"When I was pregnant with my son I drank a lot-mostly on weekends" says Marion Williams, a 45-year-old mother who lost two of her five children in childbirth.
Williams lives in one of South Africa's famous wine-growing areas in the Western Cape. She started drinking as a teenager and was taken out of school, she suspects, to work to buy wine for her parents.
Her third child was "born slow", she says. She blames herself and her drinking for the disabilities he will live with for the rest of his life.
"There is a lot he wants to do, but I must remind him he's not like other kids: he can work with his hands and build cupboards but not a thinking and writing job," she says, regretfully. "He asks me why I drank so much [while I was expecting him]. I don't really have answers for him."
Heavy drinking during pregnancy can lead to spontaneous abortion or a range of disabilities known as fetal alcohol spectrum disorders, of which fetal alcohol syndrome is the most severe.
Children with this condition are born with characteristic physical and mental defects, including short stature, and small head and brain.
There is no cure. Treatment is focused on mental health and medical services to
manage the resulting lifelong disabilities that include learning difficulties, behavioural problems, language, delayed social or motor skills, impaired memory and attention …