Alcohol exposure in utero can cause a range of abnormalities in the fetus which are included under the umbrella term Fetal Alcohol Spectrum Disorders (FASD). Identification and treatment of problem drinking prior to and during pregnancy is recognised as an effective strategy for prevention of FASD. However, only a small proportion of pregnant women who drink at problematic levels are identified and treated. There are a variety of reasons for women not to access treatment including a lack of services, attributing their problems to mental health rather than alcohol use and issues relating to their children or partner. Given the changing patterns of alcohol consumption and harm by women, attention must be paid to the way gender stereotypes influence the prevention and treatment of alcohol related problems.
Dr Deborah Loxton (Research Centre for Gender Health and Ageing, University of Newcastle)
Ms Jennifer Powers (Research Centre for Gender Health and Ageing, University of Newcastle)
Sue Miers (National Organisation for Fetal Alcohol Syndrome and Related Disorders)
Dr Adrian Dunlop (Hunter and New England Drug and Alcohol Services)
- To gain information from alcohol dependent women and clinicians who care for such women on barriers to treatment
- To produce a resource for clinicians about the management of alcohol dependence in pregnancy
- a literature review of alcohol use in pregnancy
- a qualitative survey of clinicians who work with alcohol dependent women
- a qualitative survey of alcohol dependent pregnant women
The project is complete. The final report was published in November 2013 (see 'Resources' below).
The final project report put forward the gold standard for the treatment of alcohol dependence in pregnancy. The gold standard incorporates the following principles:
- That standardised screening be undertaken of all pregnant women on their alcohol use. This should be undertaken by health professionals who see pregnant women and should be accompanied by the provision of education, brief intervention, and continued monitoring where appropriate
- That all pregnant women who screen positively for alcohol-use disorders be offered access to treatment and that this treatment be matched to the severity of the disorder. Treatment should include inpatient admission for detoxification if necessary
- That all pregnant women who are alcohol dependent be offered extended hospitalisation after their child’s birth for additional help and support. Women and children should also be followed-up through the child’s formative years. This follow-up should provide assistance in healthcare, social services, housing and parenting support
- That treatment of pregnant women who are alcohol dependent be undertaken by a multidisciplinary team. This includes alcohol and other drug services, obstetric care and a GP
Burns, L. and Breen, C. (2013) It’s time to have the conversation: Understanding the treatment needs of women who are pregnant and alcohol dependent, National Drug and Alcohol Research Centre, University of New South Wales, Sydney. (See 'Resources' below).
Burns, L., Breen, C. , and Dunlop A (2014) Treating alcohol use and dependency in pregnancy: progress and challenges. Australasian Fetal Alcohol Use Disorders Conference: Time to Learn, Time to Act, Brisbane 19-20 November, 2013.
Burns, L. and Breen, C. (2014) Treating pregnant women with problematic alcohol use in Australia: progress and challenges. First International Conference on the Prevention of FASD, Edmonton, September 2013.
Improving the detection and treatment for alcohol dependent women will reduce preventable FASD.