By: Alexandra Rockey Fleming
Original Source: www.washingtonpost.com
Kathy Mitchell wants to share something with you. She’s not proud of it, and it’s not a behavior she hopes you’ll emulate. It’s just the truth: As a teen, Kathy drank alcohol while pregnant with her daughter, Karli. It was a perilous if unwitting mistake that has defined both of their lives.
Karli is now 43 but is the developmental age of a first-grader. In the home she shares with her mother and stepfather, she collects dolls and purses, and pores over Hello Kitty coloring and sticker books. Karli has fetal alcohol syndrome, the result of alcohol exposure in utero.
In middle age, Karli has none of the awareness, self-determination and independence that most of us take for granted. She can’t recognize social cues, is easily led and manipulated, and can’t predict dangerous behaviors. She can only follow one rule at a time and doesn’t understand sequence. She can cross a street at a lighted crosswalk, but if the light is out, she’ll step in front of a car. She likes to wear pretty clothes, but she can’t remember to brush her teeth.
To Kathy, Karli’s is simply a life snuffed of promise. “I adore my very sweet daughter,” Kathy says. “She’s a forever innocent child. But not a day goes by that I don’t ask myself, ‘What if? What if alcohol hadn’t been a part of my life?’ ”
Fetal alcohol spectrum disorder, or FASD, covers a range of impairments from severe, such as Karli’s fetal alcohol syndrome, to mild. Its effects can include impaired growth, intellectual disabilities and such neurological, emotional and behavioral issues as attention-deficit hyperactivity disorder, vision problems and speech and language delays. FASD is also sometimes characterized by a cluster of facial features: small eyes, a thin upper lip and a flat philtrum (the ridge between the nose and upper lip).
And, as the Centers for Disease Control and Prevention put it, the disabilities “last a lifetime. There is no cure, though early intervention treatment can improve a child’s development.”
“In our family, though, [Karli] is a blessing,” Kathy says. “She brings joy to everyone she knows.” But, she adds, “it breaks my heart to think about why Karli is disabled.”
But Kathy says that rather than “sit in self-hatred and self-blame,” she has made it her mission in life to tell the story of her and Karli so that others won’t make the same mistakes. “I believe I would be a terrible person if I didn’t do everything in my power to prevent this from happening to another child.”
Kathy’s lengthy affair with alcohol was nearly a birthright. She grew up in Rockville, Md., the fifth child of seven in a family in which, she says, problems were barely acknowledged and rarely discussed. Especially the alcoholism that Kathy says was a part of her family history.
In 1964, when Kathy was 10, her parents opened a restaurant in Olney, which they would own for the next 33 years.
Kathy and her siblings all helped in the business, which took on a nightclub atmosphere after 8 p.m. “Customers would come for dinner, then dance and drink all night. At 1 a.m. they’d be stumbling out to their cars to drive home,” she says.
By the time she turned 12, Kathy had been drunk more than once — and figured out that she liked the euphoria of intoxication. “Drinking made me feel grown-up, cuter, smarter, and helped me flow with the rest of the world,” she says. In her chaotic, sibling-filled household, she was essentially an “invisible child,” she says, with no one noticing her drinking.
Maid of honor at age 14 at her sister’s wedding, Kathy remembers drinking beer after beer until, thoroughly intoxicated, she fled the scene — before the wedding photographs were even taken. “It was just, like, ‘Oh, that’s Kathleen!’ Looking back now, I can say that I was in the early stages of alcoholism by then, having blackouts. Everyone else was busy surviving and doing their own thing, and no one seemed to notice that I needed help.”
In 10th grade, Kathy got pregnant. She married the baby’s father — a teenage boyfriend — and dropped out of school. Their son was born a month after Kathy turned 17. The child was healthy and Kathy went back to waiting tables and tending bar. Nine months later she was pregnant again.
In those days, she recalls, people would say, “If you want to have a big fat baby, drink a beer a day” and “red wine is good for the baby’s blood.” Kathy again drank throughout her pregnancy, but usually just with friends. She’d put away a bottle of wine, or four to five beers, during a weekend.
Drinking wasn’t her only risky behavior: “The fact is, I had poor nutrition, smoked cigarettes, worked in bars and drank alcohol. None of this was conducive to a healthy pregnancy.”
In 1973, just a few months after turning 18, she gave birth to Karli.
That same year, researchers at the University of Washington Medical School published a landmark paper that described children with physical and intellectual disabilities whose mothers had drunk heavily throughout pregnancy. Alcohol was a teratogen, a substance that kills or damages developing cells, the researchers said, and then for the first time used term fetal alcohol syndrome to describe the result.
That information came too late to make a difference to Kathy or Karli.
From birth, Karli had been plagued by relatively minor health problems that didn’t raise red flags at the pediatrician’s office. When she failed to sit up on time and was slow to reach other milestones, doctors told Kathy that her baby had experienced delays because of her chronic ear infections.
Yet Karli’s problems grew more pronounced as she aged. She exhibited fine and gross motor difficulties, poor joint mobility and speech delays. At one point, a doctor diagnosed cerebral palsy, one of the many disorders and conditions whose symptoms overlap with those of FASD. Later it became clear that Karli didn’t have cerebral palsy, but “at that point it is more accurate to understand that the physician didn’t even have FASD in his lineup,” Kathy says. “Very few are trained to diagnose the disorder, and the number was even fewer back then. No one ever asked me about my alcohol use.”
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