Risks of Prenatal Alcohol and Drug Exposure
When deciding on an adoption referral or match it is hard to know if the child has been exposed to alcohol or drugs prenatally. While there are no guarantees, there are some ways to tell and to ask.

As parents we are prepared to love our children unconditionally and be with them through life through thick or thin. This is the case with all parents, regardless if they came to parenting through pregnancy or adoption. While all parents realize that their child may have health, emotional, or learning issues, adoptive parents are often in the position of deciding before their child becomes theirs if they are up to the challenges of parenting a child with this problem. One of the hardest decisions adoptive parents have to make is whether to adopt a child with known or suspected prenatal exposure to alcohol, cocaine, meth, marijuana, tobacco, etc…. I’ve never met a pre-adoptive parents who took this decision lightly. It’s not that they wouldn’t love the child if he turns out to have significant problems, but many would like to ups the odds that the child that becomes their child has the best chance for a long healthy life without the baggage of alcohol or drug exposure during pregnancy.

It’s not so easy to know if a child’s birth mother consumed alcohol or used drugs during pregnancy. With international adoption, birth mothers are often not around to ask. Social histories of the mother may not be available. All international adopted parents have to go on is the child. Although there is no way to look at a child and know for sure, there are signs and symptoms, especially for the more significantly effected children.

With domestic adoption, you usually don’t have a child to examine since the match is made pre-birth, but you can talk with the expectant woman. You might have sonogram records. The $64 million dollar question for most adopted parents is how much is too much and what are the long term risks depending on what substance was used, when in the pregnancy, and how much.

I was blown away by Dr. Ira Chasnoff, our guest expert on yesterday’s Creating a Family show, and that’s saying a lot considering I’ve been doing the show since 2007. Dr. Chasnoff is one of the nation’s leading researchers on long term effects of prenatal alcohol and drug exposure and author of a new book on the subject — The Mystery of Risk. Dr. Chasnoff is President of the Children’s Research Triangle and a Professor of Clinical Pediatrics at the University of Illinois College of Medicine in Chicago. What I absolutely loved about this interview is that he gave very specific and concrete ways to determine alcohol or drug exposure for both international and domestic adoption. He broke out the quantity and timing during pregnancy issue with great clarity, and struck that delicate balance between being honest, but not terrifying.




Single Best Way to Ask a Birth Mother if She Drank During Pregnancy

In the US, a woman would have to have been hiding under a rock for the last 10 years to not know the dangers of drinking while pregnant. Yet still, Dr. Chasnoff’s research shows that 25% or pregnant woman consumed some alcohol while pregnant, and 12% admit to heavy use. Because it is no longer socially acceptable to drink while pregnant, it is not something that many woman want to admit. Dr. Chasnoff experimented with many different ways to phrase the question to make it easier for a woman to be fully honest. He concluded that the best way to ask is: In the month before you knew you were pregnant, how much ____ did you drink. It is important to specify the specific type of alcohol and ask each one separately. Make sure to include beer, wine, wine coolers, hard lemonade, daiquiris, etc.

I can’t recommend this show enough. He was terrific.


Image credit: alexmuse