Update: Since posting this piece, I’ve come across a paper that questions ancient knowledge about the effects of prenatal alcohol exposure. In particular, the author makes a compelling argument that the biblical story mentioned below has nothing to do with the safety of drinking wine while pregnant. Another paper (sorry, paywall) suggests that the “rhetoric of rediscovery” about the potential harm of alcohol during pregnancy was part of a coordinated attempt by “moral entrepreneurs” to sell a moralist concept to the American public in the late 1970s. All of which goes to show: when science involves controversial topics, its tortuous path just keeps on twisting.

If you ask someone to draw you a roadmap of science, you’re likely to get something linear and orderly: a one-way highway, perhaps, with new ideas and discoveries converging upon it like so many on-ramps. We like to think of science as something that slowly and deliberately moves in the right direction. It doesn’t seem like a proper place for off-ramps, not to mention detours, dead-ends, or roundabouts.

In reality, science is messy and more than a little fickle. As I mentioned in the last post, research is not immune to fads. Ideas fall in and out of fashion based on the political, financial, and social winds of the time. I’m not just talking about wacky ideas either. Even the idea that drinking during pregnancy can harm a developing fetus has had its share of rises and falls.

The belief that drinking while pregnant is harmful has been around since antiquity, popping up among the Ancient Greeks and even appearing in the Old Testament when an angel instructs Samson’s mother to abstain from alcohol while pregnant. Yet the belief was far from universal across different epochs and different peoples. In fact, it took a special kind of disaster for England and, in turn, America to rediscover this idea in the 18th century. The disaster was an epidemic . . . of people drunk on gin.

By the close of the 17^th century, bickering between England and France caused the British to restrict the import of French brandy and encourage the local production of gin. Soon gin was cheap and freely available to even the poor and working classes. The Gin Epidemic was underway. Rampant drunkenness became a fact of life in England by 1720 and would persist for several decades after. During this time, gin was particularly popular among the ladies – a fact that earned it the nickname “Mother’s Ruin.”

Soon after the start of the Gin Epidemic, a new constellation of abnormalities became common in newborns. Physicians wondered if heavy prenatal exposure to alcohol disrupted fetal development. In 1726, England’s College of Physicians argued that gin was “a cause of weak, feeble and distempered children.” Other physicians noted the rise in miscarriages, stillbirths, and early infant mortality. And by the end of this gin-drenched era, Britain’s scientific community had little doubt that prenatal alcohol could irreversibly harm a developing fetus.

The notion eventually trickled across the Atlantic Ocean and took hold in America. By the early 19^th century, American physicians like Benjamin Rush began to discourage the widespread use of alcohol-based treatments for morning sickness and other pregnancy-related ailments. By the middle of the century, research on the effects of prenatal alcohol exposure had become a talking point for the growing temperance movement. Medical temperance journals sprung up with names like Journal of Inebriety and Scientific Temperance Journal. Soon religious and moralistic figures were using the harmful effects of alcohol on fetal development to bolster their claims that all alcohol is evil and should be banned. They often couched the findings in inflammatory language, full of condemnations and reproach. In the end, their tactics worked. The 18^th Amendment to the U.S. Constitution was ratified in 1919, outlawing the production, transportation, and sale of alcohol on American soil.

When the nation finally emerged from Prohibition more than thirteen years later, it had fundamentally changed. People were disillusioned with the temperance movement and wary of the moralistic rhetoric that had once seemed so persuasive. They discounted the old familiar lines from teetotal preachers – including those about the harms of drinking while pregnant. Scientists rejected studies published in medical temperance journals and began to deny that alcohol was harmful during pregnancy. In 1942, the prestigious Journal of the American Medical Association published a response to a reader’s question about drinking during pregnancy which said that even large amounts of alcohol had not been shown to be harmful to the developing human fetus. In 1948, an article in The Practitioner recommended that pregnant women drink alcohol with meals to aid digestion. Science was, in essence, back to square one yet again.

It wasn’t until 1973 that physicians rediscovered and named the constellation of features that characterize infants exposed to alcohol in the womb. The disease, fetal alcohol syndrome, is now an accepted medical phenomenon. Modern doctors and medical journals now caution women to avoid alcohol while pregnant. After a few political and religious detours, we’ve finally made it back to where we were in 1900. That’s the funny thing about science: it isn’t always fast or direct or immune to its cultural milieu. But if we all just have faith and keep driving, we’re bound to get there eventually. I’m almost sure of it.

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Photo Credit: Gin Lane by William Hogarth 1751 (re-engraving by Samuel Davenport circa 1806). Image in public domain and obtained from Wikipedia.