Prevention Conversation: A Shared Responsibility

Click here to listen to the blog (2:47).

The Prevention Conversation is an online training program for health and social service providers to increase their knowledge about alcohol and other substance use in pregnancy and provide them with the skills to have safe and impactful conversations with women and people of child-bearing age and their support networks. The Prevention Conversation recognizes that these conversations are central to ensuring that families and communities know about the risks of drinking alcohol during pregnancy and feel supported in sharing the responsibility to reduce the harms of alcohol.

In Autumn 2022, the Canada FASD Research Network released an updated version of the online course to reflect the most recent research on FASD prevention and best meet the needs of diverse communities who are accessing prevention resources.

The updated course:

  • Features best practice and updated evidence, wisdom, and language around alcohol use in pregnancy;
  • Includes new modules on stigma reduction, alcohol and women’s health, and cultural safety and humility;
  • Incorporates reflection questions that encourage course takers to reflect on how they can support women and people in the childbearing years in their local context and with the resources available to them;
  • Includes new resources and content to support a range of practitioners working in different practice settings; and,
  • Incorporates diverse peoples and knowledge systems through the addition of new content and artwork from Indigenous artists across Turtle Island. Art pieces from Indigenous artists, such as Cody Houle (see below), introduce every module, as a way to honour Indigenous knowledge systems and capture the spiritual, relational, and emotional connections to the modules. 
“Surrounded by Love” by Cody Houle introduces Module 5: Raising Awareness and Stigma Reduction. You can find his description of the piece in the online course.

The updated course follows the Four-Part Model of FASD Prevention to provide formative knowledge about alcohol and women’s health, FASD prevention and healthy beginnings, stigma reduction, cultural safety and humility, and trauma-informed practice. These modules can further facilitate open, respectful and non-judgemental conversations with women and their partners by a range of health and social service providers.

The Prevention Conversation is available online through the CanFASD e-store or can be delivered in-person in Alberta through the Prevention Conversation.

Staying Principled

Click here to listen to the blog (3:54).

In 2009 a group of women gathered in Victoria BC Canada to discuss how we would approach the development of a network on FASD prevention. We were researchers, policy advocates, service providers, community activists and those with Indigenous wisdom – all with a commitment to seeing and acting on how social determinants affect women’s health and substance use, and the ability for them influence the conditions of their lives.

Out of our discussion emerged a consensus on 10 fundamental components or principles for approaching FASD prevention from a women’s health determinants perspective. Now, in 2022, we have updated that consensus statement, so that those interested in FASD prevention are directed to new evidence and resources. The update is a testament to the soundness of the original principles and to the ever-growing expertise of the network participants and international partners. We hope this will empower those working on FASD prevention to continue to use and build upon this principle-based approach.

The principles foundational to approaching FASD prevention are:

Respectful – Grounding prevention initiatives in respectful relationships is vital to reduce stigma and discrimination.

Relational – It can be a transformative experience for women who use substances to experience care that aligns with their needs, views them as a whole person, and offers respect, understanding, and authentic collaboration.

Self-Determining Health care and other support systems can facilitate self-determined care by supporting women’s autonomy, decision making, control of resources, and including exercise of their reproductive rights.

Women+ Centred Women+ centered care moves beyond a fetus/child-centered approach, and focuses on fostering safety and empowerment when providing support to women and gender diverse individuals who are pregnant or parenting.

Harm Reduction Oriented A harm reduction oriented approach focuses on safer substance use but also on reducing broader harms, including retaining or regaining custody of children, access to adequate and stable housing, and the challenges of poverty, food insecurity, and intimate partner violence.

Trauma- and Violence-Informed Trauma- and violence-informed services integrate awareness of the impacts of trauma on health into all aspects of service delivery including wellness support and prevention of secondary trauma.

Health Promoting – Holistic, health promoting responses to the complex and interconnected influences on women’s health and substance use are vital to FASD prevention.

Culturally Safe – Respect for individuals’ values, worldviews, and preferences in any service encounter is important, as is respect for and accommodation of a woman’s desire for culturally-specific healing.

Supportive of Mothering – FASD prevention efforts must recognize women’s desire to be good mothers and the importance of supporting women’s choices and roles as mothers.

Uses a FASD-informed and Disability Lens – Uses strengths-based responses, makes person-centered accommodations, and ensures equity of access to health and social services.

We hope you will find the Consensus Statement with these principles and supporting sources – journal articles, reports and infographics – an inspiration for action.

Every Moment Matters – An evidence-based FASD prevention campaign for Australia

Click here to listen to the blog (3:54).

Every Moment Matters is a nation-wide health promotion campaign launched in Australia which shares the latest evidence-based information about alcohol during pregnancy and breastfeeding. See www.everymomentmatters.org.au/.

The messages

The messages about alcohol use in pregnancy and FASD include:

  • Every moment matters when it comes to alcohol – whether you are planning a pregnancy, currently pregnant or breastfeeding.
  • Planning a pregnancy is an exciting time. It’s also a great opportunity to go alcohol-free. Make the moment you start trying the moment to stop drinking alcohol.
    • The “planning a pregnancy” section includes
      • information about how alcohol affects fertility, the risk for miscarriage, and how the placenta is not a barrier to alcohol
      • ideas for action, when sharing information with friends, and finding help
  • All parents want to give their baby the best start in life, which is why it’s important not to drink any alcohol during pregnancy.
    • The “currently pregnant” section includes
      • information about how alcohol passes directly to the developing baby and can damage their brain, body and organs (FASD)
      • ideas for action to garner support from partners friends and family and for talking to a doctor, midwife or obstetrician
  • When breastfeeding, not drinking alcohol is safest for the health of your baby.
    • The “when breastfeeding” section includes
      • information about how alcohol enters breastmilk, noting how when there is alcohol in one’s blood, it is also in their breastmilk
      • strategies to avoid exposure when a choice is made to drink alcohol while breastfeeding

All sections of the website contain many helpful facts about alcohol and pregnancy and breastfeeding, how women can make a change in alcohol use, and how to support someone who is pregnant or planning a pregnancy. And there are links to a multitude of resources: www.everymomentmatters.org.au/resources/

The underlying research

This campaign has the most solid background research of any undertaken to date. The Foundation for Alcohol Research and Education (FARE) commissioned research to ground the campaign that involved:

  • A literature review and review of previous campaigns implemented in countries around the world, in order to establish best practice approaches to a campaign such as this.
  • Research to understand attitudes, perceptions of risk, and understanding of the issues by people in Australia, to identify potentially effective messages and framing of messages. This research included women who were pregnant, planning a pregnancy (in the next 2 years) or who might become pregnant, through an online survey, virtual focus group discussions, online journey mapping forums and virtual in-depth interviews.

Very comprehensive findings from this research guided the creation and testing of messaging for the campaign so that the messages would ‘grab attention’, contain information that was personally relevant to various segments of the population and be persuasive so that women would avoid alcohol during pregnancy.

Learn more about the research and its impact

The sponsors of the campaign, FARE, are hosting a webinar on Dec 8th (in Australia) entitled Behind the Scenes of Every Moment Matters where they will explore some of the key elements of this ground-breaking national health promotion campaign. Members of the campaign team will share insights into the formative research, message testing, creative approach, media strategy, engagement of health professionals in the campaign, and its impact to date.

This event is for people working in health promotion, public health policy, social marketing, the alcohol and other drugs sector, behaviour change, or evaluation design. 

See https://www.eventbrite.com.au/e/behind-the-scenes-of-every-moment-matters-tickets-439430427237

The Remarkable Findings of the Co-Creating Evidence Evaluation Study

Preventing Fetal Alcohol Spectrum Disorder (FASD) requires a range of efforts from general awareness to targeted prevention and treatment services. In the Canadian Four-Part FASD Prevention Model, Level 3 and 4 programs provide low barrier holistic services for pregnant or parenting women who face substance use and a range of other health and social burdens and challenges.

Over a four-year period, the Co-Creating Evidence (CCE) evaluation study has involved eight different community-based Level 3 & 4 programs that support women through the provision of holistic, wraparound services, and in doing so, see FASD prevention as part of their mandate. These programs are guided by theoretical approaches such as being trauma-informed, relationship-based, women-centred, culturally grounded and harm reducing. The evaluation team has been led by the Nota Bene Consulting Group and has involved researchers from the Centre of Excellence for Women’s Health and representatives of the eight programs. 

This CCE evaluative study (2017-2020) has had three main research questions:

  1. What are the common elements of the diverse Level 3 programs across Canada?
  2. What program components are helpful from women’s perspectives?
  3. What are best measures to evidence outcomes and what outcomes are being achieved?

The answers to these questions are now available via:

In all these documents, service providers, researchers, policy makers and women with lived/living experience will see promising approaches and outcomes that these programs provide and the women who access these programs are realizing, together with their community partners. This study makes a significant contribution to our understanding of this level of FASD prevention. It hopefully will be an inspiration to all those committed to this important work. 

Funding for this project has been received from the Public Health Agency of Canada, Fetal Alcohol Spectrum Disorder (FASD) National Strategic Project Fund. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.

Preconception Care to Optimize Health

Harm reduction and health promotion for women and their partners before conception are key to FASD prevention [1]. Providing health information and supports during the preconception period provides an opportunity for men and women to actively plan for a healthy pregnancy and learn strategies such as healthy nutrition, supplementation, and reducing alcohol and other substance use [2]. Such education and support can contribute greatly to optimizing health and preventing FASD [3].

Around the world, there are examples of unique approaches to preventing alcohol exposed pregnancies. Some interventions are geared towards women and men separately, and others are gender synchronized, creating complimentary programs for men, women, boys, and girls. Interventions may also include both members of a couple and include training for healthcare professionals.

Credit: Pretestie Bestie campaign.

Websites, such as Healthy Families BC and the Society of Obstetricians and Gynaecologists of Canada have pages offer information about alcohol use during pregnancy and clear and concise steps to consider before becoming pregnant. The recent ThinkFASD website sponsored by the CanFASD Research Network offers advice both for couples who are consciously planning a pregnancy, and those who are drinking and having unprotected sex. Other websites are interactive, such as Alberta Health Services’ Ready or Not, which allows a woman to click through different resources and prompts based on whether or not she feels ready to become pregnant. Don’t Know? Don’t Drink is a creative campaign in New Zealand, which posts fun, engaging graphics and videos to their social media platforms with messages about using contraception and supporting friends to not drink if there’s a chance they might be pregnant. The campaign caters to younger girls and encourages finding a “Pretestie Bestie”, a friend who supports you and your decision making before getting a pregnancy test, as a strategy of FASD prevention.

Interventions in the preconception period are not limited to women. Paternal drinking can impact men’s safety, sperm health, fetal/infant health, and women’s ability to reduce their alcohol use [4]. Various programs have been geared towards men’s education about contraception options, reproductive health, and how to support partners in their efforts to reduce drinking before and during pregnancy. Project Alpha is an American collaboration aimed at educating boys age 12 to 15 about fatherhood, contraception, healthy relationships, and sexuality.

MenCare+ empowers men to be active and positive participants in their own health as well as the health of their partners and children.  It has been implemented in Brazil, Indonesia, Rwanda, and South Africa and has been shown to reduce intimate partner violence in its participants, which is an important contributing factor to women’s substance use during pregnancy [5]. In addition to programming for men, MenCare also offers workshops and training for healthcare professionals on engaging men in maternal and child health.

The internet has been a preferred source of information when it comes to preconception [6] and for couples who know they want to have children, web-based interventions are helpful tools. The UK’s Smarter Pregnancy program helps couples build a profile through an online health assessment and then offers evidence-based recommendations based on their profile. A similar approach is taken by HealthyMoms and HealthyDads complimentary websites, which were created after asking expectant moms and dads what  information and supports they need to prepare for parenthood.

Culturally safe and non-judgemental interventions have been shown to be effective in reducing the risk of alcohol exposed pregnancies [7]. In the US, CHOICES and Amor Y Salud are interventions geared towards Indigenous and Latinx communities. CHOICES educates non-pregnant at-risk women about contraceptive options and uses motivational interviewing to support women to reduce drinking. Amor Y Salud, available through the Oregon Health Authority Website, offers a radionovela that follows a young couple as they learn how to optimize their health and prepare for future children. In Canada, Best Start’s website has a page for Indigenous prenatal health with information and resources that integrates Indigenous knowledge with Western health information. They also provide resources, such as Planning for Change, to support healthcare providers in educating their patients about FASD and supporting them in making meaningful changes.

The variety of preconception education and support approaches illustrates opportunities for incorporating these initiatives across the various levels of reproductive health. Childbearing years span four decades for women and are longer for men, and interventions have and can continue to focus on those that are planning or not yet planning a pregnancy, as well as for those in the period before a pregnancy is confirmed. When such preconception and early pregnancy supports are well incorporated throughout the healthcare system, this key component of FASD prevention can be realized.

1. Network Action Team on FASD Prevention. (2010). Consensus on 10 fundamental components of FASD prevention from a women’s health determinants perspective. Canada Northwest FASD Research Network.

2. The Centre of Excellence for Women’s Health. (2016). Preconception Interventions Alcohol and Contraception Example. Schmidt, R., Hemsing, N., & Poole, N. Retrieved from http://en.beststart.org/sites/en.beststart.org/files/u4/PC3-Preconception-Interventions-Poole.pdf

3. Webb, Shelby, and Diane Foley. “An Introduction to the Optimal Health Model for Family Planning Clinicians.” National Clinical Training Center for Family Planning, 17 Feb. 2020, http://www.ctcfp.org/optimal-health-podcast/.

4. McBride, N. and S. Johnson, Fathers’ role in alcohol-exposed pregnancies: Systematic review of human studies. American Journal of Preventive Medicine, 2016

5. Alhusen JL, Ray E, Sharps P, Bullock L. Intimate partner violence during pregnancy: maternal and neonatal outcomes. J Womens Health (Larchmt). 2015 Jan;24(1):100-6. doi: 10.1089/jwh.2014.4872. Epub 2014 Sep 29. PMID: 25265285; PMCID: PMC4361157.

6. Da Costa D, Zelkowitz P, Bailey K, Cruz R, Bernard JC, Dasgupta K, Lowensteyn I, Khalifé S. Results of a Needs Assessment to Guide the Development of a Website to Enhance Emotional Wellness and Healthy Behaviors During Pregnancy. J Perinat Educ. 2015;24(4):213-24. doi: 10.1891/1058-1243.24.4.213. PMID: 26834443; PMCID: PMC4718007.

7. Hanson, J., & Pourier, S. (2015). The Oglala Sioux Tribe CHOICES Program: Modifying an Existing Alcohol-Exposed Pregnancy Intervention for Use in an American Indian Community. International Journal of Environmental Research and Public Health, 13(1), 1. doi:10.3390/ijerph13010001


Preventing FASD and Intimate Partner Violence During the COVID-19 Pandemic

Twenty years ago, Astley, Bailey, Talbot, and Clarren (2000) [1] published a study that revealed how common intimate partner violence (IPV) was amongst mothers of children with FASD. The study showed the importance of thinking broadly about the risk factors and influences of FASD and demonstrated that preventing violence against women is also a preventative measure for FASD. Research efforts since Astley et al.’s study in 2000 have continued to show that IPV is an important factor to consider when supporting pregnant women who use alcohol and other substances [2].

This year, researchers at the Centre of Excellence for Women’s Health (CEWH) have been conducting a rapid review to understand the complex, multi-directional relationship between IPV and substance use during the COVID-19 pandemic and provide available and accessible research evidence to frontline providers [3]. Since the implementation of stay at home orders and social distancing recommendations, use of substances and experiences of IPV have increased. Canadians have reported an 18% increase in alcohol consumption[5] due to the stress, boredom, and lack of a regular schedule brought on by the COVID-19 pandemic[6]. One in 10 Canadian women are concerned for their safety[4] and calls to the Battered Women’s Support Services in Vancouver have tripled, demonstrating an increase in help seeking by women. These findings highlight the importance of understanding how public health policies and recommendations that help curb the spread of COVID-19 can be used by partners who cause harm in coercive and controlling ways.

In our efforts to prevent and reduce substance use during pregnancy, collaboration among service providers in substance use and IPV services is essential. Understanding the interconnectedness of these issues and how they are affected by pandemics and disasters can help us address them collectively. As examples, the Learning Network at the Centre for Research & Education on Violence Against Women & Children [7] and Calgary Women’s Emergency Shelter [8] have developed educational materials to help us understand how to support women who are experiencing IPV during the ongoing pandemic. As we deepen our understanding of the risk factors for FASD to include psychosocial factors such as IPV, materials like these can help us incorporate holistic support into service provisions and better support women who are experiencing violence and aggression during the COVID-19 pandemic.

Excerpt from the Learning Network at the Centre for Research & Education on Violence Against Women & Children’s 3 Considerations for Supporting Women Experiencing
Intimate Partner Violence During the
COVID-19 Pandemic
guide

  1. Astley, S. J., Bailey, D., Talbot, C., & Clarren, S. K. (2000). Fetal alcohol syndrome (FAS) primary prevention through fas diagnosis: II. A comprehensive profile of 80 birth mothers of children with FAS. Alcohol and alcoholism (Oxford, Oxfordshire)35(5), 509–519. https://doi.org/10.1093/alcalc/35.5.509
  2. https://bccewh.bc.ca/?s=FASD+revention%3A+An+Annotated+Bibliography+of+Articles
  3. https://bccewh.bc.ca/featured-projects/covid-19-substance-use-and-intimate-partner-violence/
  4. Statistics Canada, Canadian Perspectives Survey Series 1: Impacts of COVID-19. 2020, Ottawa, ON: Statistics Canada.
  5. NANOS Research, COVID-19 and Increased Alcohol Consumption: NANOS Poll Summary Report. 2020.
  6. Statistics Canada. Canadian Perspectives Survey Series 1: Impacts of COVID-19. 2020; Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/200408/dq200408c-eng.htm
  7. http://vawlearningnetwork.ca/our-work/infographics/covid19safety/LN-Safety-COVID-19-PDF-1.pdf
  8. https://www.calgarywomensshelter.com/images/CWES_COVIDsupport_Final_April_2020.pdf

Framing our messaging to women who access mobile apps and online content during pregnancy

Women are increasingly accessing pregnancy applications (‘apps’) as a primary source of information about health changes in pregnancy and fetal development. Pregnancy apps have features that track pregnancy signs and symptoms, do gestation calculations, and can blend functions to integrate games, social networking options, etc. [1]. Apps are well situated for women to safely and confidentially seek information that they may not feel comfortable asking of their health care professional.

Although most women use pregnancy apps for information seeking, many apps lack trusted information on important topics such as alcohol use, in part due to the limited involvement of informed health professionals and women knowledgeable about harm reduction in the content development process [1].

fasd blog June 2020

The ability to access evidence-based resources on alcohol use during pregnancy and FASD that is non-judgmental, trauma-informed, and harm reduction oriented, is more important than ever. Integrating Messages about Alcohol Use in Pregnancy and FASD: Guidelines for Pregnancy App Developers was created due to the increasing demand for pregnancy apps, paired with the need for consistent, evidence-based information across platforms.

These recommendations provide app developers with insight on how to frame messages about alcohol use and pregnancy so they are strengths-based, trauma-informed, and harm reduction oriented; recognizing that pregnancy apps are well positioned to offer women advice, links to local and national resources, and strategies that address women’s substance use and the influences on women’s drinking.

The recommendations address how there are many reasons why women may drink alcohol or use other substances during pregnancy; that reasons for alcohol use may change over the course of their pregnancy; and that a great deal of conflicting information about alcohol use and pregnancy exists. It is helpful to women and to service providers when health messaging about reducing stress, finding healthy coping strategies, enhancing support through safe relationships, and navigating social situations is integrated with information about the risks of alcohol/other substance use in pregnancy. We invite and encourage all those writing blogs and designing apps about health issues in pregnancy to use the guidance provided so that empowering and helpful information about reducing/stopping alcohol use when pregnant is consistent, becomes readily available, and discussed on all platforms.

 

  1. Hughson, J.P., Daly, J. O., Woodward-Kron, R., Hajek, J. Story, D., The rise of pregnancy apps and the implications for culturally and linguistically diverse women: Narrative review. Jmir Mhealth and Uhealth, 2018. 6(11): p. e189.

Putting evidence in women’s hands – alcohol and cannabis use when breastfeeding

Beautiful black mother breastfeeds her newborn sonTwo updated resources are available about alcohol and breastfeeding: a research update from CanFASD Alcohol and Breastfeeding and a brochure from Best Start  Mixing Alcohol and Breastfeeding.  They both illustrate how little research there is available, and how public health messaging directed to new mothers has changed over time.

The public health message currently offered to mothers is that it is safest not to drink alcohol when breastfeeding and if one chooses to drink, to avoid drinking near the time of breastfeeding, so that infants are exposed to the very least amount of alcohol. Some recent studies about alcohol use when breastfeeding have not found negative effects for infants – and instead, have found that low level drinking during breastfeeding was not associated with shorter breastfeeding duration or adverse outcomes in infants up to 12 months of age. These adverse outcomes included effects on infant feeding and sleeping behaviour, as well as developmental outcomes [1].

Yet, infants cannot metabolize alcohol in the same way as adults, and exposure to alcohol places them at risk of potential alcohol-related harm, in the short, if not long term.  As a result, the weight of decision-making about breastfeeding and drinking alcohol rests on women. What is low level drinking, and how can one assess the many confounding factors related to alcohol’s effects – sex, genetics, nutrition, use of other substances, etc.? All of these issues are in play for their own, and their infant’s health.

Similarly, in light of cannabis legalization, more attention has been placed on the impact of cannabis use on breastfeeding. As with alcohol, initial public health messaging focussed on the studies that showed risk.  But, a recent review of the literature led by Dr. Alice Ordean of St Joseph’s Health Centre in Toronto, found only two articles that addressed the impact of postpartum cannabis use by lactating women that provided developmental outcomes for infants [2]. That review found some evidence regarding health risks of post-natal exposure to cannabis, but the authors noted that further research is needed to determine the impact of cannabis exposure via breastmilk on infant neurodevelopmental outcomes beyond the first year of life. They concluded that given the conflicting evidence on outcomes from exposure to cannabis in breast milk, women are advised that it is safest to abstain from cannabis use during lactation and to reduce consumption and plan timing for least exposure, if abstinence is not possible.

What has changed in our public health messaging? As well as repeating the sound advice that it is safest not to use these substances when breastfeeding, practical harm reduction advice is also offered.  In the case of alcohol, women are advised to plan ahead to consume alcohol immediately after, and not before, breastfeeding, so that infants are exposed to the very least amount of alcohol.  In the case of cannabis, women are advised to avoid breastfeeding within 1 hour of inhaled use to reduce exposure to highest concentration of cannabis in breast milk.

In addition to what is known and not known about the effects of exposure to substances when breastfeeding, there are many other reasons women may need to think critically about their alcohol and cannabis use as new mothers. These include relational attachment, fatigue, risk of exposure to 2nd and 3rd hand smoke for infants and children, and role modelling healthy behaviour.  With limited evidence, the benefits and drawbacks of low level alcohol and/or cannabis use will continue to be forefront for breastfeeding mothers.

  1. Tay, R.Y., et al., Alcohol consumption by breastfeeding mothers: Frequency, correlates, and infant outcomes. Drug and Alcohol Review, 2017. 36: p. 667-676.
  2. Ordean, A. and G. Kim, Cannabis Use During Lactation: Literature Review and Clinical Recommendations. Journal of Obstetrics and Gynaecology Canada, epub January 25, 2020.

See
Alcohol and Breastfeeding. CanFASD Research Network April 2020
https://canfasd.ca/issue-papers-alerts/#1566440340786-344b257b-3fa1
Mixing Alcohol and Breastfeeding. Best Start/Health Nexus 2020
https://resources.beststart.org/product/a21e-mixing-alcohol-and-breastfeeding-brochure/
Cannabis Use During Pregnancy & Lacatation: Practice Resources for Health Care Proivders. Perinatal Services BC 2020
http://www.perinatalservicesbc.ca/Documents/Resources/HealthPromotion/cannabis-in-pregnancy-pratice-resource.pdf

Alcohol, social distancing, and prevention of FASD

Pregnant woman relaxing on sofa

A statement about prevention of FASD in the context of staying home to prevent  transmission of COVID-19 has been released, and is available on the CanFASD website. It highlights the data in this week’s report from the Canadian Centre on Substance Use and Addiction about how Canadians have increased their alcohol use during this period of isolation CCSA report.

So it is important for us all to be reminded about the influences on girls and women’s alcohol use, and how to prevent FASD.

  • We know that alcohol use during pregnancy can cause harm to fetal health and result in lifetime effects known as Fetal Alcohol Spectrum Disorder (FASD).
  • We also know that there are other factors in addition to alcohol use, that affect risk for FASD, such as the mother’s overall health, nutrition, use of other substances, stress level and connection to prenatal care – all of which may be affected at this time.
  • Experts agree that it is safest not to drink alcohol in pregnancy and encourage reducing or stopping alcohol consumption by women and their partners in the preconception and perinatal period.

We encourage women of child bearing years who drink alcohol to:

  • Ensure they are using a reliable contraceptive if they are not planning to be pregnant.
  • Reduce or eliminate alcohol use when planning a pregnancy.
  • Be mindful of alcohol use if you are pregnant. The safest approach is to not use alcohol during this time.
  • Seek out alternative coping strategies and support for managing the influences or pressures to drink.
  • Seek information about risks and available supports from reliable sources.
  • Talk to your health provider or other trusted practitioners.

Suggested resources:

Addressing the priorities of the pNAT in 2020

As we continue to connect our work in Canada on FASD prevention, via the Prevention Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective (pNAT), new priorities for action emerge.  These are five priorities that this virtual community identified for the coming year.

  1. Cross-sector collaboration

Collaboration across fields provides an important opportunity to support mothers, children, and women who may be at risk of using substances during pregnancy. Resources, such as Mothering and Opioids: Addressing Stigma – Acting Collaboratively, highlight opportunities for collaboration across fields to foster advocacy, streamline service delivery and referrals, and offer systems navigation.

  1. Indigenous approaches to FASD prevention

There are an increasing number of wholistic FASD prevention and wellness programs that are incorporating culture and language, traditional knowledge, and land-based programming, while responding to the needs of families and communities. Programs such as Circle of Life in Terrace, Xyólhmettsel Syémyem (Family Empowerment Team) in Chilliwack and others highlighted in the recent booklet, Revitalizing Culture and Healing: Indigenous Approaches to FASD Prevention, bring attention to the importance of community-led, community-driven FASD prevention and wellness programs.

  1. Trauma-informed practice

Trauma-informed practice and policy development are essential components in responding to each level of the four-part prevention model. Trauma-informed services recognize the interconnections of trauma, mental health, and substance use and the role that substance use may have in coping with past or current violence or trauma. When discussing alcohol and other substance use, trauma-informed approaches will promote building relationships, building upon individuals’ strengths, and offering choice and collaboration in service provision.

  1. Stigma reduction

There has been an increasing focus on reducing stigma that mothers and women who use substances during pregnancy experience. By reducing stigma, pregnant women and mothers will be able to better access necessary supports and servicces that support stigma reduction. The recent issue paper from the Canada FASD Research Network on mothers’ experience of stigma through a multi-level model offers recommendations and recommended resources for service providers, health systems planners, and policymakers.

  1. Keeping families together

More attention is being brought to service delivery models that have the goal of keeping families together. These programs, which range from co-located multi-service programming to mentor and peer support models increase women’s access to prenatal care, health care, social support, advocacy, and childcare. PNAT members from programs such as the Parent-Child Assistance Program, Sheway in Vancouver, HerWayHome in Victoria, H.E.R. Pregnancy Program in Edmonton, Manito Ikwe Kagiikwe (the Mothering Project) in Winnipeg, and Mothercraft (Breaking the Cycle) in Toronto are helping us understand how this goal can be achieved in community contexts.