Blog post by Prof. Moira Plant, Emeritus Professor of Alcohol Studies at the University of West of England in Bristol, UK, Adjunct Professor at Curtin University Perth Australia, FASD Consultant to the Fetal Alcohol Advice and Support team (FAAST) at Edinburgh University and Co-opted member of SHAAP.
In this blog, Prof. Plant discusses the various work surrounding Fetal Alcohol Spectrum Disorder (FASD) in Scotland, including support available, training provided and the importance of government funding.
Fetal Alcohol Spectrum disorder (FASD) has been increasingly acknowledged in Scotland. Over the past few years, the Scottish Government is recognising this as a serious health issue for the Scottish population and have moved forward in recognising this lifelong condition. They should be praised for their continuing funding of organisations such as the FASD Hub, part of Adoption UK which provides tiered support for parents, carers and professionals and the Fetal Alcohol Advisory Support and Training (FAAST) team based in Edinburgh University which has a National remit for training, consultation and research. Continued government funding of both these organisations has put Scotland at the forefront internationally in this area. The Scottish Criminal Justice System is also working on raising awareness. All this is of vital importance given many countries which initially funded education, services and research in this area such as Canada and the USA are finding it increasingly difficult to continue their work. One other important aspect of how Scotland differs from many other countries is the development of the Scottish FASD Strategy Group. This forum includes many of the primary organisations and individuals in Scotland in the field of FASD and is designed to enable collaboration and sharing of expertise and resources with the aim of improving outcomes for individuals, of all ages, affected by FASD. This group includes representatives from the Scottish Government to enable timely communication.
The other organisation in Scotland which has made real moves forward in this area is the Queens Nursing Institute Scotland (QNIS) which recently carried out a survey of community nurses and other health professionals in Scotland. The survey showed that in general a high proportion of those who responded reported already discussing alcohol consumption in pregnancy. Not all respondents in this survey felt comfortable raising the issue of drinking but we now have some baseline information to measure against future research. Growing from this QNIS work is Healthier Pregnancies Better Lives (HPBL) with a goal of highlighting and developing pre-conceptual care. This is another venture with which the Scottish Government is in communication.
Having said all that there is still a long way to go. Awareness amongst the general population is growing but how many young women still hear “I drank when I was pregnant with you and you’re fine”? The fact that it takes two people to make one new person still seems unknown to some people! Men are involved from the very beginning.
It is time for Scotland to more fully embrace the idea of pre-conceptual care, giving advice about drinking when a woman is already pregnant may be too late. Prenatal alcohol exposure has its most negative impact in those first few weeks of pregnancy when many women do not even know they are pregnant. Maybe we need another name for pre-conceptual care? Maybe it sounds a bit too like the old term family planning? It’s about a healthy pregnancy but also about not getting pregnant unless you choose to.
We somehow need to send a message that is a positive one – making it more about choosing when to have or not have a child and planning for either of those outcomes. This is far more positive and affirming than where we are right now which is still “Don’t drink when you are pregnant”. That message is both negative and often too late.
A final thought – and an uncomfortable one for health professionals – having the right to choose does not mean women will choose the path that health professional thinks they should. Issues such as the morality of women and drinking, remain. Women’s rights are now recognised in Scotland and the UK in general. However. it’s rare to even acknowledge the possibility of issues such as maternal foetal conflict and sadly too often pregnant women are still seen as carriers of babies rather than people in their own right who can make decisions with which others may not agree.
SHAAP Blogposts are published with the permission of the authors. The views expressed are solely the authors’ own and do not necessarily represent the views of Scottish Health Action on Alcohol Problems (SHAAP).