An Argument for Moderation

Let’s talk about blame a little bit.

Last week I read this excellent post on the problem with blaming and/or judging parents for developmental disorders in children. Among the many insightful passages was this one:

Most tragically, it is parents (like Sally’s) who have kids with significant developmental and behavioral challenges that are the most likely to be criticized by an unholy trifecta: by the media and popular pundits because it makes for good, simple-minded talk radio and TV and book sales, by other parents who lack the imagination and empathy and sophistication to understand what another parent is really going through, and by their own pediatricians who blame it all on their imperfect parenting skills.

I think the vast majority of parents love their kids passionately and are trying with all their might to do the right thing by them. And, all in all, most do a pretty good job of raising their kids and make the right decisions when there are challenges to be faced.

And if you missed it, we talked about blame here, too. How we have to tread carefully when we discuss possible prenatal asthma preventatives like following the Mediterranean diet. How we have to ensure good coverage of new research about asthma prevention without implying those of us with *sick* children or non-typical children must have screwed up somehow during pregnancy. How expectant parents can try to do everything right–I tried to do everything right–and still end up as an Asthma Mom (or Dad) themselves. Or an autism parent. Or a food allergy one.

Sometimes illness just happens.

Yet despite recognizing the bad luck factor, some of us blame ourselves, too. We know that playing the WHY game is largely futile, but if we can just figure out what went wrong the first time, dammit, then we can fix it for the next kid, right?

Like genetic or environmental factors have no bearing.
Like all those other parents dealing with chronic pediatric issues just haven’t figure it out yet.
And why stop there? Why not also try controlling natural disasters and car accidents? And life will be perfect from now on.

Except it won’t.

It’s a crutch, the self-blame. Backing off and admitting the asthma was not my fault when AG was little both scared and frustrated me because then I had to admit the possibility of other health issues in both girls’ futures, no matter how I raised them. I felt like I was opening the door to those natural disasters and car accidents, to the possibility of asthma or some other chronic issue for my younger daughter, too. But, see, the door was never shut to those things.

The other extreme is no good, either. Parents can’t exactly throw their hands up in the air, refusing to follow any preventative measures in the face of all this randomness. What I’m advocating here is that old argument for moderation:

Control what you can. Prevent what you can. Let go of the rest.

Smoking, for example. We don’t know how to ensure a perfect gestation and birth or a childhood free of breathing problems, but we sure know how to make them worse. Smoking during pregnancy is a huge risk factor for childhood health and developmental problems, including breathing issues.

A riddle for you:

What would make an expectant mother not even try to quit smoking throughout her very-much-planned-and-wanted pregnancy, and what would make the father of the baby not encourage and try to quit smoking himself along with her?

Some possible answers:

1. The couple lives in a country with severely limited access to information, including health information, and does not know how smoking can harm the developing fetus.

2. The couple did not attend and graduate from the U.S. public school system, where indoctrination on the evils of smoking starts in kindergarten.

3. The couple lacks health insurance, whether state-supplied or through employment, to help offset the cost of smoking cessation tools.

4. The couple lives in a community with hospitals that don’t offer free smoking cessation programs, or they don’t have the transportation to get to those programs.

5. The couple does not have supportive friends and family members to help them quit.

What if the answer is none of those?

What if we’re talking about an actual flesh-and-blood couple that I know?

What if that mother just gave birth last week, too early, and the baby couldn’t breathe on her own, spent her first day of life in critical condition, and doctors still don’t know what the future holds for this child?

Maybe this child will get lucky. Maybe she will grow up problem-free, despite her problems at birth. If so, it won’t be because of any great efforts by her parents during the pregnancy. I want to be very, very clear on this:

I know smoking is an addiction, and I know firsthand how hard it is to break that addiction.*** Further, I know some pregnant women will try their hardest to quit and not find complete success or try to quit with an unsupportive partner at their sides, but that’s not the case here. This is a couple with access to every possible resource that tried to conceive for more than a year and neither one even attempted to stop smoking during that year or even after she got pregnant, despite knowing the health risks to the baby, risks that include brain and lung function problems.

Not even trying, that’s the part I can’t get past. Just how does a couple make the simultaneous choices of A) making a baby while B) both continuing a dangerous personal habit that will probably hurt that baby because they don’t want to make the effort to quit? Like this is the only difficult sacrifice they’ll have to make for their kid?

When this couple chose to conceive, they didn’t just choose to have a baby. None of us do. We parents decide to make and then raise and nurture another human being for almost 20 years. Part of that nurturing includes maintaining a safe place for that person, both in the womb and outside it, to the best of our abilities and using the best resources available to us. Choosing to have a baby means agreeing to provide a life for that baby and the kid, teenager, adult, and old lady that baby will grow up to be. It means trying all the time, even if we fail. And we’ll fail sometimes, no question, but that doesn’t mean we don’t try.

I want to step into a time machine and bring my 3 or 4 year-old constantly flaring daughter back to this couple during the early stages of the pregnancy. Let them keep her for about a month. Then I could say, DON’T YOU SEE? DON’T YOU SEE HOW BAD IT CAN GET? Breathing problems in a young child are terrifying for parents and horribly difficult on the child, and while my kid had a worse time than many other asthmatics, she didn’t have the worst, not by a very long shot. And she has asthma despite no known risk factors like exposure to smoking while in the womb.

This couple took an enormous risk on their baby’s behalf by ignoring those preventatives within their power. I can understand failure because there’s not a perfect parent anywhere on this earth, but I can’t understand not making the attempt in the first place.

This isn’t a riddle with an answer. I wish it were.

***It’s a side issue, but lest you find this post too judgmental, I know how hard it is to quit smoking for a baby because I had to do it. When my home test revealed a very unexpected pregnancy with AG back in 1998, I had a pack-a-day habit that I ended immediately. Yes, it was difficult to quit cold-turkey, although probably just as difficult on those who had to be around me during those first few nicotine-free weeks.

9 responses to “An Argument for Moderation”

  1. Asthmagirl says:

    Another really excellent post! And a challenging one to write I might add. Wonderful observations…
    Thank you for writing it!

  2. blessedmomof4 says:

    Awesome Post! You go girl! I know first hand the effects of smoking and childbirth. My hubby was born at 34 weeks (46 yrs. ago!) to a mom who was a chain smoker……he shouldnt have lived. By God’s miracle he lived and amazingly is a Triathelete that rarely gets coughs, sinus issues etc!!! This is where I feel asthma etc, really is a genetic issue. I grew up with chronic bronchitis, have had sinus surgery, and probably had undiagnosed asthma…..and my parents were health nuts…….my 11 yr. dd, looks a lot like me and has the tiny nasal pasages like me (her dad has HUGE nasal openings ….LOL!) and she is blessed with the sinus issues which have then progressed to the Asthma flare……so i guess genetics really is a HUGE part of it…….And, people who refuse to even try to quit smoking when they try to conceive a child and then get pregnant (esp. since you mentioned they have all the resources necessary to do so) are just plain selfish… just boils down to thinking more of yourself than the precious life that has been given to you to care for. I did the same thing for all four pregnancies and all our kids have a different level of strength in the immune systems………and that seems genetic and then environmental too, b/c I was pregnant with my asthma child in Japan and the air quality where we were was horrible…..I had a miscarriage there as well, as did many of my friends……ok I am rambling….but I LOVE your posts :)

  3. blessedmomof4 says:

    I just read my rambling….and what I meant to write was I had excellent nutrition and exercise for all four of our pregnancies…….(I didnt smoke, drink etc…..) and each has different immune systems, with one getting sick very easily……..hope that clears up my rambling! :)

  4. Amy says:

    Hey, thanks! The even sadder part about this story–which I didn’t include b/c it was just getting too long–is that this woman was induced early b/c the baby’s health was starting to decline.

    The smoking is just one part of her overall negligent attitude about the pregnancy, and the drs. warned that things would start getting critical if they didn’t bring the baby early.

    Can you imagine? The baby might have been even worse off than she is now.

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