Background
Since 1973, the medical profession has known that alcohol in pregnancy impedes fetal brain development, affecting intelligence, learning skills and behaviour. Though the ongoing efforts of professionals and community members we are now recognizing the toll FASD is taking and building community strategies to address it.
What is FASD?
Fetal Alcohol Spectrum Disorder (FASD) is the term used to describe the range of harms that can result from prenatal alcohol exposure. FASD is often found in combination with a range of other health and social problems faced by pregnant women. These harms can include vision and hearing problems, as well as slow growth and brain damage that result in lifelong problems with attention, memory, reasoning and judgment. Fetal Alcohol Spectrum Disorder (FASD) is a leading known cause of developmental disability in Canada. As important as this issue is, effective prevention remains a key challenge.
How do you get FASD?
The only way someone can get FASD is if their mother drank alcohol when she was pregnant.
Alcohol causes brain damage in the developing baby.
THERE IS NO SAFE AMOUNT OF ALCOHOL DURING PREGNANCY. There is also no safe TIME to drink alcohol during pregnancy.
There is no gene for FASD! This means that a mother who is diagnosed with FASD will not pass it to her child if she does not drink when she is pregnant.
Can FASD be cured?
Unfortunately, FASD cannot be cured. People live with FASD for their entire life.
However, people with FASD can still do very well with helpful supports and services.
Some examples include special education, vocational programs, tutors, structured environments, and lifelong care. They can find paid work or go to school if given special assistance.
How many are affected in Canada?
FASD affects approximately 1% of people living in Canada. This means that there may be about 300,000 living in Canada today with FASD. People of all ages may be affected.
What are the economic and social costs of FASD?
In a recent Canadian study, the lifetime cost of FASD was estimated at $1 million per case. With an estimated 4,000 new cases yearly, this translates to $4 billion annually. The cost includes health problems, special education, psychotherapy and counselling, social assistance, crime, and the criminal justice system.
The costs are only the tip of the iceberg; underneath these numbers is the unnecessary human suffering caused by FASD.
How can communities help those with FASD?
With early diagnosis and appropriate intervention kids with FASD can do better and those with FASD may avoid troubling and tragic outcomes in adolescence and adulthood.
How can communities be involved in preventing FASD?
Pregnant women are part of the community. It is the responsibility of the community to:
Ensure that its members are educated about FASD
Take the action necessary to reduce the incidence of FASD
Provide appropriate care for those who have FASD.
Do prevention activities work?
Yes, there is evidence to support warning labels and posters as a means of increasing awareness and effecting short-term behaviour change among low-risk women.
There is also evidence to support multi-component community-wide initiatives as a means of increasing awareness generally, reducing consumption for pregnant women, and promoting referrals.
Source: Best Practices, FAS/FAE and Effects of Other Substance Use During Pregnancy, Health Canada, 2000
The Four-Part Model of Prevention
FASD prevention work is complex; it involves much more than providing information about the risks of alcohol use in pregnancy. Preventing risky alcohol use by pregnant women (and mothers before and after pregnancy) does not take place at only one point in time, nor does it occur through a single interaction with one care provider.
Over the past decade in Canada, health promotion and prevention specialists have been learning about how to prevent FASD using multi-sectoral, holistic approaches. Beyond advice to not drink while pregnant, these newer, holistic approaches have demonstrated that helping women plan their pregnancies, obtain prenatal care, improve their nutrition, reduce stress in pregnancy and heal from root causes of addiction such as experience of violence - all contribute to improving women's health and reducing the risk of having a child affected by FASD.
Canadian prevention specialists have identified four mutually reinforcing prevention approaches as effective in delivering FASD prevention. The four levels of prevention span general and specific practices that assist women to improve their health and the health of their babies, with support from family, support networks, services and community. They include:
- The first level of prevention is about raising public awareness through campaigns and other broad strategies. Closely linked to public awareness/social marketing, campaigns can be public policy and health promotion activities that are supportive of girls' and women's health. The engagement and involvement of a broad range of people at the community level is key to advancing social support and social change.
- The second level of prevention is about girls and women of childbearing years having the opportunity for safe discussion of pregnancy, alcohol use, and related issues, with their support networks and healthcare providers.
- The third level of prevention is even more specific. It is about the provision of recovery and support services that are specialized, culturally specific and accessible for women with alcohol problems and related mental health concerns. These services are needed not only for pregnant women, but also before pregnancy and throughout the childbearing years.
- Finally, the fourth level of FASD prevention is about supporting new mothers to maintain healthy changes they have been able to make during pregnancy. Postpartum support for mothers who were not able to make significant changes in their substance use during pregnancy is also vital. This will assist them to continue to improve their health and social support, as well as the health of their children. Early interventions for children who potentially have FASD are also important at this stage.
Source: Fetal Alcohol Spectrum Disorder (FASD) Prevention: Canadian Perspectives, Public Health Agency of Canada, 2008
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