Mothers with substance use concerns who access supportive community-based programs are often driven by the desire to be a good parent, to retain custody, and to access care for their children.
Integrating Child Health Supports in Wraparound Programming
Over the years, community-based wraparound programs have grown in their ability to meet these expressed needs of mothers. One key development is infant mental health programming for the children of mothers who are facing substance use and related health and social concerns. Such programming builds on the valuing of integrated support of mothers, of children and the mother child unit, which have often been described in this blog.
Children of substance-involved mothers are at risk for exposure to adverse childhood experiences and their developmental consequences, given that maternal substance use often co-occurs with other risk factors, including partner violence, intergenerational trauma, poverty and maternal mental health concerns. Mothers who have experienced a lack of safety and support in their own childhood often struggle to provide nurturance to their children. Thus, early intervention programs are needed to support positive outcomes for children of substance-involved mothers and the mother-child relationship.
Benefits of Very Early Intervention
We are learning more about the neurodevelopmental trajectories of children with prenatal substance exposure and the implications for support. For example, benefits from interventions for children as early in life as possible, rather than before the age of 6 years more broadly, are being explored. Our increasing understanding of risk and protective profiles, alongside the benefits of early intervention, are informing targeted evidence-based early interventions that contribute to improvement in children’s neurodevelopment.
Building the Evidence for Early Infant Mental Health Intervention
Researchers and service providers in our Prevention Network Action Team (pNAT) are committed to evidencing approaches that promote the wellness of mothers and children (see the Co-Creating Evidence study). Currently, a team involving pNAT researchers and two services, Breaking the Cycle and Maxxine Wright, are engaged in a new study that will examine the effectiveness of enhanced infant mental health components integrated in community-based services for substance involved mothers and children, compared to supportive programming for mothers and children offering basic wellness supports for children. The study aims to establish the comparative effectiveness and mechanisms of change of the enhanced infant mental health components, as well as estimate the long-term social return on investment.
This study will make a much-needed contribution to the evidence for infant mental health interventions in real life settings of programs serving mothers with substance use related health and social challenges, and their children.
A Mustard Seed of Hope is a beautiful new booklet describing culturally grounded approaches within wraparound care for pregnant and parenting women who are dealing with substance use and trauma.
It describes the Indigenous cultural programming that is being offered in some wraparound programs, to honour this work and to inspire others who provide community-based services to take up/expand upon these approaches.
The title comes from one of the mothers who spoke of the caring, non-judgemental wraparound supports that allowed her to see hope in being able to keep her baby and be a good mom. All she needed was that “mustard seed of hope” to keep coming to the program for the supports and services.
The cultural programming of three wraparound programs – Sheway, the Healthy Empowered Resilient (H.E.R) Pregnancy Program and Manito Ikwe Kagiikwe (Mothering project) – are highlighted. Beautiful photos and descriptions of their culturally grounded approaches are offered as inspiration.
The booklet ends with a powerful description of how culturally safe approaches and Indigenous cultural programming make a difference for women. The quotes and images of those who have benefitted from this programming are well worth reading.
The booklet represents a thank you to the women who accessed, and the service providers who provided, wraparound programming in the Co-Creating Evidence project.
Thanks are also due to Marilyn Van Bibber for her commitment to this work and her conception of this booklet.
Funding for this booklet and the Co-Creating Evidence project has been received from the Public Health Agency of Canada, National FASD Strategic Project Fund. The views expressed here do not necessarily represent the views of the Public Health Agency of Canada.
The Co-Creating Evidence (CCE) Project has been a first-of-its-kind-in-Canada national evaluation involving 8 different programs serving women at high risk of having an infant with FASD or prenatal substance exposure.
The goals have been to:
Bring together many of Canada’s holistic FASD prevention programs to share promising approaches and practices;
Evaluate the effectiveness of multi-service programs serving women with substance use and complex issues;
Identify characteristics that make these programs successful.
Representatives of the eight programs and researchers from Note Bene Consulting Group and the Centre of Excellence for Women’s Health have collaborated since 2017 to achieve the following:
The 8 programs involved in the CCE Project.
256 program participant interviews, 108 staff interviews, and 60 interviews with community partners of the services
A detailed report of all study findings (96 pages) for all audiences
12 info sheets on key components found to be helpful, to support the work of service providers
4 journal articles, to bring awareness of the findings to researchers and health system planners
A booklet on culturally grounded approaches within wraparound programs for all audiences (24 pages)
A digital handbook highlighting key components of wraparound programming found to be helpful, for service providers and peer mentors wishing to start a wraparound program or enhance the work they already offering
Wraparound services offered by the 8 programs participating in the Co-Creating Evidence project
The 8 programs were guided by a similar set of theoretical approaches, including being trauma-informed, relationship-based, women-centred, culturally-grounded, and harm-reducing.
The range of services offered by wraparound services is key for women in finding what works for them, and in having the opportunity to choose the order and pace of services they will use.
The study has demonstrated that pregnant and early parenting women experiencing problematic substance use and other complex issues benefit from programs that include: Wraparound services – Knowledgeable and empathetic program staff – Indigenous (re)connection – Opportunities for community/peer support.
Further, the following elements are important characteristics that contributed to the programs’ success: Well conceptualized, evidence-based approaches – Strong partnership relationships – Flexible, multi-dimensional models – Keeping clients engaged over time.
The Digital Handbook on Wraparound Programs is a key legacy of the CCE Project. The handbook was developed with multiple audiences in mind, including program planners, managers and staff, service partners from a variety of health and social sectors, funders, researchers, community members, and families affected by perinatal substance use.
The Handbook is a remarkable, accessible collection of resources about:
Relationship-based practice
Trauma- informed approaches
Culturally safe care
Harm reduction approaches
FASD informed approaches
Indigenous cultural programming
Attachment focused practice
Transitioning from wraparound services
Building partnerships
Cross sectoral work
Wraparound programs as good investments
Data collection approaches and more
Opening page of Topic 14 in the digital handbook
The Handbook supports one of the implications arising from the study:
“Ongoing learning opportunities, focusing on integrated, culturally grounded, trauma informed, relational practice, are important to practitioners in all fields and need to be actively supported.”
See the Executive Summary of the Co-Creating Evidence Evaluation Report for all the implications identified: 6 directed to practitioners, 5 for health system planners, and 6 government policy makers and funders.
Next month’s blog will feature, A Mustard Seed of Hope, a booklet created through the CCE Project about culturally grounded approaches within wraparound care for Indigenous pregnant and parenting women dealing with substance use and trauma.
Funding for this project was received from the Public Health Agency of Canada. The views expressed do not necessarily represent the views of the Public Health Agency of Canada.
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.
Over the past three years, the Co-Creating Evidence study (CCE) has been exploring best practices in the delivery of community-based wraparound programs that support pregnant and parenting women with substance use concerns in Canada. The CCE team recently published an article about how the partnerships fostered and maintained by community-based wraparound programs make a difference in their work and are in fact a best practice.
The CCE project team interviewed 60 partners and 108 staff of the eight programs involved in the CCE study. The interviews focused on the nature and benefits of interagency and cross-sectoral partnerships. The study found that these programs most commonly formed partnerships with child welfare and health services such as primary care, public health, mental health services and maternal addictions programmes, yet they also partnered to some degree with housing, income assistance, Indigenous cultural programming, infant development and legal services.
Key benefits of partnerships identified were:
improved access by clients to health and social care that addresses social determinants of health. This access includes expanded programming in the program sites, increased understanding of partners’ services, and greater ease of referral to other supports and programs as needed by clients.
increased knowledge on the part of both the interagency partners and the wraparound service providers about the experiences that women face, such as the significance of poverty and trauma to women’s substance use. In turn this positively promotes non-judgemental and trauma-informed approaches with pregnant women and new mothers, as well as provision of more multifaceted and paced supports to address their needs.
improved child welfare outcomes. The program level relationships with child welfare workers, and in some cases integration of a social worker onsite, results in increased planning for positive mother-child outcomes during the pregnancy, improved mother-child connections after birth and reduced likelihood of the infant being removed from the woman’s care at birth.
strengthened cultural safety within the programming and (re)connection to culture by women. Partnerships with Indigenous organizations enhances learning by program providers about how to work in a culturally safe way and increased opportunities for referral to Indigenous programming for those women interested in connecting to their culture as a part of their wellness/recovery.
“The programmes participating in the Co-Creating Evidence study were both creative and flexible when developing partnerships, seeking opportunities in areas in which they did not have the resources or expertise, as well as with services with whom they had a common cause, for example mutual clients, a shared desire to ‘wrap support’ around women to meet their evolving needs and aligned approaches (harm reduction, trauma informed practice).”
Hubberstey, C., Rutman, D., Van Bibber, M., & Poole, N. (2021). Wraparound programmes for pregnant and parenting women with substance use concerns in Canada: Partnerships are essential Health and Social Care in the Community https://onlinelibrary.wiley.com/doi/epdf/10.1111/hsc.13664
The partnerships continue to evolve through dialogue, collaboration and communication. What the study has identified is how, through these partnerships, wraparound program providers are contributing to the reduction of fragmentation between the health, child welfare and addictions fields – and in turn to important benefits for clients in terms of access to care and enduring connections with their children. In the work on prevention of FASD, it has repeatedly been emphasized how important the role of “Level 3 and 4” programming is, particularly in how such programs attend to the range of determinants of women’s health and alcohol use. Clearly it is in part through partnership work that FASD prevention is achieved.
Substance use and addiction are highly stigmatized, particularly for pregnant women and women of reproductive age. Women who use substances often experience multiple forms of stigma and are required to navigate notions of ‘good’ motherhood. This can contribute to women’s own belief that substance use during pregnancy is an uncaring choice. Despite the pervasiveness of stigma and public health efforts to counter it and to help women prevent Fetal Alcohol Spectrum Disorder (FASD), women’s alcohol use during pregnancy is expected to increase.
Researchers from the Centre of Excellence for Women’s Health, University of Queensland, and the Canada FASD Research Network published a study exploring women’s reasons for continued alcohol use, reduction, and abstinence during pregnancy (1). In their research, they found that there is very little research that highlight’s women’s voices in efforts to understand the barriers and facilitator’s to alcohol use in pregnancy.
To analyze women’s reported barriers and facilitator’s to reducing alcohol use in pregnancy, the authors used the Action Framework for Building an Inclusive Health System. It was released in 2019 with Canada’s Chief Public Health Officer of Health’s 2019 report, and outlines different levels of stigma (individual, interpersonal, institutional, and population) and how they operate.
Stigma remains a pervasive challenge for pregnant and parenting women who use alcohol and other substances when accessing and receiving care. Interestingly, despite the literature’s focus on women’s individual choice about prenatal alcohol use, the barriers and facilitators to women’s alcohol use in pregnancy identified in this study were a result of interpersonal, institutional, and population-level factors, not individual choice.
In Canada, toolkits and policy papers have been developed to contribute to addressing stigma and related barriers. In many countries, interventions are being developed and evidenced by communities and by health and other systems of care that are designed to reduce stigma and support women’s engagement in care, including:
inclusive awareness building that reaches women, their partners and the public
relational, trauma-, gender- and culture-informed support offered by health and social care providers; and,
welcoming, non-judgmental services that wrap a wide range of needed practical supports around mothers and their children.
These interventions act as remedies to the challenges cited by pregnant women who use alcohol and find it difficult to reduce/stop alcohol use in pregnancy. In this way, action to prevent FASD can move beyond the usual recommendations for supporting individual change to be more accurately focused on service and system level changes that have the potential to make individual change possible.
Lyall V, Wolfson L, Reid N, Poole N, Moritz KM, Egert S, et al. “The Problem Is that We Hear a Bit of Everything…”: A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. Int J Environ Res Public Health. 2021;18(7).
When we first formed the Prevention Network Action Team over a decade ago, we insisted on calling it the Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective. We did not want FASD prevention to have a sole focus on stopping or reducing alcohol use but instead to have a wider focus on the need for changing systemic as well as personal and interpersonal influences on women’s alcohol use. One such systemic influence is women’s experience of trauma and violence.
Understanding the impact of trauma and violence on women and gender diverse people’s lives has never been more important as we in Canada read and absorb the findings of Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls in Canada. We are called upon to understand and act against systemic processes such as racism, sexism and misogyny, and structural oppression related to ongoing and widespread violence against women, social and economic marginalization of Indigenous women, and the multigenerational effects of horrific colonial and patriarchal practices.
The MMIWG report sets out seven principles for change that inform the 231 Calls for Justice needing action across federal, provincial, territorial and Indigenous governments, industries, institutions, health care, child welfare, correctional services, and policing. Some of these principles we have often discussed and promoted in our work on FASD prevention. They include:
A focus on substantive equality and human and Indigenous rights
A decolonizing approach
The inclusion of families and survivors
Self-determined and Indigenous-led solutions and services
Recognition of distinctions (i.e., the diversity of Indigenous peoples)
Cultural safety
A trauma-informed approach
In addition to the Calls for Justice, several action plans have been created in order to enact change. The Native Women’s Association of Canada has committed to taking leadership and action to end the violence and genocide, and to the full implementation of an Action Plan they have developed for: ending the violence including all forms of race-and gender-based violence, and upholding dignity and justice for Indigenous women, girls and gender-diverse people in Canada. There are many opportunities within their Action Plan where we who are working on FASD prevention can work together on key actions they have identified. Here are three examples:
Continue ongoing health, policy, research, training and programs to support Indigenous-led health initiatives (page 22)
Create and implement awareness building campaigns that will educate the public about MMIWG and the issues and roots of violence (page 38)
Monitor media stories and track inaccurate portrayal of Indigenous women (page 41), so that portrayals that perpetuate negative stereotypes of Indigenous women are challenged/stopped and the “curious silence” (page 388 of the MMIWG report) of the media in covering the lives of Indigenous women is addressed.
National and regional Inuit organizations have also developed an action plan. The National Inuit Action Plan was developed by a 10-member Working Group, co-chaired by Inuit Tapiriit Kanatami (ITK) and Pauktuutit Inuit Women of Canada. The National Inuit Action Plan also identifies a wide range of areas where concrete, timely and measurable positive changes need to be made for Inuit women, girls and 2SLGBTQQIA+ people to achieve substantive equality. The image from page 6 of that report illustrates the breadth of the work that needs to be done, how we in FASD prevention can align our actions.
Harriet Visitor, an Indigenous educator and niece of Chanie Wendak, used the expression “learning to understand” on the radio this past week. She describes this as different than simply learning, it involves unlearning, not turning a blind eye, and acting. In the case of missing and murdered Indigenous women and girls, it involves supporting decolonization and revitalization of Indigenous culture and doing everything in our power to ensure the future is one where Indigenous women can thrive as leaders, teachers and healers, and be acknowledged and honoured for their expertise, agency and wisdom.
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.
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
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.
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
FASD Awareness Day started on September 9, 1999 to bring global awareness to Fetal Alcohol Spectrum Disorder (FASD).
This year, Canada FASD Research Network (CanFASD) is launching FASD Awareness Month for all of September. The goal is to bring awareness to what FASD is and challenge the stigma and misinformation surrounding the disability. In preparation, they have released a toolkit with information about FASD, speech-writing tips, and images that are strengths-based, non-judgemental, and person-centered as to reduce the stigma around FASD, alcohol, and pregnancy.
CanFASD’s campaign explores how FASD is many things; including a women’s health issue. Preventing FASD requires supporting women in addressing the issues that contribute to their substance use and experience of trauma. When women receive non-judgemental support that is tangible and offers practical help, women are able to reduce or abstain from substance use, improve their health, and be empowered mothers.
Positioning FASD as a woman’s health issue recognizes:
Communities’ roles in healthy pregnancies;
Service providers’ role in delivering services that women need (i.e. housing, employment, nutrition, anti-violence, substance use) in an accessible and non-judgemental way;
Governmental roles in creating evidence based alcohol policy, and addictions & child welfare policies that prioritize wrapping support around the mother-child unit; and,
Society’s role in learning more about alcohol use in pregnancy and FASD.
This year, Canada FASD Research Network (CanFASD) is launching 
Girls, Women, Alcohol, and Pregnancy 