In the past several decades, an explosion of research has looked more closely at how exposure to certain substances during pregnancy affect the child after birth. One of the biggest challenges of this research is that nearly all of it is based on epidemiological/observational studies. Therefore, the studies can show an association between an exposure and an outcome, but they cannot show evidence that the exposure actually caused the outcome — and the difference is crucial. When looking at exposures during pregnancy, so many confounders enter the equation that it’s hard to think of all of the possible covariates, much less actually account for them all.
For example, thousands of studies have investigated outcomes of children whose mothers took antidepressants during pregnancy, but the results are all over the map, and it’s nearly impossible to separate the possible effects of the drugs on children from the possible effects of depression and anxiety. Then there is the question of whether children born to mothers with untreated anxiety or depression do more poorly than children born to mothers who took medications for their mental health conditions (and often studies show that is, in fact, the case).
Another example is the long list of associations that have been found between a particular exposure during pregnancy and a child’s risk of autism, which has been wryly categorized in this classic post by Emily Willingham.
Writing about any of these studies can become challenging because it’s so easy to inadvertently blame a mother for those exposures, and few journalists have traditionally considered the sensitivity required to avoid doing that in their pieces (or, even more often, the headlines). But if this is difficult in writing about legal substances or exposures such as air pollution that a fetus may encounter, it’s far, far more difficult when writing about prenatal exposure to illegal drugs, when mom-blaming is far easier to slip into.
The irony, though, is that many of the drugs we think of as utterly destroying children’s chances at success in life if they’re exposed in utero are, in fact, not likely to have such extreme adverse effects. This is one of the many lessons Olga Khazan learned when reporting her piece “Into the Body of Another” at The Atlantic, which describes the mothers who were serving time in prison for using drugs during pregnancy and thereby “abusing” their then-unborn children.
In a recent tip sheet, she describes the challenges she encountered in reporting this story and tips for journalists who might report on similar topics. The first point she makes is that “Drugs are bad, but not all drugs are equally bad in the same ways.”
The most classic journalistic example of how this can go wrong was the reporting in the 1980s of the “crack babies” epidemic, revisited by The New York Times in “The Epidemic That Wasn’t” and the Retro Report “Revisiting the ‘Crack Babies’ Epidemic That Was Not.” What Khazan learned is essential for all journalists to recognize when reporting on any story involving pregnancy, exposures and outcomes, whether those exposures are legal or illicit substances. Avoid making assumptions about what’s “bad” for a baby, or how bad it is, and spend time with the medical research learning what the evidence shows.