Fetal Alcohol Spectrum Disorder Information Dissemination By Health Care Professionals: Implications for Social Work

Background and Purpose: Fetal Alcohol Spectrum Disorder (FASD) is the leading preventable cause of intellectual and developmental disabilities. It has been reported that up to 7.6% of women continue to consume some level of alcohol during pregnancy with 1.4% participating in binge drinking of 4 or more drinks at least once during their pregnancy. While efforts are made to better understand the biological implications of prenatal alcohol exposure, it is vital that women receive consistent messaging around alcohol use during pregnancy to lower the incidence of these occurrences. Therefore, the role of health care professionals in FASD prevention is critical. This study investigated health care professionals’ knowledge and attitudes toward FASDs. The study posed two research questions: 1) Is the message of the dangers of alcohol consumption during pregnancy getting out on a consistent basis across professions? 2) What are the obstacles to discussing alcohol use with clients?

Methods: The data used for this study were based on the survey of various health care professionals (N=460) collected by The Arc of the United States in 2014 as part of their FASD Prevention Project funded by Health Resources and Services Administration. Logistic regression was used for the first research question. The dependent variable was health care professionals’ perception toward alcohol use during pregnancy. Independent variables included the types of profession (e.g., physician, registered nurse, midwife, and counselor), the types of employment site (e.g., clinic, hospital, Indian health center), and whether a person is responsible for educating and screening clients about their alcohol use. Descriptive statistics were used for the second question.   

Results: Findings indicated that overall, health care professionals appear to be providing appropriate information to their patients/clients to avoid the potential for FASDs; however, a few exceptions did exist. Physicians and midwives were not as consistent as other professions, such as registered nurses and mental health and substance use abuse counselors, in recommending total abstinence from alcohol during pregnancy. This was especially true during the third trimester when physicians are 3.2 times more likely (p=0.001) and midwives are 2.5 times more likely (p=0.009) to think than other professions that some amount of alcohol was safe. The most frequently reported obstacles to discussing alcohol use with clients were clients’ denial of alcohol use followed by time constraints.

Conclusions and Implications: It is imperative for health care professionals to deliver accurate and consistent messages that no alcohol consumption during pregnancy at any time provides the best way to prevent FASDs. The findings have implications for social workers at a number of intervention points as they can assist in reinforcing the correct message. Recognizing that health care professionals continue to provide contradictory messages despite clear evidence that alcohol consumption during pregnancy is highly risky, social workers are in unique position to provide education and prevention services. Social workers have access to a wide array of individuals in their childbearing years. Therefore, they have better opportunities to reach out to these most vulnerable from the continued consumption of alcohol and other substances during pregnancy.