Vidyya.com Review:Vidyya Medical News Service - Medical news & information, drug approvals, patient education, FDA & NIH medical research news.
Country: North America, US, United States
City: Los Angeles, California
I ordered this book after hearing Elizabeth Smart interviewed on NPR. Her tone in the book is poised and compelling, terrifying and inspiring at the same time. It was a relatively quick read. If you are looking for the gory details, she generally leaves those out. This did not detract from her story, as it was a story of survival and faith, in God, in humanity, and her family. If you are looking for an accounting of exactly what happened, this isn't it. If you are interested in how the horrible experience shaped her into a survivor - and thriver - this is a great book.
I have been a doula for seven years and I work in a library in a college town. I am interested in all aspects of health (including pregnancy and birth) and do a lot of research for patrons and for my own personal interest. I'm the sort of dork who reads full-text medical journals for fun. Needless to say, when I saw that this book was being added to our collection I got really excited and I read through the whole thing in less than a week.
I ended up liking this book a lot. Unfortunately, the current attitude underlying recommendations from those in public health is that women are stupid. Having worked with many families over the years, my opinion is that this is wrong. Time and again I have watched women make the best choices for themselves and their babies when given correct information. I believe that women are smart, and I was happy to see that the author agreed. I feel more informed and empowered to make decisions when it comes time to have my own children in a few years. I highly recommend this book.
I also recommend that people ignore the (as of now, 70+) one-star "reviews" on this site. So far as I can tell they are all Fetal Alcohol Spectrum Disorder (FASD) "warrior moms" who are angry that the author suggests that it is safe for a woman to drink lightly during pregnancy and are trashing the book based on a few online articles in which the author was interviewed. Only a tiny percentage have actually read the book, and quite a lot consist of copied and pasted talking points from the National Organization on Fetal Alcohol Syndrome (NOFAS) website. The majority of such "reviews" display a lack of knowledge of basic biology and a stunning lack of understanding of research. A few delve into depths of irrationality I didn't think possible (for example, one "reviewer" wanted the book to be made illegal to read and one advocated a mass book burning!). Others literally questioned whether the author is inherently evil and just wants attention, and another claimed that she is an alcoholic trying to justify her supposed drinking problem. All claims, of course, based on absolutely nothing in a desperate attempt at mudslinging. I saw very little actual countering of her arguments with rational discussion or relevant data.
As part of my review I want to provide some counter arguments (all based on the author's book) for some of their (repeated and oft used) talking points.
1) The claim that the author "cherry picks" studies and ignores others that show problems with light or moderate drinking.
Let me start with a quote directly from the book: "The quality of the medical research on this varies enormously." Because of this fact, she evaluated the methodology of all of the relevant studies on the subject. She shared the results of the studies that she thought were done well and why, as well as the ones she thought were flawed and why. That's not "ignoring" research. This is what a good meta-analysis of studies does: it does not take the results of those that are poorly done into consideration.
2) The claim that the studies the author cites studied children only up until two to four years of age, and that developmental problems can show up in children much later than this, so these studies are irrelevant. (Also on this same theme: the claim that her conclusions are based only on her own experience with her two-year-old daughter, who may not yet show symptoms of the "damage" caused by her mother's drinking.)
If these "reviewers" had bothered to read the book they would have seen that the research she discusses evaluated children much later than this, starting at the age of two but continuing up to 14 years.
3) That the author is "promoting" moderate drinking or "giving medical advice".
The author actually states that despite the (good quality) evidence showing no long-term problems associated with light drinking during pregnancy, perfectly rational people can also decide to not drink at all. She doesn't give any advice or tell people to do one thing or the other, only discusses what the body of the medical literature says so that readers can come to their own conclusions. Again, if these "reviewers" had bothered to read the book they would have seen this.
4) The claim that drinking during pregnancy is equivalent to filling a baby's bottle with alcohol.
When you drink, your liver is constantly processing the alcohol and turning it into acetaldehyde (and later into acetate). If, for example, you were having a drink of wine with dinner, the food that you eat and the fact that you were sipping slowly would help slow down the metabolism of the alcohol into your bloodstream. Your liver can keep up with small amounts of alcohol at a time in this sort of situation, and thus very little acetaldehyde would get to the baby. Small amounts of acetaldehyde can be processed by the baby's liver (though not as much of course as an adult's). The amount of alcohol and the speed at which it is being consumed really matters, and the author is careful to explain this. But how could these "reviewers" know this when they haven't even read the book?
5) The claim that no amount of alcohol has been proven safe.
I agree with the author that it makes zero sense to say that the sort of evidence that leads us to conclude that binge drinking is problematic is paradoxically not enough to allow us to say that light drinking up to a certain amount is not dangerous. You can't have it both ways!