Alcohol consumption by a woman during pregnancy can lead to severe congenital disabilities in the baby and developmental limitation. Fetal Alcohol Syndrome (FAS) is a condition that occurs in the fetus or newborn due to intrauterine exposure to ethanol when the mother drinks alcohol during pregnancy (Abel, 2020). FAS is characterized by a group of irreversible congenital disabilities, including abnormalities in physical and mental development and behavioral disorders of varying severity (Abel, 2020). Fetal Alcohol Spectrum Disorders (FASD) is a term used to refer to a range of conditions associated with intrauterine exposure to alcohol on the fetus (Passmore et al., 2018). These disorders include FAS, partial FAS, neurodevelopmental disorders, and alcohol-related congenital disabilities (Passmore et al., 2018). Therefore, there are various types of alcohol syndromes which might negatively affect pregnant woman’s state of health.
FAS is a variant of slowed growth and development, both mental and physical, with defects in the skull, face, limbs, and cardiovascular system, found in some children whose mothers consumed alcohol during pregnancy in an amount that can be classified as dangerous. The most typical anomalies are prenatal and postnatal developmental defects including:
- Developmental delay
- Mental retardation
- Shortened eye slits
- Short upturned nose with a hanging nose bridge and thin upper lip
- Abnormal folds in the palm
The literature describes various neurological, mental, cardiovascular, gastrointestinal, metabolic disorders, defects in skeletal development, and visual and hearing impairments inherent in children with FAS and FASD.
Women who continue to consume alcohol during pregnancy should be targeted by the primary and most effective measures to completely stop liquor consumption, such as establishing a trusting relationship with a medical or social worker, a psychologist who can further assist the woman in reducing the risks of FAS formation and terminating alcohol usage. A professional is responsible for organizing several sessions of motivational counseling aimed at making a woman aware of the need to stop drinking; conflict-free contact that a complete rejection of alcohol increases the likelihood of having a healthy child; notifying that the drinking increases the chances of adverse pregnancy and childbirth outcomes. Social worker apprises about the direct harm of ethanol to the health of the unborn child, informs about the adverse health and social consequences of alcohol consumption, creates discussion of the results of analyzes and examinations in a form accessible to female; involving, with the consent of a person in preventive work. Pregnant women who drink alcohol can be supported both in health care organizations and crisis centers.
It is advisable to teach the skills of preventing FAS to any staff and volunteers of public organizations, which can be contacted by expectant girl on a wide range of issues. It should be noted that enceinte female are reluctant to discuss alcohol use with obstetricians-gynecologists or social workers due to fear negative attitudes and stigmatization. Therefore, preventive measures should be implemented in the most trusting format of communication. When identifying alcohol consumption by a pregnant woman, the specialist is recommended to motivate the girl to stop drinking alcohol during pregnancy and lactation, avoiding confrontation and value judgments (Abel, 2020). If a pregnant woman has consumed alcohol and has developed FAS, early diagnosis and timely treatment can significantly correct the child’s mental disorders and behavioral conditions. Alleviating the degree of cerebral and cognitive impairments in children with FAS is possible in the context of a competent organization of the medical and rehabilitation process, psychological and pedagogical support, inclusion in specialized personalized training programs, and psycho-correctional measures. Only active rehabilitation work with the involvement of various medical, psychological, and social specialists helps increase the level of mental development and social adaptation of children with FASD, reduces the risk of progressing secondary disorders in the form of a tendency to antisocial behavior, tort, alcohol and drug abuse.
To assess the risk level, it is necessary to record all alcohol consumed during the day, with further recalculation to pure ethanol. It should be borne in mind that in most cases, there is no need to calculate the number of consumed standard servings of alcohol with excessive accuracy, especially during the initial conversation. First of all, the priority is to determine the pattern of alcohol consumption by the respondents and to understand to what level of risk such drinking can be attributed (Shabtai & Fainsod, 2018). If a repeated meeting or consultation is planned, the applicant should learn to determine the alcohol content in the drinks consumed or record the amount of liquor. The most effective way is to keep an “alcohol diary” where a person should note how much and what drinks an individual has drunk.
Conversion to standard servings of alcohol can be done either independently or later with a doctor or other specialist’s help. It is the “alcohol diary” that is the most reliable way to assess the situation and observe the level of progress in the presence of motivation to change the situation with alcohol consumption (May et al., 2018). Currently, the WHO recommends using the AUDIT test (Alcohol Use Disorders Identification Test) for the early detection of alcohol-related problems (Sanchez-Roige et al., 2019). The AUDIT test is a structured interview of 10 questions, consisting of three sections: the first three questions characterize the frequency and dose of alcohol consumed, questions 4 to 6 reveal the presence of symptoms of alcohol dependence, the last four questions are focused on identifying various types of problems associated with alcohol abuse (Sanchez-Roige et al., 2019). The purpose of screening using the AUDIT test is an objective assessment by the doctor of the level and pattern of alcohol consumption of the subject and providing the latter with recommendations following the results. The test questions should be asked by a trained person, providing explanations if necessary.
Motivational counseling in the format of an educational seminar on the prevention of FAS is a short-term preventive intervention aimed at reducing alcohol consumption by young girls and women. The purpose of motivational counseling is to target women at risk, which stimulates them to change. Motivational counseling can impact changing a woman’s problem behavior, which can be both a cause and a consequence of alcohol consumption. For example, disharmonious family relationships can contribute to the onset of alcohol use by a girl, followed by other adverse health and social consequences. On the other hand, the start of alcohol abuse by a woman can worsen marital and partner relationships and cause conflict relationships with other members of her family. Screening and motivational counseling of women drinking alcohol is a critical practical skill that trainees should master in mastering this topic, which can be useful and help avoid the need for treatment in the future. Motivating women planning pregnancy and pregnant women to stop drinking alcohol altogether will prevent FAS development in a child and serve as a factor in protecting the woman’s reproductive health, which affects the successful outcome of childbirth.
Abel, E. L. (2020). Fetal alcohol syndrome: From mechanism to prevention. CRC Press.
May, P. A. et al. (2018). Prevalence of fetal alcohol spectrum disorders in 4 US communities. JAMA, 319(5), 474-482. Web.
Passmore, H. M., Mutch, R. C., Burns, S., Watkins, R., Carapetis, J., Hall, G., & Bower, C. (2018). Fetal alcohol spectrum disorder (FASD): Knowledge, attitudes, experiences and practices of the Western Australian youth custodial workforce. International Journal of Law and Psychiatry, 59, 44-52. Web.
Sanchez-Roige, S., Palmer, A. A., Fontanillas, P., Elson, S. L., 23andMe Research Team, the Substance Use Disorder Working Group of the Psychiatric Genomics Consortium, Adams, M. J., Clarke, T. K. (2019). Genome-wide association study meta-analysis of the Alcohol Use Disorders Identification Test (AUDIT) in two population-based cohorts. American Journal of Psychiatry, 176(2), 107-118. Web.
Shabtai, Y., & Fainsod, A. (2018). Competition between ethanol clearance and retinoic acid biosynthesis in the induction of fetal alcohol syndrome. Biochemistry and Cell Biology, 96(2), 148-160. Web.