Background:
Fetal Alcohol Spectrum Disorder (FASD) is a condition that has historically been poorly understood, resulting in inconsistencies in public health practitioners’ management, prevention, and understanding of this disorder. As a result, there are widespread international differences in health care practice regarding FASD.
Researchers have shown that health care practitioners and service providers are often working in a space of incomplete information in regard to issues such as FASD. As a result, their professional practice may be, at least in part, informed by their personal values and experiences that fill these knowledge gaps resulting from a lack of information. This practice means that “non-clinical factors” (i.e., personal viewpoints, experiences, values, beliefs, and observations) may be influencing the quality of care and services provided to individuals with FASD and their families.
This research looks at the personal perspectives of health practitioners in relation to alcohol and pregnancy in order to understand if their professional practice is significantly impacted by these non-clinical factors.
This study is based off data collected from interviews with various health and social services practitioners in New Zealand. While some comments made by practitioners in this study parallel data collected in other communities, it is important to note that the findings themselves cannot be extrapolated to explain the attitudes and opinions of health and social service practitioners in other countries, or at different points in time.
Main Findings:
The authors of this study identified four major themes regarding practitioners’ perceptions of alcohol and risk:
- Personal Reflections on Alcohol Consumption and Pregnancy
- Reflections on Other’s Prenatal Alcohol Consumption
- Social Constructions of Alcohol Use and Misuse
- Alcohol Compared to Other Drugs
From these themes, the researchers came to the following conclusions:
- Alcohol and pregnancy is an evocative subject that can cause discomfort but also provoke strong opinions.
- The experiences, opinions, and attitudes that professionals have surrounding substance use during pregnancy influence how they view issues such as FASD.
- Professionals are sometimes unwilling to become involved with FASD work in their practice because of the fear and concern of further stigmatizing mothers by engaging in these conversations.
- Professionals see the risk associated with alcohol consumption during pregnancy as being beyond their ability to control or approach, in both professional practice and personal relationships.
- Professionals believe that society exposes women to incorrect or unclear messaging about the risks of substance use during pregnancy.
- Professionals believe that FASD is stigmatized and the risks of prenatal alcohol exposure are related to social class, education, substance use disorders, the morality of legal and illegal drug use, and women’s rights and bodily autonomy.
Recommendations:
- The stigma surrounding FASD warrants a complete reframing of the disorder as a public health issue that deserves the same level of attention and supports as any other disability.
- Professionals need a solid understanding of FASD from a family systems perspective, and training in how to build supportive relationships with families and communities using trauma-informed practice in order to reduce stigma regarding FASD.
- Professionals need help and support in the form of professional training to better understand their own experiences and attitudes about alcohol use and alcohol use during pregnancy and to improve their approach to FASD prevention and intervention activities.
Take home message:
Health care practitioners and service providers often have an incomplete understanding of best practices surrounding FASD prevention and intervention. Discussions with health and social service practitioners in New Zealand found that the non-clinical factors, such as personal experience and opinions, are influencing their professional practice in relation to FASD prevention and intervention. Consistent, evidence-based training programs for health professionals are sorely needed to improve FASD practice.
Authors: Kerryn Bagley and Dorothy Badry
Date: 31 May 2019
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