In response to this year’s Women’s Health Month in May, FASD United wants to flip the script on prenatal alcohol exposure. We often hear messages that suggest that prenatal alcohol exposure (PAE) and FASD are the responsibility of women during pregnancy. In fact, men and partners have a crucial role to play as well. PAE and FASD are also the responsibility of doctors and systems of care. 

Of course, we need to be discussing FASD in pregnancy, planning, and prenatal health. But FASD needs to be talked about before, during, after, and outside pregnancy conversations. 

1. FASD is not solely a maternal-child health issue.  

• FASD does not affect only infants and young children. While most people are diagnosed with FASD between 8 months and 8 years of age, many people have been diagnosed much later into adolescence and adulthood. 
• Adults with FASD will likely require services and support, especially through life transitions. This can include mental health and medical services, occupational therapy, or caregiver services. It is important to support adults by carrying conversations about FASD past pregnancy and child development. 
• Taking a public health perspective on FASD allows us to shift focus from the pregnant person to the larger issue of social determinants of health. People who were given misinformation about alcohol consumption during pregnancy or pregnant individuals who drank before recognition of pregnancy are often less likely to screen their children for FASD. This is exacerbated by societal stigma regarding alcohol and the stigma towards people living with FASD. 

2. Fathers and male pregnancy partners play an important role when it comes to PAE.   

• Recent studies are showing that the father’s alcohol use prior to pregnancy can impact fetal development.  
• Paternal alcohol use has been shown to increase the risk of a range of health conditions in offspring, as well as negatively impacting fertility.   
• Fathers and partners play a crucial role in preventing PAE by supporting the pregnant person to have a healthy lifestyle and avoid alcohol and other substances.  One way a partner can help is by avoiding alcohol themselves. 

3. Screening for FASD occurs disproportionately in child welfare systems. 

• FASD can be found cross-culturally, in all geographic areas. There may be limited contact between people caring for a child and the birth mother. We must share resources and education on FASD that impacts those with the disability, even if they do not have access to the medical history of a birth parent. 
• When a pregnant person has a substance use disorder (SUD) and their child is moved into the foster care or child welfare system, they are more likely to be screened for developmental and neurobehavioral disabilities that may come as a result of consumption during pregnancy.  
• We must improve screening tools and encourage universal screening to identify those with FASD and prenatal alcohol exposure earlier in their lives. This way, accurate services are available sooner, improving the quality of life for those living with the disability and those supporting them. This includes birth mothers, foster, kinship, and adoptive families.  

4. Since not all people who become pregnant identify as women, it is important that trans and gender-nonconforming people have access to pregnancy planning education.  

5. Systems of care have a responsibility to be FASD-informed.  

• The responsibility to ensure healthy pregnancies should not fall on women and pregnant people alone but should include systems of care providing accurate information and equitable support and resources.  
• To be FASD-informed, systems need to know about FASD and be able to refer people to evidence-based services that are designed specifically for people with FASD.  Systems should make accommodations for people with FASD and use non-stigmatizing and inclusive language. 
• We can educate systems about how to be FASD-informed through training and awareness activities.   
• Systems that need to be FASD-informed include the criminal justice system, the healthcare system, the child welfare system, the education system, among many others. 

Give FASD a seat at the table and ask questions that widen the lens. Women’s health is just one of the many tables where FASD and prenatal alcohol exposure should not only have a seat, but inform decisions. We all have a role to play in the awareness and education of FASD.  

Ask:  

• Are medical professionals engaging in universal screening for alcohol use?  
• Do pregnant people from all backgrounds have access to substance use treatment?  
• Can families afford healthcare? 
• Do families feel supported by their providers and community in their pregnancy journeys?