faseout project 2006 alcohol use and pregnancy

FASEout Project 2006 www.faseoFASEout Project 2006 www.faseout.caut.ca

Alcohol Use and Alcohol Use and PregnancyPregnancy


Age & Drinking During Age & Drinking During PregnancyPregnancy

11.714.1

16.4

22.6

0

5

10

15

20

25

-25 25-29 30-34 35+

Percentage Womenwho drank duringpregnancy, 1996-97

Age


Awareness in CanadaAwareness in Canada Health Canada Study released January 2000Health Canada Study released January 2000

High level of knowledge re: alcohol use in High level of knowledge re: alcohol use in pregnancy can lead to life long problems (89%)pregnancy can lead to life long problems (89%)

Most women said they would stop or cut back if Most women said they would stop or cut back if pregnant (73%), only 4% said they would not pregnant (73%), only 4% said they would not changechange

Confusion on when to stop drinking, safe Confusion on when to stop drinking, safe drinking levels and characteristics of drinking levels and characteristics of

FASDFASD


Adolescent Girls and Young Adolescent Girls and Young Women: Alcohol Use and Women: Alcohol Use and

PregnancyPregnancy Survey found 22% of girls in grade Survey found 22% of girls in grade

10, 12% in grade 8, and 2% in grade 10, 12% in grade 8, and 2% in grade 6 reported drinking an alcoholic 6 reported drinking an alcoholic beverage once a week or morebeverage once a week or more

Research indicates that girls out of Research indicates that girls out of the mainstream have higher rates of the mainstream have higher rates of alcohol use and riskier patterns of alcohol use and riskier patterns of useuse


Adolescent Girls and Young Adolescent Girls and Young Women: Alcohol Use and Women: Alcohol Use and

PregnancyPregnancy Studies have shown that young Studies have shown that young

people are more likely to engage in people are more likely to engage in sex without the use of contraception sex without the use of contraception when they are drinkingwhen they are drinking

Some indication that young women Some indication that young women identify their pregnancy later in term identify their pregnancy later in term than older womenthan older women


Why do some women use Why do some women use alcohol while pregnant?alcohol while pregnant?

Many women don’t plan to get pregnantMany women don’t plan to get pregnant Some women are unaware of, Some women are unaware of,

misinformed, about the consequences of misinformed, about the consequences of alcohol’s effect on the developing fetusalcohol’s effect on the developing fetus

Most will want to reduce or stop alcohol Most will want to reduce or stop alcohol use when they find out they are pregnantuse when they find out they are pregnant

Women who are addicted may not be able Women who are addicted may not be able to stop drinkingto stop drinking


Those Who Keep Those Who Keep DrinkingDrinking

AddictionAddiction Social acceptanceSocial acceptance Family/peer/professional pressureFamily/peer/professional pressure Cope with painful feelings or stressful Cope with painful feelings or stressful

eventsevents Self medicate a mental health condition Self medicate a mental health condition


Barriers to Seeking Barriers to Seeking SupportSupport

Denial of drinking problemDenial of drinking problem Guilt and shameGuilt and shame Fear of losing childrenFear of losing children Childcare, finances, loss of homeChildcare, finances, loss of home Opposition from family & friendsOpposition from family & friends Stigma associated with alcohol use Stigma associated with alcohol use

during pregnancy and FASDduring pregnancy and FASD


Prevention Efforts Prevention Efforts Must…Must…

……move the focus from women’s move the focus from women’s alcohol use to an increased alcohol use to an increased understanding of related health and understanding of related health and social problems that contribute to social problems that contribute to FASD.FASD.


Determinants of HealthDeterminants of Health

Income and social Income and social statusstatus

Social support Social support networksnetworks

EducationEducation Employment and Employment and

working conditionsworking conditions Social environmentsSocial environments Physical environmentPhysical environment GenderGender

CultureCulture Personal health Personal health

practices and coping practices and coping skillsskills

Healthy child Healthy child developmentdevelopment

Health servicesHealth services Biology and genetic Biology and genetic

endowmentendowment


Our responsibility is to …Our responsibility is to …

……provide a network of supports provide a network of supports that directly address these that directly address these contributing factorscontributing factors


Key MessagesKey Messages

Drinking alcohol during pregnancy Drinking alcohol during pregnancy can cause birth defectscan cause birth defects

There are no known safe limitsThere are no known safe limits It is best to plan ahead and to stop It is best to plan ahead and to stop

drinking before you get pregnantdrinking before you get pregnant It is never too late to stop drinkingIt is never too late to stop drinking


Don’t Forget ….Don’t Forget ….

Emphasize the importance of the health Emphasize the importance of the health of both the woman and the fetus/childof both the woman and the fetus/child

Be sensitive to physical/sexual trauma Be sensitive to physical/sexual trauma (past and present)(past and present)

Address family issues and offer support Address family issues and offer support to family members, whenever possibleto family members, whenever possible


Alcohol Risk AssessmentAlcohol Risk Assessment

No risk Low Risk Moderate Risk High Risk

Problems have not developed Problems have developed

Risk Reduction

Early Intervention

Treatment/Intervention

Health Enhancement

Risk Avoidance

70% of women who drink will avoid alcohol during their pregnancy if they understand it will cause

damage to the developing fetus

20% of women will require support of

their partner, family and friends to avoid

alcohol

10% of women will require specific intervention to reduce and/or

eliminate alcohol (harm reduction)


Screening ToolsScreening Tools

Brief alcohol screening questionnaires Brief alcohol screening questionnaires developed to detect periconception risk-developed to detect periconception risk-drinking associated with adverse pregnancy drinking associated with adverse pregnancy outcomes (defined as two or more drinks per outcomes (defined as two or more drinks per day)day)

Tools assess alcohol intake indirectly by Tools assess alcohol intake indirectly by asking about tolerance to alcohol’s effects, asking about tolerance to alcohol’s effects, i.e., psychological consequences and i.e., psychological consequences and significant other’s concernssignificant other’s concerns


T-ACET-ACE How many drinks does it take to make you How many drinks does it take to make you

feel high? (feel high? (Score 2 for 3 or more drinks)Score 2 for 3 or more drinks) Have people annoyed you by criticizing Have people annoyed you by criticizing

your drinking? (your drinking? (Score 1 for yes)Score 1 for yes) Have you ever felt you ought to cut down Have you ever felt you ought to cut down

your drinking? (your drinking? (Score 1 for yes)Score 1 for yes) Have you ever had a drink in the morning Have you ever had a drink in the morning

to steady your nerves or get rid of a to steady your nerves or get rid of a hang over? (hang over? (Score 1 for yes)Score 1 for yes)

Score of 2 or more = high risk, 0 or 1 = low riskScore of 2 or more = high risk, 0 or 1 = low risk


TWEAKTWEAK

Tolerance (number of drinks)Tolerance (number of drinks) Worry about drinking (has anyone Worry about drinking (has anyone

worried about your drinking in the worried about your drinking in the past year?)past year?)

Eye-openersEye-openers Amnesia (blackouts)Amnesia (blackouts) Cut down on alcoholCut down on alcohol


Stages of ChangeStages of Change

Pre-contemplation – not thinking Pre-contemplation – not thinking about quittingabout quitting

Contemplation – thinking about Contemplation – thinking about quittingquitting

Preparation – getting ready to quitPreparation – getting ready to quit Action – process of quittingAction – process of quitting Maintenance – staying substance freeMaintenance – staying substance free


Increasing Awareness Increasing Awareness

Provide informationProvide information Marriage preparation classes Marriage preparation classes Preconception classesPreconception classes Pregnancy support programsPregnancy support programs Keep up-to-date on informationKeep up-to-date on information Make referrals to well informed Make referrals to well informed

resourcesresources Ask what would be helpfulAsk what would be helpful


Fathers-to-beFathers-to-be

Clarify that their drinking cannot cause Clarify that their drinking cannot cause FASD, but can lead to infertility and less FASD, but can lead to infertility and less viable spermviable sperm

Important role in supporting partner Important role in supporting partner through pregnancythrough pregnancy

Their behavior can help a partner Their behavior can help a partner stop drinkingstop drinking


Things to Keep in MindThings to Keep in Mind

There are no known safe limits and no safe time There are no known safe limits and no safe time to drink during pregnancyto drink during pregnancy

Raise awareness without raising panicRaise awareness without raising panic

Information is not enoughInformation is not enough

Promote the benefits of a planned pregnancyPromote the benefits of a planned pregnancy

Working on prevention can raise community Working on prevention can raise community interest in support for those with FASDinterest in support for those with FASD


ResourcesResources

Keys to a Successful Alcohol and Keys to a Successful Alcohol and Pregnancy Campaign, Pregnancy Campaign, www.beststart.org/resources/alc_reductiowww.beststart.org/resources/alc_reduction/index.htmln/index.html

Alberta Alcohol and Drug Abuse Alberta Alcohol and Drug Abuse CommissionCommission

www.aadac.comwww.aadac.com

http://www.beststart.org/resources/alc_reduction/index.html

http://www.beststart.org/resources/alc_reduction/index.html


ResourcesResources

[email protected]@utoronto.ca “ “Father Involvement and FASD: Father Involvement and FASD: Developing Best Practices,” Developing Best Practices,” 2005.2005.

Rutman, D., Callahan, M., Lundquist, A., Jackson, S., Field, B. Rutman, D., Callahan, M., Lundquist, A., Jackson, S., Field, B. Substance Use and Pregnancy: Conceiving Women in the Substance Use and Pregnancy: Conceiving Women in the Policy-Making ProcessPolicy-Making Process. Status of Women, Canada, August . Status of Women, Canada, August 2000. 2000.

British Columbia Reproductive Care Program. British Columbia Reproductive Care Program. BCRCP BCRCP Guidelines for Alcohol Use in the Perinatal Period and Fetal Guidelines for Alcohol Use in the Perinatal Period and Fetal Alcohol Spectrum DisorderAlcohol Spectrum Disorder. 2005. www.rcp.gov.bc.ca. 2005. www.rcp.gov.bc.ca

Leslie, M., Reynolds, W.Leslie, M., Reynolds, W. The Smart Guide: Motivational The Smart Guide: Motivational Approaches Within the Stages of Change for Pregnant Women Approaches Within the Stages of Change for Pregnant Women Who Use Alcohol: A Training Manual for Service ProvidersWho Use Alcohol: A Training Manual for Service Providers , , March 2002March 2002

mailto:[email protected]

faseout project 2006 alcohol use and pregnancy

Documents

pregnant women

young women

older women

faseout project

pregnancy slide

use of contraception

age drinking

higher rates of alcohol