Drowning our sorrows: clinical and ethical considerations of termination in alcohol-affected pregnancy

Martin, Roger; Bruxner, George; Ng, Gary; Brewster, C.; Kothari, Alka

doi:10.1186/s12884-020-03012-9

Cited by 3 publications

(3 citation statements)

References 40 publications

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“…154 Most recently, the articles published in this sec tion emphasized that there is still work to be done to raise awareness of FASD and alcoholrelated harms, particularly among healthcare providers, to further prompt efforts to screen and provide brief interven tions that are nonjudgmental and that promote alcohol reduction and social support. 143 Further, pub lications reinforced the continued need to situate alcohol use during pregnancy in women's socioeco nomic and structural contexts. Authors note that pre conception health efforts need to be more expansive to integrate partners and communities, recognizing their influential role in preconception health.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, an additional category was established to account for shifting trends in the literature that addressed philosophical and systemic issues that intersect with FASD prevention. Research on sys temic, destigmatizing, and ethical considerations included topics such as national and international costs associated with FASD, 139,140 social justice, 141 and ethical considerations, 142,143 the need for com munitybased FASD prevention strategies, 144,145 and data harmonization and advocacy for a standard measure for alcohol consumption. 146 In 2016, articles were published with a greater emphasis on ethical and legal issues.…”

Section: Systemic Destigmatizing and Ethical Considerationsmentioning

confidence: 99%

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At a Juncture: Exploring Patterns and Trends in FASD Prevention Research from 2015 – 2021 Using the Four-Part Model of Prevention

Wolfson

Poole

Harding

et al. 2022

Journal of Fetal Alcohol Spectrum Disorder

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Background and Objective: FASD prevention efforts have been expanded in the last 25 years to go beyond the moral panic that guided early public awareness campaigns and policy responses. In Canada, a Four-Part Model of FASD Prevention has been developed and used that describes a continuum of multi-sectoral efforts for women, girls, children, and their support networks, including broad awareness campaigns, safe and respectful conversations around pregnancy and alcohol use, and holistic and wraparound support services for pregnant and postpartum women with alcohol and other health and social concerns. The purpose of this article is to describe the state of the evidence on FASD prevention from 2015 – 2021, including the prevalence and influences on alcohol use during pregnancy, interventions at each of the four levels of the Four-Part Model, as well as systemic, destigmatizing, and ethical considerations. Materials and Methods: Using EBSCO Host, seven academic databases were annually searched for articles related to FASD prevention from 2015 – 2021. English language articles were screened for relevance to alcohol use in pregnancy and FASD prevention. Using outlined procedures for thematic analysis, the findings were categorized within the following key themes: prevalence and influences on women’s drinking; Level 1 prevention; Level 2 prevention; Level 3 prevention; Level 4 prevention; and systemic, destigmatizing, and ethical considerations. Results: From January 2015 – December 2020 n = 532 articles were identified that addressed the prevalence and influences on alcohol use during pregnancy, interventions at each of the four levels, and systemic, destigmatizing, and ethical considerations. The most recent research on FASD prevention published in English was generated in the United States (US; n = 216, 40.6%), Canada (n = 91, 17.1%), the United Kingdom (UK; n = 60, 11.3%), and Australia (n = 58, 10.9%). However, there was an increase in studies published from other countries over the last six years. The literature heavily focused on prevalence and influences on alcohol use during pregnancy (n = 182, 34.2%), with an increase of prevalence research from countries outside of Canada, the US, Australia, and the UK, and on Level 2 prevention efforts (n = 174, 32.7%), specifically around the efficacy and implementation of brief interventions. Across Level 1 and Level 2 prevention efforts, there was an increase in literature published on the role of technology in supporting health promotion, education, screening, and brief interventions. Attention to Levels 3 and 4 demonstrated nuanced multi-service, trauma-informed, relational, and holistic approaches to supporting women and their children. However, efforts are needed to address stigma, which acted as a systemic barrier to care across each level of prevention. Conclusion: Research and practice on FASD prevention has continued to expand. Through our generated deductive themes, this review synthesized the findings and demonstrated how the work on FASD prevention has been amplified in recent years and how efforts to support women and children’s health are complex and interconnected. The findings highlight opportunities for prevention through research and evidence-informed policy and practice.

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Section: Discussionmentioning

confidence: 99%

Section: Systemic Destigmatizing and Ethical Considerationsmentioning

confidence: 99%

At a Juncture: Exploring Patterns and Trends in FASD Prevention Research from 2015 – 2021 Using the Four-Part Model of Prevention

Wolfson

Poole

Harding

et al. 2022

Journal of Fetal Alcohol Spectrum Disorder

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“…As AUDs are associated with neurobiological adaptations that reduce an individual’s cognitive control, clinicians must be non-judgmental, non-directive, and private [ 37 , 38 ]. Empathy and mutual respect are also important as previous research has found a positive association between these factors and recovery from substance abuse among pregnant women [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Alcohol Use Disorders and Increased Risk of Adverse Birth Complications and Outcomes: An 11-Year Nationwide Cohort Study

Jee

Park

et al. 2020

IJERPH

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For women who suffer from Alcohol Use Disorders (AUDs), the use of alcohol before and/or during pregnancy may result in various birth complications, including miscarriage, stillbirth, or preterm delivery. Thus, this study aimed to explore whether Alcohol Use Disorders (AUDs) are associated with increased risk of adverse birth complications and outcomes. A total of 76,799 deliveries between 2003 and 2013 in the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC) were analyzed. Women with an AUD diagnosis preceding delivery were identified as individuals with alcohol dependence. A multivariate Cox proportional hazards model was used to estimate the hazard ratio of adverse birth complications and outcomes associated with alcohol dependence. Diagnosis of an AUD was associated with increased risk of adverse birth complications (Hazard Ratio [HR]: 1.15, 95% CI: 1.01–1.31, p = 0.0302). This was especially the case for women whose AUD diagnosis was in the same year as their delivery (HR: 1.53, 95% CI: 1.24–1.88, p < 0.0001). AUDs were associated with increased risk of adverse birth outcomes, especially when prevalent in the same year as a woman’s delivery. Our study confirms that the monitoring of expecting women with a diagnosis of alcohol-related problems may be useful in preventing adverse birth complications.

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Beyond the bump: ethical and legal considerations for psychologists providing services to pregnant individuals who use substances

Maralit

2022

Ethics & Behavior

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Drowning our sorrows: clinical and ethical considerations of termination in alcohol-affected pregnancy

Cited by 3 publications

References 40 publications

At a Juncture: Exploring Patterns and Trends in FASD Prevention Research from 2015 – 2021 Using the Four-Part Model of Prevention

At a Juncture: Exploring Patterns and Trends in FASD Prevention Research from 2015 – 2021 Using the Four-Part Model of Prevention

Alcohol Use Disorders and Increased Risk of Adverse Birth Complications and Outcomes: An 11-Year Nationwide Cohort Study

Beyond the bump: ethical and legal considerations for psychologists providing services to pregnant individuals who use substances

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