Reducing harms related to alcohol use in pregnancy: policy and practice recommendations
The widespread use of alcohol during pregnancy is a significant public health concern in Australia. Prenatal exposure to alcohol, caused by maternal alcohol use in pregnancy, increases the risk of miscarriage, stillbirth, and FASD. Individuals living with FASD experience lifelong neurodevelopmental impairments across a range of areas, and are at increased risk of secondary disabilities, including mental illness, disengagement from education and the workforce, and contact with the justice system.
Despite National Health and Medical Research Council (NHMRC) Alcohol Guidelines recommending alcohol abstinence as the safest option for women who are pregnant, planning a pregnancy, or breastfeeding, alcohol use in pregnancy in Australia is amongst the highest in OECD countries. Prevalence studies demonstrate that rates of FASD are extremely high in some sub-populations in Australia. Australian policymakers are therefore faced with both the challenge and the opportunity to reduce the burden associated with antenatal alcohol use in pregnancy through comprehensive and coordinated prevention approaches.
Major barriers to the prevention of PAE and FASD include a lack of public awareness of the Alcohol Guidelines and the risks associated with PAE, as well as limitations in antenatal alcohol screening and data collection. With the NHMRC Guidelines currently under review and the National Alcohol Strategy and FASD Strategic Action Plan in development, it is timely to consider how health sector policy and practice can be effectively used to address antenatal alcohol use in Australia. A co-ordinated and multi-level prevention approach is recommended.