Vasha Singh didn’t want a child at her age. In fact, her
life was supposed to be completely different. If only she hadn’t listened to
her “friends,” if only she hadn’t have been so impressionable. What was a 20
year old like her supposed to do? She hadn’t finished high school and had no
prospects at all for employment or anything. She had no idea how she was going
to raise a child. She worries about the drugs and alcohol that she was into
before she knew about the pregnancy. Would any of that hurt the baby? She
really had no idea. She thought that maybe she learned about the pregnancy in
time…When was the last time she got really drunk? She couldn’t exactly remember,
and that fogginess allowed her to pretend that the last several incidents were
further in the past than another part of her knew that they were. Still, she
would love this child no matter what.
Vasha had been talking to a pastor that she met during one
of her bouts of despair – for some reason, the two struck up a conversation as
she was buying cigarettes, and they wound up talking for over an hour. Vasha’s
Hindu past was just that – well in the past, and she struggled to find meaning
in her life. This person seemed to provide an open door when all other such
doors were locked and dark. Vasha started going to a Christian church, and it
seemed to help her just a little. The pastor talked with Vasha about AA, and
she was really considering going, even while she was 8 months pregnant.
·
1) What are the typical developmental milestones
for the child in utero? Outline the
stages of pregnancy and the threats to optimal development at each stage. When
are teratogens most dangerous for the developing child?
· 2) Describe the various conditions that can result
when someone uses alcohol at various stages of development. Is Terrance at-risk
for any of these conditions given Vasha’s history of substance use and her “fogginess”
with regard to knowing whether or not she “stopped in time?”
· 3) Given Vasha’s substance abuse and its possible
effect on her child, what kinds of treatment options could she explore?
Describe how Alcoholics Anonymous (AA) purports to work (and/or Narcotics
Anonymous, Al-Anon, etc.).
DECISION POINT ::: Does Vasha decide to attend AA? Why or why not?
1. The typical developmental milestones for a child in utero span over the 9 months of gestation. It begins at the end of four weeks when the fetus is ¼ inch long, the heart, digestive system, backbone and spinal cord begin to form, the placenta begins to develop and the single fertilized egg is now 10,000 times larger than it was at conception (Fetal Development, 2008).
ReplyDeleteAt the end of 8 weeks the baby is 1-1/8 inches long, the heart is functioning, eyes, nose, lips, tongue, ears and teeth are forming and the penis begins to appear in boys (Fetal Development, 2008).
At the end of 12 weeks the baby is 2-1/2 to 3 inches long, weight is about ½ to 1 ounce, nails start to develop and earlobes are formed, eyes are almost fully developed, the baby has developed most organs and tissues (Fetal Development, 2008).
At the end of 4 months the baby is 6-1/2 to 7inches long, weight is 6 to 7 ounces, tooth buds are developing, fingers and toes are well defined, skin is bright pink, transparent and covered with soft, downy hair (Fetal Development, 2008).
At the end of 5 months the baby is 8 to 10 inches long, weight is about 1 pound, hair begins to grow on baby’s head, mothers begin to feel fetal movement, internal organs are maturing, eyebrows, eyelids and eyelashes appear (Fetal Development, 2008).
At the end of 6 months the baby is 11 to 14 inches long, weight is about 1-3/4 to 2 pounds, eyelids begin to part and eyes open sometimes for short periods of time, skin is covered with protective coating called vernix and baby is able to hiccup (Fetal Development, 2008).
At the end of 7 months the baby is 14-16 inches long, weight is about 2-1/2 to 3- ½ pounds. Taste buds have developed, fat layers are forming, organs are maturing, and skin is wrinkled and red. If the baby is born at this time, the baby will be considered premature and require special care (Fetal Development, 2008) .
At the end of 8 months the baby is 16-1/2 to 18 inches long, the weight is about 4 to 6 pounds, overall growth is rapid at this time. Most body organs are now developed, except for the lungs. Movement or kicks are strong enough to be visible from the outside. Kidneys are mature, and fingernails now extend beyond fingertips(Fetal Development, 2008) .
At the end of 9 months the baby is 19-20 inches long, weight is about 7 to 7 ½ pounds, lungs are mature, the baby is now fully developed and can survive outside the mothers body. Skin is pink and smooth and the baby settles down lower in the abdomen to prepare for birth and may seem less active (Fetal Development, 2008).
A normal pregnancy lasts about 40 weeks and the stages are grouped into three trimesters. During the first trimester hormonal changes affect almost every organ system in the body. As the body changes, daily routines might also change, resulting in discomfort. During the second trimester the woman’s abdomen will begin to expand as the baby continues to grow. The body makes changes in order to make room for the growing baby. This causes boy aches, stretch marks and more in most women. During the last trimester some of the discomforts continue. In addition, many women find breathing more difficult, swelling of the ankles, fingers and face, the baby starts “dropping” and finally contractions (Stages of Pregnancy, 2012).
Teratogens are environmental agents that produce abnormalities in the developing fetus. They are most dangerous for the developing fetus during the first trimester of the pregnancy. This is the time of rapid growth and any dangerous influences can affect development. This can drastically hurt the baby. Some examples of teratogens are drugs, smoking and nicotine, alcohol, diseases, diet and physical condition, and age of mother. All of these various teratogens can affect the baby at any time during the pregnancy, but with the most drastic affects occurring during the first trimester. A list of the possible affects of the child are listed in the next question below.
2)
ReplyDeleteConsuming alcohol during pregnancy can lead to an array of lifelong disorders and birth defects. These disorders are known as fetal alcohol spectrum disorders (FASDs) and more specifically as fetal alcohol syndrome (FAS). Do to the rate at which the brain is developing during the first trimester of pregnancy, especially the latter half (days 43 to 84), children born to mothers who drank during this period seem to have the most severe problems (CDC, 2012). Alcohol consumed in the second and third trimesters of pregnancy may also greatly affect the nervous systems since some of the most complex developmental stages in the brain occur during this period.
Since Terrance’s mother’s memory about her substance abuse is vague, she most likely has been drinking more often and of greater quantity then she can recall. Because of Vasha’s alcohol consumption, Terrance is at risk for the following (Kids Health, 2012):
• low birth weight
• small head circumference
• failure to thrive
• developmental delay
• organ dysfunction
• facial abnormalities, including unusually small eye openings, flattened cheekbones, and a smooth ridge between the nose and upper lip
• epilepsy
• poor coordination/fine motor skills
• poor socialization skills, such as difficulty building and maintaining friendships and relating to groups
• lack of imagination or curiosity
• learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills
• behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety
There is no exact evidence that can determine exactly how much alcohol consumption can cause birth defects. If Vasha stopped consuming alcohol during her eight-months of pregnancy it may not be “in time” but it certainly would not exacerbate the situation.
3.)
ReplyDeleteThere are several options available for Vasha to try in order to over come her alcoholism, but all of these will include symptoms of withdrawal. The severity of the withdrawal symptoms will depend on how frequently she drank alcohol and in what quantities, but because this is “foggy” to her, we are unaware of how often and how much alcohol was actually consumed.
There are alcohol rehabilitation and treatment facilities that can be of assistance to her during this process. These facilities can be short term residential or in-patient hospitalization to long-term. They may also be outpatient counseling and therapy based. However, due to the fact that she will soon be a 20 year old mother with no job, little education, and no word on the involvement of the father of Terrance, this expensive option is mostly certainly out of the question.
There are also pharmaceutical treatment options for alcoholics that do not “cure” the person of the disease, but can help the alcoholic to remain sober once that feat has been accomplished. These medications can have several affects to attain this goal: “1) Antabuse makes the person physically sick if they consume alcohol, 2.) Nalterxone reduces the craving for alcohol and blocks it from affecting the brain if consumed, and 3) Acamprosate relieves the distress and discomfort alcoholics experience when they stop drinking (T, 2010).” I would not recommend Vasha to take any of these medications while pregnant with Terrance, nor would I recommend her to take them until she is done breastfeeding Terrance, if that is her option due to the unknown affects the drugs may have on the unborn fetus, and later the milk being produced for Terrance.
Finally there are support groups, like AA, that are free to join and provide support through the experience of a fellowship made up of alcoholics, for alcoholics. This is the option that I would highly recommend to Vasha after looking into her current circumstances.
There are young members of AA, as young as teenagers, that attain equal support as any other member of AA would. There is no stigma nor an age requirement to join AA. The best thing for Vasha to do at this point would be to join a support group immediately in order to impede any further negative affects on her unborn child.
It would also be recommended to quit smoking cigarettes immediately as well, and possibly by quitting them both together, use the same support system and techniques to successfully beat both addictions. I would not recommend the over the counter nicotine pouches or gum in the assistance of quitting smoking due to the continuous harmful affects that they will have on Terrance.
3 continued) Alcoholics Anonymous is a fellowship of men and women who openly realize that they not only have a drinking problem, but that they are alcoholics. They all have in common the strong passion to stop drinking and recover from this illness. These members include over 2 million people from over 180 different countries all over the world.
ReplyDeleteAlcoholism is viewed as an illness in AA. It is important for members to know that this illness is not curable. Alcoholics cannot control their drinking due to the affect that has taken over their bodies, minds, and emotions to hinder them from stopping. Without any intervention this illness will proceed to get worse and worse. It has been stated by the American Medical Association and the British Medical Association that Alcoholism is indeed an illness that needs treatment in order to receive sense of recovery.
New members of AA need to make the decision to have the determination to follow through with this program. This is not just a 12 step program that will cure your addiction, but it is a life long battle that you will endure to stay sober. Once this commitment has been made, the new member will usually go to their first meeting where they learn about the “24-hour Plan.”
This recovery begins with what AA calls, “the 24 hour plan.” It is called this simply because it is unrealistic for an alcoholic to make a large commitment that says they will stop drinking for the rest of their lives, and that be it. This is a plan that the alcoholic agrees their best to abide by, and entails them to simply not drink for one day. If they feel the urge to have a drink they can tell themselves that they can have it tomorrow. The plan is to “stay away from one drink, one day at a time (A.A. General Service Conference , 2011).”
The final program is called “the twelve step program.” This program allows the member to come to multiple realizations about their drinking habits, their spirituality, and the harm and impact it has had on their lives. They need to graduate from one step to the next in a process that will help them reach their recovery point. The twelve steps of Alcoholics Anonymous below have been directly taken from their beginner’s pamphlet:
“1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater that ourselves could restore us to sanity.
3. made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humble asked Him to remove our short-comings.
8. made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having has a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
(A.A. General Service Conference , 1972)”
With the completion of these 12 steps by the alcoholic and a continuing want to stay sober, and the unceasing resilient support by other fellow recovering alcoholics, is how AA purports the success of its program.
Decision Point
ReplyDeleteAlthough 8 months pregnant, Vasha decided her attendance at AA would still be beneficial to her and her baby’s future. Deciding about whether or not to attend AA was an easy decision after Vasha weighed the advantages and disadvantages of becoming a member.
AA provides individuals with the opportunity to express their feelings without judgment, and the opportunity to support and relate to others with similar problems. Vasha found these aspects of the AA program to be very intriguing. Vasha’s desire to recover was not only established by her pregnancy, but also by her newfound Christian church membership and advice from her pastor. After looking into the aspects of attending AA meetings, Vasha was relieved to discover that AA also takes a spiritual approach towards treating addicts (Earhart, 2009). Another positive aspect of the AA program is that it is offered for free to all individuals (Alcoholics Anonymous World Services, Inc., 2012). Although AA is associated with many advantages, there is one major disadvantage associated with the program. The most common disadvantage associated with AA is that the meetings can lead to a false sense of gratification (Spiritual River to Recovery). This disadvantage is due to the fact that some individuals feel that just attending the AA meetings alone is enough to overcome their addiction. However, the recovery process is much more in depth and requires members to also apply what they’ve learned to all aspects of their life. Another disadvantage associated with AA is that meetings, and following through with the entire program can be very time consuming. Although there were some negative aspects of AA meetings, these aspects were not enough for Vasha to change her mind. Overall, Vasha felt she was more than capable of attending and following through with the “12 step” AA program for herself and her baby.