2 July 2019
GPs are often the first health professional a woman goes to when she is either planning a pregnancy or thinks she may be pregnant. Because of this, GPs have an important role in providing the best possible information for women to have a healthy pregnancy and healthy baby. It is crucial that GPs ask every woman about alcohol use during pregnancy in a non-judgemental manner and advise then of the risks of drinking alcohol during pregnancy. It is important that any alcohol use before and after confirmation of pregnancy is recorded.
In partnership with the Western Australian Primary Healthy Alliance, researchers from the Telethon Kids Institute have developed three short videos aimed at informing GPs of the importance of asking all pregnant women and women planning a pregnancy about their alcohol use. Topics covered in the videos include; ‘Alcohol and pregnancy: It’s everybody’s business’, ‘Asking questions about alcohol in pregnancy’ and ‘Recording Alcohol use in pregnancy’.
Australian research has reported most women of child-bearing age want their health professionals to ask them about alcohol use in pregnancy, and to advise them that not drinking alcohol is the safest choice.
Information about the risks of alcohol use during pregnancy is important advice which should be part of the general conversation with pregnant women about doing everything they can to have a healthy pregnancy and healthy baby. If you ask about smoking, why not alcohol?
Why ask about alcohol?
Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term for severe neurodevelopmental impairments that result from alcohol exposure during pregnancy. It is a condition that has significant impacts on individuals, their families, caregivers and the wider community. There is a common misconception that only women from low socio-economic or remote areas drink alcohol during pregnancy. The truth is that women of all ages, all socio-economic status, every ethnicity and from all parts of Australia may consume alcohol at different times during their pregnancy.
Australian research has found that in mainstream public antenatal care, higher income and tertiary educated women were 2-4 times more likely to drink alcohol throughout pregnancy than women with only secondary school education. The data also highlights that 50 per cent of pregnancies are unplanned and that almost 50 per cent of Australian women report consuming alcohol while pregnant, before knowing they are pregnant and 25% continue to drink alcohol after knowing they were pregnant.
Because the liver of the developing baby is not fully formed until late in pregnancy, the baby has the same, or possibly even higher blood alcohol content as the mother and it remains at that level longer.
Don’t assume that women are aware of the risks of drinking alcohol during pregnancy.
It is critical that alcohol use before and after confirmation of pregnancy is recorded.
FASD can potentially be seen in every practice and GPs should also be aware that children with prenatal alcohol exposure or FASD may present with ‘other’ neurodevelopmental, behavioural or mental health problems. FASD often co-occurs with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder, however it is also frequently misdiagnosed as Autism and ADHD.
The timing, frequency and quantity of alcohol exposure are all linked to the severity of FASD. Facial features are strongly associated with a diagnosis of FASD, however less than one third of all diagnosed cases have any of the sentinel facial features.
What can GPs do?
For GPs it involves five easy steps when consulting with pregnant women or women planning a pregnancy.
Every GP needs to:
- Ask – the question about alcohol use
- Assess – alcohol use (Using AUDIT-C)
- Advise – about the risks and recommendation that no alcohol in pregnancy is the safest option
- Assist – women to stop or reduce alcohol consumption through positive reinforcement
- Arrange – for further support if required
These videos and a promotional card and other resources are available on the FASD Hub website.