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Alcohol use before and during pregnancy

November 25, 2015

Alcohol consumption has many negative consequences for individuals who drink but can also have permanent effects on others associated with them. A dramatic example of the second hand effects of alcohol is Fetal Alcohol Spectrum Disorder (FASD), which includes permanent brain damage caused by maternal alcohol use during pregnancy.  FASD is an umbrella term describing the range of effects that can occur in an individual whose birth parent drank alcohol during pregnancy.  It is the leading cause of a wide range of neurodevelopmental impacts such as physical, cognitive, behavioural, social and developmental disabilities among children in Canada. There is no cure for FASD, and for the majority of individuals it is an invisible disability.  While the extent of brain damage is often not reflected by any outward physical features, individuals are faced with significant challenges because of this damage.

The incidence of FASD is estimated at 9 per 1,000 live births (PHAC 2005).  A recent Government of Ontario report found that one in one hundred Canadians is affected by FASD, meaning over 130,000 Ontarians are living with FASD. (2015)
FASD cost Canada $1.8 billion in 2013. This conservative estimate of the overall burden and costs was reported in a recent study by the Centre for Addiction and Mental Health entitled The Burden and Economic Impact of Fetal Alcohol Spectrum Disorder in Canada (2015).  FASD is 100% preventable by avoiding alcohol use during pregnancy and by encouraging women to limit alcohol consumption during their reproductive years.

However, there are many reasons why a woman may drink during pregnancy including inconsistent messages related to the risks of alcohol use during pregnancy, the fact that 50% of pregnancies are unplanned, and that more women are drinking during their childbearing years.  Other reasons can include mental health issues, substance abuse and addictions.  The social environment can also influence a woman’s alcohol consumption e.g. alcohol availability, cost and access to cheap alcohol, and marketing and promotion targeting women. 

The OPHA Alcohol Work Group advocates for both broad and targeted evidence based alcohol policies and action.  At a population level, limits on alcohol availability, controls on marketing, and pricing policies can reduce overall consumption and prevent alcohol related harms including FASD. 

Along with the OPHA Reproductive Health Work Group, we applaud the recent FASD Provincial Roundtable Report from the Parliamentary Assistant to the Minister of Children and Youth Services which identified a number of targeted actions to create a supportive environment for FASD prevention.  Proposed actions include the development of a comprehensive FASD Strategy, awareness building strategies, campaigns to address stigma, and earlier diagnosis.    

Integrating broad alcohol policy with FASD prevention and awareness is critical.  OPHA along with a number of provincial partners is calling for a broad provincial alcohol strategy to reduce the harms and costs, coordinate action across Ministries, and demonstrate Ontario’s ongoing commitment to a socially responsible approach to alcohol.

·         Licit and Illicit Drug Use during Pregnancy: Maternal, Neonatal and Early Childhood Consequences:
·         Fetal Alcohol Spectrum Disorder (FASD): A Framework for Action:
·         The Burden and Economic Impact of Fetal Alcohol Spectrum Disorder in Canada
·         FASD Provincial Roundtable Report:
·         Health Canada (2006). It’s your health: Fetal alcohol spectrum disorder, Minister of Health. Retrieved from Health Canada website: Aug, 2nd, 2011.

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