Research states need of better support for pregnant women to prevent FASD

Foetal alcohol spectrum disorders (FASD) ̶ a group of conditions categorised by physical, mental and behavioural abnormalities, that occur as a consequence of prenatal alcohol exposure ̶ place a huge burden on our social, educational, health and even justice systems. Intervention strategies to prevent FASD should also address the socio-economic circumstances of pregnant women who drink, as well as the limited emotional support and mental health services.

This is according to Dr Marlene de Vries from the Department of Psychiatry at Stellenbosch University (SU). De Vries, who has been doing research on FASD in rural areas in the Western Cape since 2008, recently obtained her doctorate in Social Work at SU.

For her study, she interviewed women in the Langeberg Municipal area who had previously received FASD prevention services during pregnancy. She wanted to gain an in-depth understanding of the lives, circumstances and realities of these women, the factors that influenced their alcohol use during pregnancy, and what prevention strategies are needed to support a sober lifestyle during pregnancy.

De Vries says that over the years a lot of prevention work has been done in the communities where she and her colleagues have been working and, although it has had a positive influence on many women, the question why women drink despite knowing the negative influence on their unborn children, remained.

​“It is important to keep in mind that they do not drink to deliberately harm their babies. When you listen to these women’s stories, you hear their hardships, the difficulties they have endured and the role of drinking as an escape mechanism but also the main social activity in their lives.”

De Vries adds that none of the women in her this study completed their schooling. This left them vulnerable in the labour market and financially dependent.

“Some have carried their childhood trauma and loss into adulthood and suffer from depression without receiving any counselling or treatment. They live in communities where weekend binge-drinking is considered a normal and acceptable way of socialising. Often their extended families, partners and friends are heavy drinkers.

“Many women were abandoned by their partners, had partners who abused drugs and alcohol, assaulted them physically, and failed to support them financially and emotionally. This experience had a huge influence on the women’s drinking behaviour during pregnancy.”

De Vries says her research also showed that the support pregnant women received from social workers on the FASD research team had a positive impact on their lives.

“To some, it gave the courage and determination to stop drinking completely, while others felt that the non-judgemental support helped them survive their circumstances.”

Social workers are well positioned to not only provide such support to pregnant women, but also to inform and educate men and women from all age groups about FASD and the consequences of drinking during pregnancy, enabling people to make informed choices.

Recommendations

Given that South Africa has the highest recorded prevalence of FASD in the world and that children suffering from FASD carry it with them into adulthood, better support is needed for women who may have a higher risk of drinking during pregnancy, says De Vries.

She recommends mental health services and trauma counselling where needed, as well as support from social services, health professionals, law enforcement agencies and community groups for these women.

“Although FASD prevention and support services are available, they are fragmented by a lack of coordination, collaboration, and policy regarding FASD, and therefore failing those most in need of these services.

“We should not underestimate the role of mothers and grandmothers of pregnant women who are likely to drink alcohol. These women either lean heavily on their mothers for financial support or to care for their children.”

De Vries says that since the role of fathers in the prevention of FASD is still underplayed and neglected, there is a need for FASD prevention programmes focussing on men. Such programmes should emphasise the importance of emotional and financial support, the role of partners in the drinking behaviour of women during pregnancy and the devastating effects of domestic violence on the well-being of women and children.

She also emphasises the key role of social workers in the prevention of FASD.

​“Social workers should use the method of group work with adolescents with high-risk behaviour, foster children, foster parents, and parent-support groups to inform and educate communities about the risks, realities, and challenges of FASD. Peer support groups for pregnant women could be formed to create an environment where they feel more supported and understood.

“Parenting groups can be extended to include and educate grandmothers and extended family members about their role in supporting pregnant women and help them to stay away from alcohol.

Social workers should also collaborate with parents, schools, and the Department of Education to prevent children from dropping out of school and drinking at a young age.”

We also need closer cooperation between the Departments of Health and Social Development as well as a national policy to improve the availability and quality of services rendered for FASD prevention and intervention, concludes De Vries.