early stages of treatment, because of the similarity of behaviour problems. However, generally ADHD and ODD respond to certain types of therapies which are not effective in FASD cases (ritalin, for instance, would not help an FASD child, unless the child also had ADHD Yikes!)

In fact, I would be inclined to think that FASD was Under diagnosed, or misdiagnosed.


Thanks, Alice. Based on that information, I'm suspecting that what I am seeing is parents and perhaps peditricians blaming alcohol for learning disabilities (the peditrician may never use the words FAS - I'm talking to the parents who are just telling me their kid has FAS), and the parents then classify their kids as FAS. I've met some of these kids (others I've seen pictures of), and most don't have the facial abnormalities (at least, not to my untrained eye) that I've seen - i.e. you don't look at these kids and say "something is wrong." (One, you do look at at say, "something is wrong" - even with his hard to read Asian face - and his mother calls it FAS - and I find that believable).

i.e. Mom goes into the peditrician with Bobby who is seven and is having trouble learning to read and paying attention in class and says "what is wrong with my child and why" Doctor hems and haws - says something about "do you know if his birthmother drank, that might have had an impact on his IQ, ability to pay attention, ability to learn, etc?" Mom grabs that information (she, like us, may not have any information on the pregnancy one way or the other) and runs. The correct answer might be "Bobby is a seven year old boy and not the brightest bulb on the Christmas tree" but that answer doesn't appease mom.

If you look down the CDC list, all of them, except the facial abnomalities, are also considered as effects of institutionalization. And, ADHD has been proven to be more common in adopted kids (apparently there is a genetic link and ADHD people are theorized to be more likely to have unplanned pregnancies that result in adoption).

[alice_in_wonderland]

Thanks, Alice. Based on that information, I'm suspecting that what I am seeing is parents and perhaps peditricians blaming alcohol for learning disabilities

Well, the other thing I wonder is if your cohort is self-selecting. I don't actually know the numbers, but perhaps there is a higher instance of FASD in adopted children - this doesn't strike me as totally improbable - I imagine a woman with a drinking problem severe enough to have an FASD baby could also be ruled an unfit mother and have her child removed, or decide of her on volition that raising a child may not be the best choice for her now.

[levdrakon]

We're told to tell pregnant women that they should avoid alcohol, but if having a glass of wine every day is going to make them less stressed and anxious than having one, they should drink the wine.

Getting a preganat woman (especially a very heavily pregnant woman) upset and anxious by not serving her a glass of wine is probably going to do more harm to her baby than the wine itself.

I'm not buying this one. Are pregnant women really so fragile we have to tip-toe around them lest we upset them and damage their babies? Are their babies really so easily damaged? And is the health of the baby really so important that we, the general public have to take an active role in women's not harming their own babies? Good God man, just give her some alcohol or she'll go into the shakes and miscarriage right here!

The OP didn't say the bartender refused to serve this woman, he just talked about it with the server. Spare your bartender the histrionics, and get your doctor to buy you a drink next time. Or find a bar where they don't give a shit who drinks what, or how much.

[kung fu lola]

I'm not buying this one. Are pregnant women really so fragile we have to tip-toe around them lest we upset them and damage their babies? Are their babies really so easily damaged? And is the health of the baby really so important that we, the general public have to take an active role in women's not harming their own babies? Good God man, just give her some alcohol or she'll go into the shakes and miscarriage right here!

I agree that no one should dictate to a pregnant woman whether she should drink or not. It's up to women to look at the evidence and decide for themselves, and everyone else can STFU.

However, the "the stress of not drinking is worse than the alcohol" line sounds like BS to me.
Alcohol is, literally, a poison. The sensation of "being drunk" is your body's natural reaction to being poisoned.

It just doesn't make logical sense that drinking poison is better than not drinking poison.

[Dangerosa]

My doctor told me a similar thing.

As explained to me: I'm an anxious depressive. A glass of wine a day they have a pretty good idea of what it doesn't do to a fetus. They had no idea what anti anxiety meds would do, and if it got bad and I went into the depression spiral, harming myself is going to do no good at all to either me or my daughter.

I had one anxiety attack, drank a glass of wine (after discussing it with my OB - which is where I got this), went to sleep, woke up fine.

(yes, Alice, for the general population of adoptees, FAS is more common. For international adoptees from Eastern Europe its a real concern. My self selecting sample is Asian adoptees, where alcohol abuse by women is very uncommon as its still culturally inappropriate for women to drink in Korea and China (changing, but still not what you'd have with US or EE birthmoms). So it would be statistically odd to have a lot of FAS in the set)

[alice_in_wonderland]

My self selecting sample is Asian adoptees, where alcohol abuse by women is very uncommon as its still culturally inappropriate for women to drink in Korea and China (changing, but still not what you'd have with US or EE birthmoms). So it would be statistically odd to have a lot of FAS in the set)

:confused:
Huh - well that's sort of odd. Perhaps the Drs in your area really dig the FASD diagnosis.

I dunno. Anyhow - I'm gald your little guy is ok. :)

[Quartz]

You know in cartoons when a character gets so mad that steam comes out of his ears? In the event some idiot said the above to me, I would look exactly like that, except my head would probably pop off from irritation as well. I mean, seriously, WTF? Because some uninformed moron read a blurb about pregnancy and alcohol in TV Guide and decided they were educated on the subject, I'm supposed to humor their ignorance? No, I'd be having a talk with the manager, owner, regular barflys, the cleaning people, the local media, and I might even call their mother and tell her she raised an effing dolt.
Then I'd suggest that you'd not be doing very well in the fight against ignorance; you'd be confusing ignorance with stupidity. What exact issue do you have with someone admitting their ignorance and going to check?

[Chanteuse]

Maybe he can't tell her what to drink, but I'd damn sure have her sign a waiver saying that she understood the risks and forfeited any right to sue in the event of "worst case scenario." Why? Because even though she'd have been warned out the wazoo about drinking while pregnant, she might decide, "Well, they shouldn't have served it to me!" And there would be a judge and jury stupid enough to buy her argument, just like there are those willing to financially reward people who KNEW smoking was dangerous, but did it anyway, got cancer, and sued. The old "it's everyone's fault but mine" syndrome. Well, I'd be absolutely certain my ass was covered, that's for sure!

That way perhaps he could "MHOB" without losing it.

[Sat on Cookie]

Then I'd suggest that you'd not be doing very well in the fight against ignorance; you'd be confusing ignorance with stupidity. What exact issue do you have with someone admitting their ignorance and going to check?

He or she can go check all they want to; I'll be talking to the manager. I'm not asking them whether or not, in their opinion, I should have a drink. I'm the pregnant one and I've made an educated decision to have a drink. Period. It's none of their business. And anyone *remotely* educated on the subject knows there are many schools of thought on the issue; i.e., for every doctor who says one should not drink, there's a doctor saying a glass of wine every once in a while is fine. There simply is no definitive answer. If the server is that torn up over it, or if the server believes strongly in one school of thought, he/she shouldn't be serving.

p.s. The above is hypothetical; I choose not to drink at all.

[Barbarian]

My friend just finished her PhD studying Fetal Alcohol Syndrome, including full reviews of all the literature, analyses of kids with FAS and their mothers, and turning lots of pregnant rats into alcoholics.

The one-sentence answer: a pregnant woman has to down bottles of liquor every week to deliver a kid with FAS.

If the pregnancy prohibition people were right, every human born in Europe in the past 3,000 years would have FAS.

One drink ain't gonna affect anybody, or their fetus.

[kung fu lola]

The one-sentence answer: a pregnant woman has to down bottles of liquor every week to deliver a kid with FAS.

But I thought there is a continnum, of which FAS is just the most severe result. Cite (http://www.cdc.gov/ncbddd/fas/fasask.htm#how). This means that moderate or minimal consumption of alcohol can result in neurological and other congenital defects, just not ones severe enough to be diagnosed as FAS.

[WhyNot]

But I thought there is a continnum, of which FAS is just the most severe result. Cite (http://www.cdc.gov/ncbddd/fas/fasask.htm#how). This means that moderate or minimal consumption of alcohol can result in neurological and other congenital defects, just not ones severe enough to be diagnosed as FAS.
For a physician's diagnosis (the kind medical insurance will accept,) it's FAS or nothing. Anecdotally, in parenting groups and even among researchers, yes, there is a continuum of symptomology, falling under the name "Fetal Alcohol Spectrum Disorders". It does not logically follow that therefore moderate or minimal consumption of alcohol causes moderate or minimal FASD. (It may feel intuitively "right," but the statistics simply do not bear out this hypothesis.) The fact is that moderate or minimal consumption has been overwhelmingly shown to be safe, and that lesser forms of FASD are not caused by moderate or minimal consumption of alcohol.

Perhaps they're caused by biochemical differences in women who are heavy drinkers, perhaps some heavy drinkers binge drink sporadically, perhaps some heavy drinkers who have decent nutrition bear children with minimal FASD. There are many possibilities, and they should be investigated further, but minimal to moderate alcohol consumption has been ruled out.

[lee]

Soft cheeses and salamis and cold cuts and sushi are to be avoided in pregnancy because of the risk of listeria which can lead to stillbirth. Nothing to do with raw milk at all.

Bartender was in the wrong IMO.
Sprouts are also out as they cannot be throroughly washed. Raw vegatables unless washed very thoroughly are out. I did not trust any restaurant salad while I was pregnant.

Salami is also a danger because of nitrates. Nitrates should be limited, but if you have them, have something acidic with vitamin c in it at the same time. That somehow is supposed to prevent them from forming the bad stuff that may damage the fetal heart.

On the other side chocolate has benefits for both mother and child.

Tell me, would that bartender refuse to sell her hot wings with fresh blue cheese dressing and celery sticks? Does he make sure the women he server are not going to be nursing later? He is an ass and if smart, the management would, if they knew he did this, warn him to stop and if he refused, fire him.

When alcohol is the most dangerous to fetal development, pregnancy is not visible. This is not about real concern for mother or child but petty, controlling, self rightious minding of others business.

[Barbarian]

But I thought there is a continnum, of which FAS is just the most severe result. Cite (http://www.cdc.gov/ncbddd/fas/fasask.htm#how). This means that moderate or minimal consumption of alcohol can result in neurological and other congenital defects, just not ones severe enough to be diagnosed as FAS.

Don't forget the critical word on the page you cited: possible.

Just about anything is possible, including killing my pregnant wife by inducing an embolism during cunnilingus. Yeah, there's only one case on record-- world wide-- and it's somewhat suspect, but that 'pregnancy classic' What to expect when you're expecting tells couples to practice safe muff-diving to avoid accidental death :rolleyes:

Much of the literature on pregnancy available in the western world comes down firmly on the 'fear and loathing' side of the scale, with very little evidence to justify any of the various prohibitions. (Probably a hangover from the 'delicate flower' period during England's history.) And admittedly, if you're an agency like the CDC, how do you determine a safe level of alcohol for all pregnant women, from age 11 to 61, weighing anywhere from 80 to 400 pounds? You can't, so you take the easy way out and and say there's no safe level.

But realistically, if you're a healthy woman, eating properly, and getting enough rest, exercise, and nutrients, you're going to have a healthy baby even if you indulge in the occasional glass of wine. And even if you don't eat properly, smoke constantly, binge drink, and go into the hospital thinking you have appendicitis but come out with a full-term baby (like my cousin in T.O.), you can still have a healthy, well-adjusted, kid. And if you've got a good support group, your kid, even if he does have FAS, is going to be able to overcome all sorts of drawbacks.

As far as we can tell, nurture is just as important as nature (until someone does the double-blind study involving 1000 pairs of twins separated at birth).

[Shrinking Violet]

BEER is the answer. High in Folic Acid. Helps to prevent neural tube defects. BEER!!!!

As recently as the Sixties, to my knowledge, doctors in the UK encouraged pregnant women to down a pint of "stout" (ie Guinness, Mackeson's) a day "for the good of the baby". My late MIL would still complain bitterly (sorry for the pun, UKers :D ) to her dying day of having to force down a pint of that awful stuff each day when expecting my ex-hubby.


I was a very heavy smoker before I got pregnant. I tried really hard to quit and got down to 2-3 a day but I just couldn't shake those last couple. I was in tears at the doctors one day because I was feeling so guilty about what those cigs might be doing and the doctor said, "If you repeat this I will deny it but the stress of giving up is more harmful to the baby. Don't smoke more then 3 a day". I have a very healthy son

Ditto, almost word-for-word, except I had an extremely healthy full-term daughter. To this day I still feel very guilty about it, though.