News Maternity and Birthing

Texas To Seek Universal Fetal Alcohol Syndrome Screening: Will It Be Used to Further Shame Women?

Andrea Grimes

State health officials in Texas say asking women a few questions can dramatically decrease their alcohol use during pregnancy.

Last week state health officials in Texas announced they’re aiming to have “universal screening” of all pregnant Texans to determine their alcohol use, in an attempt at curbing instances of Fetal Alcohol Syndrome, which they report affects one in 100 children in the state and can cause developmental delays and physical or behavioral disorders.

I talked to Janet Sharkis, Executive Director at Texas Office for the Prevention of Developmental Disabilities, about the initiative, which includes five questions and an “intervention” that basically amounts to handing a woman an information pamphlet. Sharkis says the quick conversation between a woman and her doctor (or other medical provider) is proven to help reduce alcohol use and FAS.

“They’ll ask her a few questions, and from that they’ll determine whether she’s at higher risk or not,” explains Sharkis. “The beauty of it is in a very short amount of time you can have a huge impact on a child’s life.”

Research from Washington State suggests that screening does reduce FAS, but we couldn’t help feeling apprehensive about a potentially embarrassing and shaming conversation. Too often, pregnant women’s behavior is analyzed, shamed and criticized, leaving women feeling helpless and attacked.

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Listen to our own Amanda Marcotte when she talks about a study that links FAS to male infertility: “My concern isn’t with this study or the reporting so much as the hyper-focus on pregnant women’s behavior and choices over all other influences on fetal health, particularly environmental ones pregnant women have no control over.” Even though state health officials in Texas clearly mean well, I can’t help but think of potentially creepy implications related to the anti-choice personhood movement, which in part aims to analyze every move a pregnant woman makes in hopes of catching her in a criminal act for endangering her fetus.

But Sharkis says, “This is not about getting women in trouble.” The screening questions, which include inquiries about “other people the person knows,” are “designed to really make women comfortable talking about it.” If a woman is thought to be at risk, she gets a booklet which includes information about the dangers of using a number of drugs while pregnant. “For a total time of four minutes, wow, what results you get.”

In Texas, however, we have a huge uninsured population, and with rapidly and dramatically shrinking public health funds here, it may be harder than ever to reach pregnant women for even basic prenatal care, let alone FAS screening. Fifty percent of births in Texas happen on Medicaid, notes Sharkis, and she says it’s more important than ever to pass health care reform so pregnant women can have the health care they need. “If that is implemented fully, more people will have access to health care,” she says. Even Lousiana didn’t cut funds the way Texas has, she says, because “this is saving money.”

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