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Alcohol Use and Pregnancy


move the focus from women's alcohol use to an increased understanding of related ... Biology and genetic endowment. 2008. Our responsibility is to ... – PowerPoint PPT presentation

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Title: Alcohol Use and Pregnancy

Alcohol Use and Pregnancy
Prevention Efforts Must
  • move the focus from womens alcohol use to an
    increased understanding of related health and
    social problems that contribute to FASD.

Determinants of Health
  • Income and social status
  • Social support networks
  • Education
  • Employment and working conditions
  • Social environments
  • Physical environment
  • Gender
  • Culture
  • Personal health practices and coping skills
  • Healthy child development
  • Health services
  • Biology and genetic endowment

Our responsibility is to
  • provide a network of supports that directly
    address these contributing factors

Key Messages
  • Drinking alcohol during pregnancy can cause birth
  • There are no known safe limits
  • It is best to plan ahead and to stop drinking
    before you get pregnant
  • It is never too late to stop drinking

Dont Forget .
  • Emphasize the importance of the health of both
    the woman and the fetus/child
  • Be sensitive to physical/sexual trauma (past and
  • Address family issues and offer support to family
    members, whenever possible

Alcohol Risk Assessment
Problems have not developed
Problems have developed
No risk Low Risk Moderate Risk
High Risk
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
Screening Tools
  • Brief alcohol screening questionnaires developed
    to detect periconception risk-drinking associated
    with adverse pregnancy outcomes (defined as two
    or more drinks per day)
  • Tools assess alcohol intake indirectly by asking
    about tolerance to alcohols effects, i.e.,
    psychological consequences and significant
    others concerns

  • How many drinks does it take to make you feel
    high? (Score 2 for 3 or more drinks)
  • Have people annoyed you by criticizing your
    drinking? (Score 1 for yes)
  • Have you ever felt you ought to cut down your
    drinking? (Score 1 for yes)
  • Have you ever had a drink in the morning to
    steady your nerves or get rid of a hang over?
    (Score 1 for yes)
  • Score of 2 or more high risk, 0 or 1 low risk

  • Tolerance (number of drinks)
  • Worry about drinking (has anyone worried about
    your drinking in the past year?)
  • Eye-openers
  • Amnesia (blackouts)
  • Cut down on alcohol

Stages of Change (Prochaska, DiClemente 1984)
  • Pre-contemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance
  • Relapse

Stages of Change Pre-contemplation
  • Characteristics
  • Not thinking about their drinking
  • Not currently considering change
  • Interventions
  • Validate lack of readiness
  • Clarify the decision is theirs
  • Encourage re-evaluation of current behaviour
  • Encourage sel-exploration, not action
  • Explain and personalize the risk

Stages of Change Contemplation
  • Characteristics
  • Thinking about quitting but not ready to quit
  • May feel ambivalent about change
  • Interventions
  • Validate lack of readiness
  • Clarify the decision is theirs
  • Encourage evaluation of pros and cons of
    behaviour change
  • Identify and promote new, positive outcome

Stages of Change Preparation
  • Characteristics
  • Getting ready to quit
  • The decision to quit is made and steps are taken
    to get ready
  • Interventions
  • Help select best action/approach to change,
    reduce barriers, strengthen self-efficacy
  • Help identify social support
  • Verify that she has underlying skills for
    behaviour change
  • Encourage initial steps

Stages of Change Action
  • Characteristics
  • Quitting or actively trying to quit
  • Using several techniques to quit
  • High risk to relapse
  • Interventions
  • Bolster self-efficacy for dealing with obstacles
  • Acknowledge and find support in learning
    cessation techniques and planning small
    achievable goals
  • Help overcome feelings of loss and reiterate
    long-term benefits

Stages of Change Maintenance
  • Characteristics
  • Remaining alcohol-free
  • Learned to anticipate and handle temptation
  • Able to use new ways of coping
  • Interventions
  • Plan for follow-up support for lifestyle changes
  • Help identify and use relapse prevention
  • Affirm her resolve and self-efficacy
  • Reinforce internal rewards
  • Discuss coping with relapse

Stages of Change Relapse
  • Characteristics
  • Resumption of old behaviour
  • Normal occurrence
  • Interventions
  • Evaluate trigger for relapse
  • Reassess motivation and barriers
  • Plan stronger coping strategies
  • Help resume process of change

  • Clarify that their drinking cannot cause FASD,
    but can lead to infertility and less viable sperm
  • Important role in supporting partner through
  • Their behavior can help a partner
  • stop drinking

Things to Keep in Mind
  • There are no known safe limits and no safe time
    to drink during pregnancy
  • Raise awareness without raising panic
  • Information is not enough
  • Promote the benefits of a planned pregnancy
  • Working on prevention can raise community
    interest in support for those with FASD

  • Keys to a Successful Alcohol and Pregnancy
  • Alberta Alcohol and Drug Abuse Commission

  • Father Involvement and
    FASD Developing Best Practices, 2005.
  • Rutman, D., Callahan, M., Lundquist, A., Jackson,
    S., Field, B. Substance Use and Pregnancy
    Conceiving Women in the Policy-Making Process.
    Status of Women, Canada, August 2000.
  • British Columbia Reproductive Care Program. BCRCP
    Guidelines for Alcohol Use in the Perinatal
    Period and Fetal Alcohol Spectrum Disorder. 2005.
  • Leslie, M., Reynolds, W. The Smart Guide
    Motivational Approaches Within the Stages of
    Change for Pregnant Women Who Use Alcohol A
    Training Manual for Service Providers, March 2002

Thank you!