Kathy Mitchell wants to share something with you. She’s not proud of it, and it’s not a behavior she hopes you’ll emulate. It’s just the truth: As a teen, Kathy drank alcohol while pregnant with her daughter, Karli. It was a perilous if unwitting mistake that has defined both of their lives.

Karli is now 43 but is the developmental age of a first-grader. In the home she shares with her mother and stepfather, she collects dolls and purses, and pores over Hello Kitty coloring and sticker books. Karli has fetal alcohol syndrome, the result of alcohol exposure in utero.

In middle age, Karli has none of the awareness, self-determination and independence that most of us take for granted. She can’t recognize social cues, is easily led and manipulated, and can’t predict dangerous behaviors. She can only follow one rule at a time and doesn’t understand sequence. She can cross a street at a lighted crosswalk, but if the light is out, she’ll step in front of a car. She likes to wear pretty clothes, but she can’t remember to brush her teeth.

To Kathy, Karli’s is simply a life snuffed of promise. “I adore my very sweet daughter,” Kathy says. “She’s a forever innocent child. But not a day goes by that I don’t ask myself, ‘What if? What if alcohol hadn’t been a part of my life?’