Up to 4% of Canadians have Fetal Alcohol Spectrum Disorder. Preventing FASD is more complex than recommending no alcohol use in pregnancy. FASD can happen in any community or group where alcohol is used.

With 1 in 25 Canadians having FASD, chances are you know someone with FASD; a neighbour, a friend, or a relative. You might not even know it. To look at the bigger picture of FASD helps people move away from the shame, blame, stigma, and discrimination of FASD. The best way to make a difference is to support women, individuals with FASD, and their families. Supporting women can include learning about the reasons they may use alcohol in pregnancies.

Each person with FASD has different strengths and challenges. Each person will need different supports. Each person with FASD can have successes.

What is FASD?

Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe impacts on the brain and body of individuals prenatally exposed to alcohol. FASD is a lifelong disability. Individuals with FASD will experience some degree of challenges in their daily living, and need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential. Each individual with FASD is unique and has areas of both strengths and challenges (CanFASD, 2019).

Alcohol is used in pregnancy for many reasons

The reasons a woman may use alcohol before she is pregnant are still there the day the pregnancy test is positive. There are many reasons for prenatal alcohol use, such as:

Unplanned pregnancy and alcohol was used before pregnancy confirmation
Use of alcohol while planning a pregnancy and until pregnancy is confirmed
Depression
Partner’s drinking behaviour
Drinking is normal in her society/group/community/family/friends
Social pressure to drink from families and friends
Stigma and being afraid to talk about alcohol use because of shame and blame
Abuse
Violence
Confusing messages about alcohol and pregnancy
To cope with trauma or difficult life situations
Drinking habit, dependency, or substance use disorder
Mental health challenges
Not knowing that alcohol can harm the baby
Some doctors say that it’s okay to drink a little in pregnancy
Knowing other women who drank during pregnancy whose children appear healthy
To relax or reduce stress
Ways of drinking before becoming pregnant (e.g., risky drinking, drinking every day)
Indifference or being unhappy about the pregnancy
Family history of alcohol abuse
Inadequate or no prenatal care

Shame and blame don’t work

Many people know that it is healthiest for both mother and baby when alcohol is not used in pregnancy. However, many people don’t know that shame and blame do not change the many reasons alcohol might be used during pregnancy. In fact, shame and blame (stigma) are often reasons people don’t ask for help, talk about alcohol use, or go for prenatal care. When we make it easier to talk about prenatal alcohol use, we make it easier for people to get help, be as healthy as possible, and have healthier pregnancies. Removing stigma will make it easier for people to ask for help.

Partners make a difference

It is easier for a pregnant woman to not use alcohol when her partner supports her. This includes a partner not drinking or cutting back on drinking when they are trying to get pregnant, and during the pregnancy. It is also a healthy start for baby when both mom and dad see their healthcare professionals when they decide to have children.

When a woman who is pregnant lives with someone who drinks heavily, she is more likely to use alcohol. It is also harder for a pregnant woman to stop using alcohol if:

she is forced to drink by her partner
she is abused by her partner
she is using alcohol to deal with stress or depression

A father’s alcohol use does not cause FASD. Researchers have found that a father’s alcohol use can cause changes to:

his sperm (e.g., how they look, how many, and ability to penetrate the egg)
the genes (DNA) he passes on to his baby
epigenetics (which genes are turned on or off)

Research also shows that a father’s alcohol use might make the fetus more vulnerable to prenatal alcohol exposure. However, more research is needed in this area.

Alcohol use affects every person and pregnancy differently

Alcohol affects every person’s body differently. Alcohol also affects every fetus (unborn baby) differently. That is why each person with FASD has different strengths and challenges. Here are some reasons:

Health of mother (food, exercise, prenatal vitamins, and illnesses)
How much alcohol is used at a time (a lot or a little)
What part of the baby is developing when alcohol is used
DNA (genetics) of mother and father
Depression, stress, violence, poverty, or trauma
Where she lives, learns, works, and socializes (social determinants of health)

Working together for success for children with FASD (protective factors)

Protective factors for children with FASD include:

diagnosis before 6 years of age
loving, nurturing, and unchanging home with no violence
getting help from special education and social services when needed
building on strengths of the child

Faith – Ability – Strength – Determination (Myles Himmelreich)

Myles Himmelreich, a motivational speaker with FASD, gives another view of FASD: Faith, Ability, Strength, and Determination. When raising awareness of FASD, it is better to talk about strengths and challenges. This helps to understand needs and how to provide help. Focusing on problems builds stigma for people with FASD and their families.

Most mothers of children with FASD want to help their children get help. Families that have supports tend to do better. Secondary challenges can be prevented if an individual’s primary disabilities are well supported. Recommendations for supports work best when they consider the child’s specific needs and they line up with the supports that are available in the community.

FASD and the brain

The brain is continually changing and adapting. This is called neuroplasticity. Although areas of the brain may be affected before birth, the brain has an amazing way of working around this. When the brain is affected by alcohol prenatally, it may not work the way that it might have worked if it wasn’t exposed. It may take a lot of practice to learn something in a different way, but the brain can learn new ways of working.

Research is providing hope that effective therapies can have a positive impact on the brain damage caused by prenatal exposure to alcohol.

Alcohol can make changes in fetal development

During pregnancy, alcohol can affect any part of the baby’s developing body. This includes the brain. The brain develops for all 9 months of pregnancy. Alcohol’s effects to the brain and body can happen before a woman knows she is pregnant.

When alcohol affects the brain, it can make a child’s growing and learning harder. Alcohol can cause challenges with:

motor skills
brain structure and functioning
thinking, reasoning, and understanding
language
achieving educational goals
memory
attention
executive function (ability to plan, pay attention, remember instructions, and manage many tasks), impulse control, and hyperactivity
affect regulation (ability to change emotions to meet the demands of the environment), including anxiety, depression, and mood dysregulation (severe and frequent outbursts with change of mood between the outbursts)
adaptive behaviour (ability to change behaviour to get along with others), social skills, or social communication

Other parts of the baby that are developing when alcohol is used can be affected. There may be problems with:

hearing
seeing
sleeping
feeding
heart, kidneys, bones

Reducing harm

It is never too late to reduce harm by quitting drinking or cutting back on drinking. It is not easy to stop drinking if it is a habit or a dependency. Working on changes before pregnancy can make it easier. When a partner, family, and friends are supportive, it is not as difficult to make changes. Healthcare professionals and counsellors can also help.

What if an unborn baby has been exposed to alcohol?

If a baby has been prenatally exposed to alcohol, talking to a healthcare provider and watching for any physical or developmental challenges can help protect the baby. Putting early supports in place, getting a diagnosis when the time is right, and supporting the family may help prevent some secondary challenges.

How much alcohol is safe to use in pregnancy?

Science shows that alcohol use in pregnancy can affect the unborn baby. There is not enough evidence to show a safe amount of alcohol use. The safest choice is no alcohol.

Ideas for women to help have a healthy baby

Take prenatal vitamins before and during pregnancy. They help keep you and your baby healthy.
Use birth control that works well if you are having sex and do not want a baby now.
If you and your partner think you might be pregnant, get a pregnancy test. Do your best to not use alcohol until you know you are not pregnant.
If you are pregnant, do your best to not use alcohol.
Partners, family, and friends can support women to be healthy.

For help, talk to:

a doctor, nurse, or health centre
Saskatchewan HealthLine at 811
addictions services where you live
someone who you trust

These people are here to support everyone’s health: mothers, fathers, and babies.

For more information:

Science shows that alcohol use in pregnancy can affect the unborn baby. There is not enough evidence to show a safe amount of alcohol use. The safest choice is no alcohol.