A quick look at FASD prevention in the world’s largest wine producer

FASD prevention first came into the public eye in France in 2004. Four women who had given birth to children with FASD accused the government of not having informed them about the potential dangers of drinking alcohol during pregnancy.

After this media attention, the government took steps towards addressing FASD. In terms of prevention activities, the government identified three areas: (1) awareness campaigns to encourage women not to drink during pregnancy (2) incorporating information about FASD into high school education, and (3) training for health care and social service providers.

How big a problem is FASD in France? It’s hard to tell as I couldn’t find any recent nationally representative data of either rates of diagnosed FASD or rates of alcohol consumption during pregnancy.

However, a study in 2006 showed that while most women appeared to stop drinking alcohol on their own during pregnancy, that more than 40% continued to drink, with almost 5% drinking more than 2 standard drinks per day (Vabret F., Houet T., Dreyfus M., Davy A. (2006). Consommation déclarée d’alcool de 150 femmes hospitalisées en maternité. Alcoologie et addictologie, 28 (3):217-222.). Another study in 2008 suggested that over 50% of women in France continue to drink during pregnancy. And a study described in Le Parisien in December 2010 reports that over 25% of French women continue to drink occasionally during pregnancy, with 6% drinking more than two drinks in the same day.

FASD prevention in the world’s largest producer of wine raises some interesting questions. Most areas of France produce wine and wine is a part of daily food culture. In fact, there have been lobbies to have red wine recognised as a foodstuff (for a different discussion of this issue, see an earlier post Beer considered alcohol (not food) for the first time in Russia, March 14, 2011). Until recently, advice to pregnant women allowed for 1-2 glasses of wine a day. After all, generally speaking, wine is good for the heart and beer can facilitate breastfeeding, right? In this type of context, policies to address alcohol abuse are often perceived as policies against the wine industry.

Despite these concerns, the government moved forward with a “zero alcohol during pregnancy” campaign. Beginning in 2007, all alcoholic beverages have been required to have a warning label in either the form of a picture or a sentence such as “Consumption of alcoholic beverages during pregnancy, even in small quantities, can have serious consequences health to the child.”

The new law was accompanied by a major media campaign and there was widespread discussion of its effectiveness. Health advocates criticized the law because the warning labels on the bottles were so tiny as to be invisible. On the other hand, the campaign was resisted in part because many do not want to accept that wine can be as harmful as other forms of alcohol. (See the story Warning Labels Mandated for Wine Bottles in France, Elizabeth Beardsley, NPR, January 5, 2008)

How effective was the campaign? An evaluation study between 2004 and 2007 showed that awareness of the recommendation that pregnant women should not drink alcohol increased somewhat from 82% in 2004 to 87% in 2007. The idea that risk to the fetus began with the first glass of alcohol increased from 25% in 2004 to 30% in 2007. This is in keeping with research on awareness campaigns in other parts of the world which show that campaigns do increase awareness (although they rarely bring about behaviour change).

To learn more about work in the area of FASD in France, visit SAF France. This organization was created in the summer of 2008  and works to provide information, training, research, care, and support around FASD. (For the English version of the site, click on the British flag).

Learn more about prevention efforts with women with current or past difficulties with alcohol use by visiting REUNISAF. You may want to take a look at the book Miroir de Verres which explores the stories of 10 women who have given birth to children with FASD.

Also, the first European conference on FASD was held in November 2010. Click here for more info.

References

Dumas A., Toutain S., Simmat-Durand L. (2010). “The French Paradox : Forbidding alcohol during pregnancy, but making an exception for Wine.” In Joshua D. Hoffman (ed.), Pregnancy and Alcohol Consumption, Hauppauge NY, Nova Science Publishers, Chapter 9, 245-261.

Lamblin, D. and Kruchten, S. (2009). Status of FASD Prevention in Nine Areas of France and Recommendations to Support FASD Prevention. Presentation at the 3rd International Conference on Fetal Alcohol Spectrum Disorder, Integrating Research, Policy and Promising Practice Around the World: a Catalyst for Change. Victoria, BC.

Toutain, S. (2010), What women in France say about alcohol abstinence during pregnancy. Drug and Alcohol Review, 29: 184–188. doi: 10.1111/j.1465-3362.2009.00136.x