Supportive alcohol policy as a key element of fetal alcohol spectrum disorder prevention

Abstract

In Canada, a Four-Part Model of Fetal Alcohol Spectrum Disorder (FASD) Prevention has been developed that describes a continuum of multi-sectoral efforts, including broad awareness campaigns, safe and respectful conversations around pregnancy and alcohol use, and holistic and wraparound support services for pregnant and postpartum women with alcohol, and other health and social concerns. Supportive alcohol policy is at the centre of the four mutually reinforcing levels of prevention. The purpose of this narrative review is to describe alcohol policies related to specific levels of FASD prevention, and to consider the implications of alcohol policies on FASD prevention and women’s and fetal health. The majority of the evidence focused on alcohol in pregnancy guidelines, alcohol warning labels, and knowledge and uptake of national or regional alcohol and pregnancy guidelines. Several US studies described shifts in alcohol and pregnancy policy over the 7-year period, including moves to punitive approaches that criminalize women’s substance use or prompt child apprehension. This review indicates that more attention could be paid to the role of alcohol policy in FASD prevention and in promoting women’s and fetal health, and that policy actions and advocacy could be important catalysts for both FASD prevention and women’s health promotion. Moving forward, it is essential that alcohol policies are rooted in evidence; attend to and promote women’s health including health during pregnancy; and are collaborative in order to prompt a higher standard of care, and more holistically respond to the factors that contribute to women’s alcohol use during pregnancy.

Unmet need for alcohol use disorder treatment in reproductive-age females, with emphasis on pregnant and parenting populations in the United States: Findings from NSDUH 2015–2021

“…Increasing knowledge about the consequences of alcohol use during pregnancy can empower individuals, including healthcare providers, policymakers, and the general public, to prioritize the treatment and support of pregnant individuals with AUD [ 47 ]. Education efforts should not only target pregnant individuals themselves but should also extend to their support networks, including partners, family members, and healthcare providers [ 48 ]. The finding also underscores the need to continually address the stigma surrounding AUD treatment during pregnancy and parenting, as it remains more noticeable in these groups of women.…”

Fetal alcohol spectrum disorder and Aboriginal and Torres Strait Islander men: A discussion to be had

“…A research project led by men using yarning and other culturally safe research methods could provide insights into perceptions of alcohol consumption during pregnancy [8]. This would be important because the alcohol consumption of men can influence that of their partner [9][10][11].…”

Integrated Supports for Women and Girls Experiencing Substance Use and Complex Needs

“…[53][54][55] Many of the approaches recommended in FASD best practice, such as client-centered, gender-sensitive, strengths-based, trauma-informed, relationship-focused, culturally safe, structured, flexible, and integrated care 53,54,56 are priorities at the 2nd Floor. Importantly, these approaches, coupled with multilevel supportive alcohol policies, 57 can contribute to FASD prevention by reducing the likelihood of alcohol-exposed pregnancies. Together, these findings indicate that FASD screening, access to assessment and diagnosis, and continuous FASD-informed supports warrant consideration within substance use treatment and policy for pregnant women, girls, and gender diverse people.…”