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Message in a Bottle: The Making of Fetal Alcohol Syndrome

by Janet Golden Harvard University Press
Pub Date:
09/2006
ISBN:
9780674022379
Format:
Pbk 240 pages
Price:
AU$49.99 NZ$53.04
Product Status: Available in Approx 14 days
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A generation has passed since a physician first noticed that women who drank heavily while pregnant gave birth to underweight infants with disturbing tell-tale characteristics. Women whose own mothers enjoyed martinis while pregnant now lost sleep over a bowl of rum raisin ice cream. In Message in a Bottle, Janet Golden charts the course of Fetal Alcohol Syndrome (FAS) through the courts, media, medical establishment, and public imagination. Long considered harmless during pregnancy (doctors even administered it intravenously during labor), alcohol, when consumed by pregnant women, increasingly appeared to be a potent teratogen and a pressing public health concern. Some clinicians recommended that women simply moderate alcohol consumption; others, however, claimed that there was no demonstrably safe level for a developing fetus, and called for complete abstinence. Even as the diagnosis gained acceptance and labels appeared on alcoholic beverages warning pregnant women of the danger, FAS began to be de-medicalized in some settings. More and more, FAS emerged in court cases as a viable defense for people charged with serious, even capital, crimes and their claims were rejected. Golden argues that the reaction to FAS was shaped by the struggle over women's relatively new abortion rights and the escalating media frenzy over 'crack' babies. It was increasingly used as evidence of the moral decay found within marginalized communities--from inner-city neighborhoods to Indian reservations. With each reframing, FAS became a currency traded by politicians and political commentators, lawyers, public health professionals, and advocates for underrepresented minorities, each pursuing separate aims.
Message in a Bottle raises key questions about public policy, the politicization of medical diagnosis, and the persistent failure to address the treatment needs of pregnant alcoholic women. Janet Golden traces the history of FAS from a medical problem to moral judgment that stigmatizes certain mothers but fails to extend to them the services that might actually reduce the incidence of this diagnosis. The women most in need of effective treatment and compassion are more likely to receive blame and punishment. Golden has written an accessible, readable, and important book. Lynn M. Paltrow, Executive Director, National Advocates for Pregnant Women Golden's book is a must-read for anyone interested in alcohol problems, maternal-fetal health and society's response to a newly identified risk. It tells the fascinating story of the discovery of the fetal alcohol syndrome and its subsequent effects on medicine, public health, government, law, journalism and public opinion. When alcohol is involved in public health considerations, the result is always controversy, contention, and publicity. FAS is no exception. The needs of addicted women still go largely unmet while society condemns these women as unfit mothers. Sheila B. Blume, M.D.Former medical director, Addiction Services, South Oaks Hospital, Amityville, New York Message in a Bottle provides a much-needed overview of a crucial topic in the recent history of medicine and public health. Golden has delved deeply in the primary and secondary literature, and has pulled the major episodes in the story of fetal-alcohol syndrome into a coherent narrative, producing not just the story of FAS, but a thoughtful and thought-provoking analysis of an exceedingly complex and controversial subject. In order to understand the medical, social, legal and political aspects of FAS, the author argues, we must address in significant ways, medicine, feminism, issues around reproductive freedom, the media and politics. Golden has written a brilliantly researched and compelling book; I hope it will be widely read and discussed. Christian Warren, New York Academy of Medicine Janet Golden's Message in a Bottle explores the fascinating history of the discovery of alcohol's damaging effects on fetuses. does a solid job of delivering the science that backed the diagnosis, as well as the social context that shaped America's view of the condition...In the first chapter, Golden promises to provide a comprehensive look at the discovery of fetal alcohol syndrome, as well as the scientific, historical and social context that framed the debate over the condition. She delivers on all counts. Most interestingly, the book explains how laypeople and doctors alike were hesitant to accept that alcohol might be dangerous...The book details the chronology of changing medical knowledge and delivers its information remarkably well. January W. Payne Washington Post Book World Golden's is a model study of the wide-ranging sociocultural consequences that can follow the clinical identification and description of a new syndrome. Robin Room The Lancet Message in a Bottle by Janet Golden is the most comprehensive and easily read text on the history, politics, public health debate, legislation, psychosocial and family dynamics, and media discussion concerning fetal alcohol syndrome. This is a must-read for any professional involved in the study of alcohol abuse and neurodevelopmental outcomes of children, fetal medicine, pediatrics, social work, psychiatry, and other areas of mental health. Denis Viljoen Journal of Clinical Investigation This book is an almost essential read for students of developmental disabilities and diagnostic clinicians. For other readers it offers an engaging and informative insight into the effects of the discovery of new diagnoses on wider society. Raja A. S. Mukherjee British Medical Journal Janet Golden's versatile cultural and medical history of Fetal Alcohol Syndrome (FAS) in America is an enlightening addition to the literature on the social history of medicine, alcohol and drug problems, and women's health...This book would work well as a text in an undergraduate class on society and medicine or gender and health. At the same time, Golden's well-researched and documented study will enhance the knowledge of professionals in many fields, including history, gender studies, medicine, communications, and sociology. Pamela E. Pennock American Historical Review
Janet Golden is Professor of History, Rutgers University