Prenatal Health

Prenatal health is something we are well aware of in the United States.  Pregnant women are told not to drink, smoke, consume cold cuts, change the cat litter, etc.  They are warned to avoid second hand smoke and other environmental dangers.  We take it very seriously, in fact, if you saw an obviously pregnant women smoking or drinking, you would likely tell someone. 
In Bulgaria, illicit drug use is very rare.  More Americans smoke marijuana, or try it once, than in Bulgaria.  I always found it amusing that it grew every where in Bulgaria.  Behind my block apartment building was scrubby trees and weeds, mostly marijuana; it also grew all around the elementary school.  But I never knew any Bulgarian who used it, not even once.  
However, it is not uncommon to see a pregnant women smoking.  Most Bulgarians know that it is unhealthy for the baby, but nicotine is addictive and they struggle with quitting.  Most women I knew did try to stop or at least cut back when they were pregnant.  Though, I was told, on more than one occasion, if you crave cigarettes while you are pregnant its because the baby wants it.  Right.  Not your own addiction. 
According to the March of Dimes there are many serious side effects of smoking while pregnant, and it is harder for smokers to get pregnant.  The most common side effect is low birth weight, which is more serious than it sounds.  Babies with low birth weights are more at risk for certain life long disabilities like cerebal palsy. 
Bulgarians drink a lot of coffee, but effects of caffeine on an unborn child are not fully understood.  
Interesting enough, the most dangerous drug to an unborn baby is alcohol.  Alcohol is most dangerous during first 8 weeks of pregnancy, before many women are even aware that they are pregnant. 
Like many other Eastern Europeans and citizens of former Soviet States, Bulgarians drink.  If you were invited over to a Bulgarian's home for dinner, plan on drinking rakiya- brandy usually made of grapes.  Probably followed by beer and wine. 
Alcohol can cause numerous life long disabilities in an unborn child.  It can also cause miscarriages or stillbirths.  Women who drink while pregnant risk having a child who has development delays, hearing or vision deficiencies, heart and brain defects, low birth weight, premature birth the list goes on.  Just one night of heavy drinking during pregnancy can lead to Fetal Alcohol Syndrome.  You can check out the March of Dimes for more information. 
Why adopt from Bulgaria then with these risks?  The risk of drug use during pregnancy is minimal, less than in the United States.  As far as smoking and alcohol are concerned, the risks are similiar to the United States and far less than other countries (like Russia.)  Bulgarian have access to free universal health care- though the standard of care is not as high as ours.  Bulgarian women are educated, most Bulgarians have a college degree, and are aware of the risks and take steps to minimize them.  Bulgarians have healthy diets with plenty of fresh fruits and vegetables, and plenty of calcium (mainly from yogurt) and have adequate exercise.   Bulgarians give birth in hospitals with qualified doctors and nurses. 
Many of the children available for adoption in Bulgaria are Roma.  Roma culture is different than Bulgarian.  They are more likely to live outside of town and have limited access to health care.  They are more likely to have children when they are young, while Bulgarians wait until their late 20s or 30s.  Bulgarians have on average less than 2 kids, very few have 3; Roma have many more.  While Bulgarians are overwhelmingly Eastern Orthodox Christians, Roma populations can be Muslim, Orthodox or Evangelical.  Fortunately, Muslims and Evangelicals are less likely to consume alcohol.  Although Roma are more likely to be unemployed, the government provides welfare payments (known as pomosht or "help") to families, so you are unlikely to meet someone who is hungry or homeless.

With all the risks associated with pregnancy, sometimes it seems daunting.  But everyday, healthy women who had excellent prenatal care give birth to children with disabilities and women who had no access to healthcare and were exposed to environmental dangers have healthy children.  A lot of health is beyond our control, so we can just try our best and have faith that we will be dealt what we are capable of managing. 
Also, it is easy to sit here and tell someone else what they must do when they are pregnant.  I don't smoke, but could I give up caffeine for 9 months?  Cold cuts?  Sushi?