Alcohol and pregnancy

AER, fourth peer review

Why is it harmful?

The child gets the same blood alcohol concentration as the mother

The Placenta can’t stop alcohol from passing over to the child

The child get’s as intoxicated as the mother

What happens?

The brain develops from the third week and forward

The child grows rapidly between the 10th and 20th week

The production of brain cells is damaged when the mother drinks alcohol

– Caused by alcohol use in the prenatal period– Most common preventable cause of mentalretardation• First trimester- morphologic abnormalities• Second trimester- spontaneous abortion• Third trimester-poor fetal growth– Through out- Central Nervous System/BrainDamage

Fetal Alcohol Spectrum DisorderFASD

Consequences of FASD

• Primary Disabilities– Brain damage– Lowered cognitive function– Inability to learn from consequences– Facial dysmorphology– Growth deficiency• Secondary Disabilities– Disrupted school experiences– Trouble with the law– Inappropriate sexual behaviors

– Alcohol/drug problems

Why do pregnant women drink?

Women are older when they get children 29-30 years old

Changed social patterns Increased consumption of alcohol A subject we don’t talk about Lack of knowledge about how alcohol effects the

unborn child?

Riskbruksprojektet

National initiative concerning alcohol prevention in the primary health care

Maternity health care is one part Started in 2004 Education and training to all

midwives

Objectives

The midwife in the primary health care must have:

knowledge about how alcohol effects the pregnancy and the child

knowledge about methods to identify and support women who drinks during pregnancy

see the possibilities of working with alcohol prevention in the primary health care

Why alcohol prevention in the maternity health care?

Pregnancy is a unique opportunity to influence the drinking habits among women

Pregnant women with a hazardous consumption are highly motivated to change this during pregnancy

Pregnant women want help to change It’s unethical to do nothing when the pregnant

woman is motivated to change her life and receive help for this

(Source: Göransson & Magnusson, KI, 2004)

What have we done in Jönköping?

Changed routines concerning the first visit to the maternity health care. From 12th week to the first call!

Changed questions about alcohol consumption Screening through AUDIT and TLFB (time line follow

back) Support through out the pregnancy, those identified

as addicted gets help from professionals outside the primary health care

A team working on education and information in the primary health care

Developed a new policy and action plan for alcohol and drug prevention

AUDIT–Alcohol Use Disorder Identification Test

Instrument for screening (WHO 1982) to find persons with early drinking problems

AUDIT is used in 30 countries

What are the key problems your region faces in this context?

What policies have you adopted to respond to these problems?

Present an example of a policy your region has implemented and evaluate its success