In an article on Healthy Debate website, Dr. Peter Hutten-Czapski, a family doctor and obstetrician in Temiskaming Shores, Ontario, says that while he thinks the public health message around drinking is “right where it should be,” there is often need for a “more nuanced conversation” in a family doctor’s office. He meets women who are worried about the occasional drink they had in the first trimester, before they knew they were pregnant. “I tell them there is no evidence that a little bit of alcohol causes FASD because my job at that point is to reduce their anxiety,” he says. But he also recommends they stop drinking going forward, explaining that “with everything in pregnancy, we want to be absolutely safe and sure and the best way to do that is to abstain. You know you’re going to be fine if you don’t drink.”
In another article I found, the following advice (and study) to help clinicians:
The term “brief interventions” (BI) refers to a collection of time-limited motivational counselling strategies aimed at helping patients reduce or eliminate at-risk alcohol use. Most successful brief interventions include 3 components:
1. Assessment and feedback after assessment aimed at increasing awareness;
2. Advice including provision of pamphlets and discussion of strategies for reducing or eliminating problematic alcohol use; and
3. Assistance in the form of eliciting ideas about change strategies, goal setting to reduce or eliminate alcohol use, positive reinforcement, and referrals to supportive services.
In one study, BIs were an effective method of helping women who screened positive for at-risk drinking during the pre-conception period reduce problematic alcohol use over a 48-month period. Women in the treatment group who became pregnant during that time had the most dramatic decreases. There is also good evidence that BIs are effective in helping women reduce possible alcohol-exposed pregnancies with low- and medium-risk as well as high-risk drinkers in the pre-conception period. Significantly more women reduced the risks of an alcohol-exposed pregnancy in a BI treatment group than in a control group. The BI group consisted of four MI counselling sessions and one contraception- planning visit. The MI counselling sessions consisted of personalized feedback about risk of an alcohol-exposed pregnancy; choice to focus on alcohol use, contraception, or both; discussion about ways to reduce risk and increase confidence; and developing a personalized change plan.
For more information on the above quoted study, click here
I am not a medical professional, so I can only provide quotes from and links to articles I have found on the topics I am posting about. What I can say is there should be no stigma or shame. Women should feel safe to express their concerns. And women should not feel that because they have had an alcoholic drink they should abort the child – as some recent articles are suggesting women are being frightened by the no alcohol message and possible implications.
Not every woman who drinks alcohol will have a child with FASD. Not every child born with FASD will have the same outcomes. There are many factors. And even if a child is born with FASD, early intervention and supports for child and family will result in better outcomes. There are many adults living with FASD who are living with success stories. The issue (I think) has been the lack of awareness and understanding and interventions and support provided. That is what we need to work on.
We know alcohol has an effect. Women always have a choice. But we need to provide the information so they can make well-informed choices.
Come back tomorrow for another FASD tip, quote, fact or piece of information on the 99 Days to 9/9 journey!