Nursing assignment: Fetal alcohol disorders

Specialties Ob/Gyn

Published

Hello, my name is Christine. I am currently a second semester nursing student and I have an assignement to write a paper about a question that I will ask you all wonderful nurses and summarize the comments. I have been reading the discussions for a while and I find it very interesting and I have learned alot.

The question I pose has to do with a neighbor that I knew. She is young, 24 years old, this is her first pregnancy (4 months pregnant)and has a history of cervical cancer. Ever since her diagnosis of cancer, she has been worried about having children, and now that she is pregnant she is paranoid over everything. She is constantly worried and stressed about how this pregnancy will go. Her doctor has prescribed her a glass of wine every night to relax her and decrease her stress level. My neighbor said she talked to the doctor and nurse about the order and no one questioned the order.

I have done some research on this, and I came across the article "One drink can last a lifetime" by Dunbar, C., in the Nursing Spectrum 2005 6(6):23-24. The article explicitly states that there is no established safe level of alcohol use for pregnant women and hence should be advised to abstain from all forms of alcohol.

I also read in the Journal of the American Academy of Nurse Practicioners,(2005, 17(5): 187-193) an article called "Fetal alcohol spectrum disorders prevention: an exploratory study of women's use of attitudes toward adn knowledge about alcohol" by Walker and Fisher. This article states that there is a spectrum of disorders that can occur when a woman consumes alcohol during pregnancy. It states FAS is the most common, but there can be behavioral problems, cognitive problems and they don't always have to have physical features such as facial deformities to pin point it out. It also states that in all trimesters, the baby can be affected by alchol.

My question is do you all know any doctors or midwives who have suggested this?? What do you think about what this doctor and nurse did considering the uncertainty of what alcohol can do? What do you all tell your patients about alcohol use? What would you have done if this was your patient. I would appreciate thoughts and opinions about the subject and opinions and experiences with this.

Hope to see some responses,=)

Christine

Up Vote Up Vote ×
Specializes in Public Health, DEI.

What you've read about no recognized safe level of alcohol during pregnancy is what I've been taught, and what I've read or heard from every reputable source I've ever known to address this matter. My personal opinion is that this ob/gyn is probably from the bad old days when there was a school of thought that alcohol didn't cross the placenta. Yes, there have been babies born to mothers who drank all through their pregnancy and appeared to be unaffected. Many more exhibit a full range of problems, some of which aren't conclusively linked to alcohol exposure in utero, but we know that something caused them. Why on earth take a chance? Personally, I consider the 'advice' gross negligence, but that's an emotional statement, not a legal one. I really don't know if he could be criminally charged, but if this baby is born with ever dxed with Fetal Alcohol Effect (the milder condition that you mentioned) or Fetal Alcohol Syndrome, I would certainly be looking towards this doctor and filing a malpractice claim.

Up Vote Up Vote ×

I agree that the doctor who prescribed this glass of wine must be an old doctor who refuses to comply with current knowledge about the effects of alcohol on the fetus. I can understand that he was trying to give advice to help the mother, but nonetheless, it was very bad advice. I believe this is were consumers of healthcare need to do their own research. The effects of alcohol on the fetus is rather pervasive throughout this country and for the mothers to blindly comply with the doctor's orders is very irresponsible on her part.

Slick RN

Up Vote Up Vote ×

Hello, I'm a L&D nurse and I find so coincidental that you ask this question. Just the other day I was talking to some doctors about a friend I knew who was pregnant and her doctor told her it was okay to drink a glass of wine every now and then to relax herself. When I heard this I was shocked. I told her to not listen to him and it was not great advice. I told her it was better to be safe than sorry. However, my friend believed the doctor knew best and sure enough I have seen her drink. The doctors I was talking to told me this advice was well intended, but bad advice. Just because a child does not have FAS, it can have FAE, which is fetal alcohol effects. There are children who may not have the facial abnormalities , but they can have cognitive and behavioral problems. Hopefully, doctors like this are very rare; Many people who are not completely educated about health often believe doctors know all and are afraid to not comply. Education is key to stopping preventable problems like this.

Up Vote Up Vote ×

Hello, I am a newly graduated nurse and I didn't know about this whole spectrum of disorder. Thanks for sharing some new information. I wanted to respond by saying that I do agree the doctor must be an old doctor, but I am really surprised to hear that the nurse did not question the order. I find that to be very irresponsible of the nurse. I believe the nurses job is to teach and inform patients and what that nurse did gives us all a bad name. If I were the woman, and something happened to my child, I would sue too.

Up Vote Up Vote ×

I agree that the nurse failed on her duties to be a patient advocate and question the doctor's orders. there are so many ways for a pregnant woman to reduce stress, surely he could have suggested something else. I do agree with many of you that the pregnant woman was partly at fault. I see commercial adversiing about how pregnant women shouldn't drink, smoke, eg. Seems like this woman isn't too bright.

I have heard of FAS and the current recommendation, but i didn't know about all the other disorders. I think there should be more information to warn the public about these things.

Hope this helps with your paper.

ming

Up Vote Up Vote ×
I agree that the nurse failed on her duties to be a patient advocate and question the doctor's orders. there are so many ways for a pregnant woman to reduce stress, surely he could have suggested something else. I do agree with many of you that the pregnant woman was partly at fault. I see commercial adversiing about how pregnant women shouldn't drink, smoke, eg. Seems like this woman isn't too bright.

I have heard of FAS and the current recommendation, but i didn't know about all the other disorders. I think there should be more information to warn the public about these things.

Hope this helps with your paper.

ming

Wow. I can't believe this doctor would say this is okay. I had an "old school" doctor who told me I wouldn't get pre-eclampsia twice. Not only did I get it a second time, but the University hospital where my second preemie was born, asked me, "just who told you that you wouldn't get it again?" My odds were 60-80% for a second pregnancy...not less than 10% as my ob-gyn led me to believe.

Frustrating...because critical decisions can be made when you believe your doctor. Your friend is likely drinking this wine completely trusting what her doctor told her. I did the same...and was NOT prepared for the birth of another very premature baby...because I trusted my doc.

~J

Up Vote Up Vote ×
+ Add a Comment