Identifying Use of Alcohol and Other Substances During Pregnancy – a Nordic Overview
In this research report, the Nordic Welfare Centre gives an overview of the use of alcohol, tobacco and other substances among pregnant women in the Nordic countries and describes the consequences of prenatal exposure for the fetus.
Exposure to alcohol and/or other substances during pregnancy is a major risk to the development of the fetus. From the unborn child’s perspective, only zero consumption is risk-free. The consequences of prenatal exposure to alcohol and/or other substances can be lifelong, and the exposure may harm several developmental domains of these children. Preventing the harm early on is also important from the society’s perspective, as the negative consequences can lead to significant societal costs. The negative consequences of the use of alcohol and/or other substances during pregnancy should be a more integrated part of the school curriculum and discussed with everyone from an early stage. Moreover, it should be a general part of the training of healthcare professionals, because they have a crucial role in identifying potential use among pregnant women.
This report has briefly described the antenatal care system in each of the Nordic countries, how the use of alcohol, in particular, is identified, and by which screening instruments. The aim has been to describe the screening instruments available and used in the Nordic countries. The country profiles can help to learn from other countries’ practices and to reflect on one’s own practices in relation to other Nordic countries.
All the Nordic health authorities recommend total abstinence from alcohol and/or other substances during pregnancy. It is important to send a clear message that only zero consumption is risk-free in order to avoid spreading confusing information among pregnant women, healthcare professionals, and the general population.
The prevalence estimates of alcohol use among pregnant women presented in the report indicate that there might be differences between the countries. However, this report is not able to answer why such differences might exist or what could explain the differences, but future Nordic research collaboration could address the underlying reasons for the potential differences.
What is also needed are prevalence studies of FASD/FAS in the Nordic countries to help better understand how many are affected and to appreciate the size of the problem. However, if there is a lack of knowledge to diagnose FASD/FAS, it is difficult to conduct prevalence studies. Without prevalence studies, the scale of the problem cannot be known, and without knowing the size of the problem it is difficult to influence the political level to get the right support and funding. Without the right support for the affected population group, it can lead to stigmatizing of people with FASD/FAS. If no support is available, it is difficult to help the affected individuals and to ensure better interventions targeting alcohol use during pregnancy.
These questions require more attention to secure a healthy alcohol free pregnancy and to support the affected individuals. The authors conclude that, prenatal exposure to alcohol is a blind spot and needs to be put under the spotlight.