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Midwives join fight against FASD

Strong support and high demand has led to the early release of an Institute-developed learning package designed to empower midwives to tackle FASD.

Strong support and high demand has led to the early release of an Institute-developed learning package designed to empower midwives to tackle Fetal Alcohol Spectrum Disorder by warning against and screening for alcohol use in pregnancy.

Circulated State-wide by the WA Department of Health, the modules are aimed at upskilling midwives in using the AUDIT-C alcohol risk screening tool and ensuring it is conducted three times as a routine part of pregnancy care, together with brief educational interventions.

“The reason we ask midwives to do that is, although a woman might start out with the intention of not drinking in pregnancy, this may change over the course of time,” senior research fellow Dr Tracy Reibel said.

“Alcohol is a cheap, readily available drug and may be used by women if their life circumstances change or if they don't understand the implications of alcohol use in pregnancy."

“It is also really important that special occasion drinking is recorded – such as a few glasses of champagne at a wedding or birthday."

“If down the track there are concerns regarding a child’s developmental delay and the question is asked ‘Was there any alcohol consumption in pregnancy?’, the woman may have forgotten by the time her child is three, six or 12. But if there is an AUDIT-C score in her medical records, we can either include or dismiss prenatal alcohol exposure as a possible cause.”

What's next?

Modifying the learning package for use in the Northern Territory and advocacy to make the package available in other jurisdictions.

What is AUDIT-C?

AUDIT-C is a three question alcohol risk screening tool suitable for use with pregnant women. Each question is scored relevant to the answer given, leading to a total score. The total score indicates whether a woman’s alcohol use risk profile is low, medium, or high.
It is recommended the AUDIT-C tool is used three times during pregnancy to identify any changes in a woman’s use of alcohol. Importantly, AUDIT-C is a means of starting a conversation with a woman about the impact of alcohol on baby’s development.

Damage from alcohol

  • Fetal Alcohol Spectrum Disorder (FASD) includes neurodevelopmental and/or physiological damage from a child's exposure to alcohol during pregnancy. Disabilities are lifelong and may not be seen at birth.
  • May result in delayed development, social, behavioural and learning problems. These can lead to poor school performance, unemployment, substance abuse, mental health problems and early engagement with the justice system.
  • The placenta cannot keep harmful substances such as alcohol away from the fetus. The National Health and Medical Research Council of Australia advises women who are planning a pregnancy, are pregnant or breastfeeding that 'no alcohol is the safest choice'.