Alcohol Use and Pregnancy
FASEout Project 2006
www.faseout.ca
Age & Drinking During Pregnancy
25
22.6
20
15
16.4
Percentage Women
who drank during
pregnancy, 1996-97
14.1
10
11.7
5
0
-25
25-29
30-34
35+
Age
FASEout Project 2006
www.faseout.ca
Awareness in Canada

Health Canada Study released January 2000
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High level of knowledge re: alcohol use in
pregnancy can lead to life long problems (89%)
Most women said they would stop or cut back if
pregnant (73%), only 4% said they would not
change
Confusion on when to stop drinking, safe
drinking levels and characteristics of
FASD
FASEout Project 2006
www.faseout.ca
Adolescent Girls and Young Women:
Alcohol Use and Pregnancy

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Survey found 22% of girls in grade 10,
12% in grade 8, and 2% in grade 6
reported drinking an alcoholic beverage
once a week or more
Research indicates that girls out of the
mainstream have higher rates of alcohol
use and riskier patterns of use
FASEout Project 2006
www.faseout.ca
Adolescent Girls and Young Women:
Alcohol Use and Pregnancy
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Studies have shown that young people are
more likely to engage in sex without the
use of contraception when they are
drinking
Some indication that young women
identify their pregnancy later in term than
older women
FASEout Project 2006
www.faseout.ca
Why do some women use
alcohol while pregnant?
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Many women don’t plan to get pregnant
Some women are unaware of,
misinformed, about the consequences of
alcohol’s effect on the developing fetus
Most will want to reduce or stop alcohol
use when they find out they are pregnant
Women who are addicted may not be able
to stop drinking
FASEout Project 2006
www.faseout.ca
Those Who Keep Drinking
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Addiction
Social acceptance
Family/peer/professional pressure
Cope with painful feelings or stressful
events
Self medicate a mental health condition
FASEout Project 2006
www.faseout.ca
Barriers to Seeking Support
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Denial of drinking problem
Guilt and shame
Fear of losing children
Childcare, finances, loss of home
Opposition from family & friends
Stigma associated with alcohol use
during pregnancy and FASD
FASEout Project 2006
www.faseout.ca
Prevention Efforts Must…
…move the focus from women’s alcohol use
to an increased understanding of related
health and social problems that contribute
to FASD.
FASEout Project 2006
www.faseout.ca
Determinants of Health
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Income and social status
Social support networks
Education
Employment and working
conditions
Social environments
Physical environment
Gender

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Culture
Personal health practices
and coping skills
Healthy child
development
Health services
Biology and genetic
endowment
FASEout Project 2006
www.faseout.ca
Our responsibility is to …
…provide a network of supports that
directly address these contributing
factors
FASEout Project 2006
www.faseout.ca
Key Messages



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Drinking alcohol during pregnancy can
cause birth defects
There are no known safe limits
It is best to plan ahead and to stop
drinking before you get pregnant
It is never too late to stop drinking
FASEout Project 2006
www.faseout.ca
Don’t Forget ….
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Emphasize the importance of the health of
both the woman and the fetus/child
Be sensitive to physical/sexual trauma
(past and present)
Address family issues and offer support to
family members,FASEout
whenever
possible
Project 2006
www.faseout.ca
Alcohol Risk Assessment
Problems have not developed
No risk
Health
Enhancement
Low Risk
Problems have developed
Moderate Risk
Risk
Avoidance
Risk
Reduction
70% of women who drink
will avoid alcohol during
their pregnancy if they
understand it will cause
damage to the developing
fetus
High Risk
Early
Intervention
20% of women will
require support of
their partner, family
and friends to avoid
alcohol
FASEout Project 2006
www.faseout.ca
Treatment/
Intervention
10% of women will
require specific
intervention to
reduce and/or
eliminate alcohol
(harm reduction)
Screening Tools

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Brief alcohol screening questionnaires developed
to detect periconception risk-drinking associated
with adverse pregnancy outcomes (defined as
two or more drinks per day)
Tools assess alcohol intake indirectly by asking
about tolerance to alcohol’s effects, i.e.,
psychological consequences and significant
other’s concerns
FASEout Project 2006
www.faseout.ca
T-ACE
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How many drinks does it take to make you
feel high? (Score 2 for 3 or more drinks)
Have people annoyed you by criticizing your
drinking? (Score 1 for yes)
Have you ever felt you ought to cut down
your drinking? (Score 1 for yes)
Have you ever had a drink in the morning to
steady your nerves or get rid of a hang over?
(Score 1 for yes)
Score of 2 or more = high risk, 0 or 1 = low risk
FASEout Project 2006
www.faseout.ca
TWEAK
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Tolerance (number of drinks)
Worry about drinking (has anyone worried
about your drinking in the past year?)
Eye-openers
Amnesia (blackouts)
Cut down on alcohol
FASEout Project 2006
www.faseout.ca
Stages of Change
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Pre-contemplation – not thinking about
quitting
Contemplation – thinking about quitting
Preparation – getting ready to quit
Action – process of quitting
Maintenance – staying substance free
FASEout Project 2006
www.faseout.ca
Increasing Awareness
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Provide information
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Marriage preparation classes
Preconception classes
Pregnancy support programs
Keep up-to-date on information
Make referrals to well informed resources
Ask what would be helpful
FASEout Project 2006
www.faseout.ca
Fathers-to-be
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Clarify that their drinking cannot cause
FASD, but can lead to infertility and less
viable sperm
Important role in supporting partner
through pregnancy
Their behavior can help a partner
stop drinking FASEout Project 2006
www.faseout.ca
Things to Keep in Mind

There are no known safe limits and no safe time to drink
during pregnancy
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Raise awareness without raising panic
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Information is not enough
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Promote the benefits of a planned pregnancy
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Working on prevention can raise community interest in
support for those with FASD
FASEout Project 2006
www.faseout.ca
Resources
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Keys to a Successful Alcohol and
Pregnancy Campaign,
www.beststart.org/resources/alc_reduct
ion/index.html
Alberta Alcohol and Drug Abuse
Commission
www.aadac.com
FASEout Project 2006
www.faseout.ca
Resources

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Robin.Gearing@utoronto.ca “Father Involvement and FASD:
Developing Best Practices,” 2005.
Rutman, D., Callahan, M., Lundquist, A., Jackson, S., Field, B.
Substance Use and Pregnancy: Conceiving Women in the PolicyMaking Process. Status of Women, Canada, August 2000.
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British Columbia Reproductive Care Program. BCRCP Guidelines for
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Leslie, M., Reynolds, W. The Smart Guide: Motivational Approaches
Alcohol Use in the Perinatal Period and Fetal Alcohol Spectrum
Disorder. 2005. www.rcp.gov.bc.ca
Within the Stages of Change for Pregnant Women Who Use Alcohol:
A Training Manual for Service Providers, March 2002
FASEout Project 2006
www.faseout.ca