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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.

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

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:

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.

In Canada, FASD prevention advocates work together to link up the local, provincial and national efforts through a virtual prevention research network, which receives financial support from the Canada FASD Research Network (CanFASD). Recently CanFASD refreshed their website, so national action on prevention is profiled. See https://canfasd.ca/topics/prevention/

The Prevention Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective (pNAT) has four objectives. To advance prevention research, the pNAT builds multidisciplinary research teams, which develop research proposals, and conduct research, including evaluation research.  A second objective is to develop and implement strategies for moving “research into action”, for example through preparing and delivering workshops and curricula (both online and offline), and preparing and distributing policy briefs and reports. A third objective is to influence policy and service provision by proactively and collaboratively working with governments and communities to identify and implement service and policy improvements. It is through the fourth objective of networking and networked learning, that the other objectives are achievable. A virtual, national network becomes a location for sharing knowledge, expertise and skills.

The participants in the Canadian pNAT are inclusive of researchers, service providers,

jan 24, 2020

This document about 10 fundamental components of FASD prevention was one of the first documents that the pNAT members wrote together, ten years ago now
https://canfasd.ca/wp-content/uploads/2016/09/ConsensusStatement.pdf

health system planners, policy analysts, community based advocates and (where possible) mothers with lived experience. To achieve this participation, the pNAT employs a virtual community of inquiry (vCoI) model, supplemented by face-to-face meetings often held in conjunction with national and international conferences. Through the vCoI, participants are able to voluntarily attend monthly webmeetings to:

  • Share updates on their work;
  • Learn of recent additions to the evidence on FASD prevention;
  • Discuss research, service provision and advocacy developments undertaken by members and by others in Canada; and
  • Plan collective action.

In this way, participants learn together about FASD prevention, and are able to situate their own work within the field.

The community of inquiry framework developed by Garrison and colleagues (2003) provides the foundational, evidence-based design of the virtual community, and grounds it as a ‘learning’ one. In communities of inquiry, people construct meaning through epistemic engagement, as learners, teachers and social connectors (Shea & Bidjerano 2009). In key ways this virtual learning community model reflects the approach that service providers are finding helpful in interactions with mothers and families: i.e. as both teachers and learners, in relationships that prioritize safety, resilience and connectedness.

In addition to the monthly virtual community meetings, the pNAT uses this blog to share outwardly some of the key issues identified in the virtual community.  Visit the https://canfasd.ca/topics/prevention/ location to learn more about the pNAT and its many activities.

Garrison, D. R. and T. Anderson (2003). E-Learning in the 21st Century: A framework for research and practice. New York, NY, Routledge Falmer.

Shea, P., & Bidjerano, T. (2009). Community of inquiry as a theoretical framework to foster “epistemic engagement” and “cognitive presence” in online education. Computers & Education, 52(3), 543-553.

Pregnancy Outreach Programs (POPs) in British Columbia incorporate FASD prevention efforts in their community-based programming. While these programs do not necessarily advertise themselves as providing FASD prevention, their open, non-stigmatizing, and non-judgemental nature make them successful in offering brief support on a range of issues, including alcohol and other substance use.

There are over 70 local pregnancy outreach programs available across the province, including a number of programs that are funded through the Canada Prenatal Nutrition Programs (CPNP). These outreach programs provide support to high-risk pregnant women who are interested in accessing free and voluntary prenatal information and perinatal support services.

Originally, these programs were developed to improve the nutritional status of high-risk pregnant women who typically don’t access such information and services. They offer a variety of supports, often unique to the community that they serve. Some offer daytime support groups for parents and caregivers. Others offer nighttime events where participants get together for arts, crafts, and mocktails. Among other things, these programs provide women with free access to nutrition and health counselling; peer support groups; physical needs (i.e. food vouchers & prenatal vitamins); referrals to counselling services; supports to address issues with alcohol and/or substance use; and supports and resources to help care for their newborns. The diversity in what is offered and their dedication to meeting women where they’re currently at in their life is what makes these programs so effective.

Research shows that a helpful way to encourage disclosure about alcohol consumption during pregnancy is by using a conversational approach.  Approaches that are non-confrontational, women-centred, and recognize the social pressure that women may be experiencing are effective at opening “doorways to conversation.” These approaches allow providers to build relationships with their participants, creating a safe space to discuss risks of  alcohol and other substance use, and related challenges women face during their pregnancy. In providing a safe and non-judgemental environment that is based on building trust and relationships with women, the practice model of POPs providers fits with this best practice.

Facilitating understanding of FASD and brief support in POPs

Nancy Poole with Heather Cameron, BCPOPs Executive Director, at BCAPOP Annual Conference

The British Columbia Association of Pregnancy Outreach Programs (BCAPOP) is the provincial association for all of the pregnancy outreach programs (POP). Through their work, they provide a platform through which skills, supports, resources, expertise, and information can be shared. Their recent resource, BC Pregnancy Outreach Program Handbook Supplement on Perinatal Substance Use includes information on how to support women and girls facing substance use concerns in a trauma-informed way.  The content of this resource is being shared for free through in-person training throughout BC to over one hundred outreach workers by November 2019. BCAPOP also offered a workshop led by Myles Himmelreich at their recent annual conference in Richmond BC, to support understanding by POP workers of the realities of living with FASD.

Nancy Poole with Myles Himmelreich at BCAPOP Annual Conference.

The important role of social service providers in delivering effective brief interventions on alcohol and substance use, should not be ignored or underestimated. Outreach programs, including CPNP programs, offer a space that provides unconditional supports and resources for women, regardless of where they are at in their health or recovery journeys. We should look to the practice approaches modeled by these programs to find additional ways to meet community needs for action on FASD prevention and build programs that respond to the unique needs of each woman and each community.

Building awareness about the risks surrounding alcohol use when pregnant and supports for making change in alcohol use are foundational to preventing Fetal Alcohol Spectrum Disorder (FASD).

AFPC-1-Bingo-20190814

Awareness building can come in many forms, from posters and websites to warning labels and events. However, not all awareness approaches are effective. Over the past several decades, researchers have conducted studies to determine the most effective approaches for awareness raising. By using these evidence-based approaches and linking them to other levels of prevention we will have more impact.

As September comes to a close, we’d like to share three Canadian FASD Awareness initiatives that used evidence informed and innovative messaging and/or images, to raise awareness this International FASD Awareness month.

1. New Posters from the Foster Family Coalition of the North West Territories

These beautiful new posters from the Foster Family Coalition of the NWT highlight the importance of noticeability in developing effective communications. These bright posters have a simple and consistent colour scheme that draws the eye.

They’ve also aimed to increase the effectiveness of the campaign through integration. Integration is when you combine your messaging with how to act on the information. This could involve collaboration with other organizations, releasing materials in many different formats (i.e. social media, posters, brochures, events), or incorporating other related information into your messaging.

In this case, they’ve included the phone number and website of the NWT Help Line for those in need of support to make changes.

2. New Campaign from the Piruqatigiit Resource Centre

FASD awanareness month campaign

One very important consideration to keep in mind when developing your communication campaigns is comprehension. Your message needs to have clear, simple, and direct information that your specific audience can relate to. Every audience that we communicate with is different.

The new FASD awareness approach from the Pirugatigiit does an amazing job of respecting the culture of their audience when developing their resources. They are working to raise awareness of FASD in Nunavut, which has a large Inuit population. Not only do they offer resources in English and Inuktitut, but they’ve also integrated imagery, values, terminology, and practices specific to Nunavummiut within their approach.

3. Alcohol and Pregnancy Don’t Mix Brochures by BC Liquor Stores

Research shows us that it’s important for us to develop a message that is relevant for our audience (threat) while at the same time encourages them to take action (efficacy).  It is a balance between providing the information needed while preventing feelings of helpless to act.

Campaigns with strong fear based messages (i.e. “One drink can harm your baby”) or that have unnecessarily graphic images (i.e. a fetus floating in alcohol) can be off-putting. Such messages and images can prompt a fear-based response that can cause women who have consumed alcohol while pregnant to feel helpless and ashamed.

The messaging in the BC pamphlet is effective because it does a good job of balancing the threat with an appropriate response with sentences like:

  • “If you did drink and find out you’re pregnant, it’s important to realize it’s never too late to quit or cut down on your drinking if quitting isn’t possible.”
  • “There is no known safe level of alcohol use during pregnancy, so it is safest not to drink at all when women are pregnant.”

Above all, these campaigns are positive! They help break down the stigma surrounding alcohol and pregnancy by highlighting FASD as a relational and societal issue, and not just the responsibility of women who are pregnant. These campaigns show us that we all play a part in FASD prevention.

To find out more tips for how to create effective alcohol and pregnancy awareness campaigns please check out this resource from Canada FASD Research Network and the Government of Alberta.

One year ago, the Centre of Excellence for Women’s Health released Doorways to Conversation: Brief Intervention on Substance Use with Girls and Women. Since then, there has been a growing interest in expanding work on brief interventions and FASD prevention, to be inclusive of multiple substances and multiple health issues for women, their families and communities.

Here are four innovative ways that brief discussion about alcohol and other substance use is being expanded:

In Sexual Health

Sexual health clinicians are well positioned to deliver brief substance use interventions due to their open, non-judgmental and harm reduction-oriented model of practice. Sexual health providers are able to discuss substance use together with contraceptive use and/or sexually transmitted and blood borne infections [1, 2]. Conversations about substances, sex, and safety can support a woman’s decisions and confidence for change towards improving health in whatever area fits for her.

Linking Discussion of Multiple Substances

Cannabis legalization provides a ‘window of opportunity’ to engage in discussions about alcohol, tobacco, and cannabis use in pregnancy. Discussing what we know and don’t know about cannabis use in pregnancy can now be linked to open conversations about alcohol and other substance use in pregnancy.

Understanding the Link to Adverse Childhood Experiences (ACEs)

Research on ACEs shows how a history of childhood stressors, including physical, sexual, and emotional abuse, may influence alcohol use among adults including pregnant women [3]. Adopting a trauma-informed approach in conversations about alcohol use in pregnancy supports women who experienced childhood adversity with safety, choices, collaboration, self compassion and skills for change.

Advancing Indigenous Wellness Approaches

Holistic, relational, community-based, and culture-led FASD prevention initiatives are key to wellness for pregnant women in Indigenous communities [4]. These interventions address the broad social and structural determinants of health that are associated with substance use and respond to the Truth and Reconciliation Commission Call to Action #33.

References

  1. Lane, J., et al., Nurse-provided screening and brief intervention for risky alcohol consumption by sexual health clinic patients. Sexually Transmitted Infections, 2008. 84(7): p. 524-527.
  2. Crawford, M.J., et al., The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR). Health Technology Assessment, 2014. 18(8): p. 1-48.
  3. Frankenberger, D.J., K. Clements-Nolle, and W. Yang, The Association between Adverse Childhood Experiences and Alcohol Use during Pregnancy in a Representative Sample of Adult Women. Women’s Health Issues, 2015. 25(6): p. 688 – 695.
  4. Wolfson, L., et al., Collaborative Action on Fetal Alcohol Spectrum Disorder Prevention: Principles for Enacting the Truth and Reconciliation Commission Call to Action #33. International Journal Of Environmental Research And Public Health, 2019. 16(9).

Service providers and FASD prevention advocates are well aware of the intersections of trauma, substance use, and mental health issues as first described by researchers like Lisa Najavits (Najavits, Weiss, & Shaw, 1997). Research from the Women and Co-occurring Disorders and Violence study substantiated what many understood intuitively – that women with substance use problems facing complex life issues are best served through multi-leveled, integrated service models that are trauma-informed, gender-specific, and holistic (Amaro, Chernoff, Brown, Arévalo, & Gatz, 2007; Brown & Melchior, 2008).

There is an upcoming opportunity to learn more about applying these approaches to FASD prevention and care in a webinar on April 18th at 9:00 am MST. The CSS Learning Series webinar as part of their FASD Learning Series will feature speakers Candice Sutterfield, Lakeland Centre for FASD, and Dr. Peter Choate, Assistant Professor of Social Work at Mount Royal University and clinical supervisor for the Alberta College of Registered Social Workers. They will address both a prevention and supports & services perspective. Sign up here: http://csslearningseries.ca/trauma-informed-fasd-prevention-and-care-registration-2/

Programs in Canada, like Breaking the Cycle and HerWay Home, currently offer integrated programs for/with pregnant and parenting women with substance use issues. Their program frameworks are trauma- and FASD-informed and they offer substance use treatment/support programming as well as needed social services and referrals at a single access point. Program evaluation findings show that relationship building is the key component benefiting women’s growth and supporting the mother-child relationship long-term. (See their evaluations here: Breaking the Cycle and HerWay Home).

In a very recent study undertaken in Ontario, findings from interviews with women participating in integrated programs, described qualities of a therapeutic relationship that helped women improve emotional regulation and executive functioning (Milligan, Usher, & Urbanoski, 2017). Therapeutic relationships that incorporate trust, care, positive regard and a non-punitive attitude can create a safe attachment from which women can apply effective problem solving in all areas of their lives.

Sign up for the webinar and see these earlier posts for more information:

The Mother-Child Study: Evaluating Treatments for Substance-Using Women, March 18, 2015

HerWay Home Program for Pregnant Women and New Mothers in Victoria, BC, February 12, 2013

REFERENCES

Amaro, H., Chernoff, M., Brown, V., Arévalo, S., & Gatz, M. (2007). Does integrated trauma-informed substance abuse treatment increase treatment retention? Journal of Community Psychology, 35(7), 845-862.

Brown, V. B., & Melchior, L. A. (2008). Women with co-occuring disorders (COD): Treatment settings and service needs. Journal of Psychoactive Drugs, SARC SUPPL 5, 365-385.

Milligan, K., Usher, A. M., & Urbanoski, K. A. (2017). Supporting pregnant and parenting women with substance-related problems by addressing emotion regulation and executive function needs. Addiction Research & Theory, 25(3), 251-261. doi:10.1080/16066359.2016.1259617

Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women. A research review. The American Journal On Addictions / American Academy Of Psychiatrists In Alcoholism And Addictions, 6(4), 273-283.

 

Brief Interventions

Indigenous Mothering

Welness

Community Action

Reconciliation & Healing

Five new booklets on Indigenous Approaches to FASD Prevention have just been published. They were developed  following the Dialogue to Action on Prevention of FASD meeting in May 2017, and reflect the 8 tenets of the Consensus Statement created by participants for enacting the Truth and Reconciliation Commission of Canada Call-to-Action #33:

“We call upon the federal, provincial, and territorial governments to recognize as a high priority the need to address and prevent Fetal Alcohol Spectrum Disorder (FASD), and to develop, in collaboration with Aboriginal people, FASD preventive programs that can be delivered in a culturally appropriate manner.” – Truth and Reconciliation Commission of Canada

The booklets were written by Tasnim Nathoo and Nancy Poole of the Centre of Excellence for Women’s Health in collaboration with the Thunderbird Partnership Foundation, and Canada FASD Research Network. Topics include: Brief Interventions with Girls and Women, Mothering, Wellness, Community Action, and Reconciliation and Healing. Printed booklets are being shared with those who attended the meeting in May and with Indigenous communities who may find them helpful as they plan FASD prevention efforts. Links to PDF versions are included in this blog.

Grounded in research, the booklets prioritize Indigenous knowledge for implementing culturally-safe, cross-disciplinary, cross-organizational, and collaborative approaches to FASD prevention. As well, each booklet offers discussion questions that shift the lens from a primary focus on alcohol use during pregnancy, to a holistic focus that aligns with Indigenous values and worldviews to support change and transformation in all systems of care.

The Truth and Reconciliation Commission of Canada (TRC) provided a process for discovering the harms and injustices that Aboriginal people experienced as part of the Indian Residential School system with an aim to build a lasting and respectful foundation of reconciliation across Canada. TRC findings were released in 2015 along with 94 Calls-To-Action (CTA), including CTA #33, which focuses on FASD prevention.

 

See earlier posts on these topics:

DEVELOPING AN INDIGENOUS APPROACH TO FASD PREVENTION IN BC’S FRASER SALISH REGION December 11, 2017

INNU COMMUNITY FASD PREVENTION IN LABRADOR October 27, 2017

FASD PREVENTION WITH INDIGENOUS COMMUNITIES IN AUSTRALIA April 3, 2017

THE MOTHERING PROJECT/MANITO IKWE KAGIIKWE IN WINNIPEG, MANITOBA May 1, 2015

POSTCOLONIAL THEORY FOR BEGINNERS
September 1, 2010

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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