The Prenatal Promise: The Challenges and Hope of an Alcohol Free Pregnancy

1. The Prenatal Promise:The Challenges and Hope of an Alcohol Free Pregnancy By the: Texas Officefor Preventionof Developmental Disabilities www.topdd.state.tx.us Staff: Janet Sharkis, Patricia Bailey, June Villarreal

2. True or false –fun quiz! • Alcohol exposure can be more damaging to a baby than drug exposure. • With the right support, children with FASD catch up to their peers. • Prenatal alcohol exposure is the leading cause of mental retardation in the United States. • FASD is as prevalent as Autism Spectrum Disorder. • FASD was identified 30 years ago. • FASD is more common among wealthier families. • Children with physical signs of FASD, such as their facial appearance, demonstrate the most behavioral issues. • Fewer than 10% of the people born with an FASD can live independently. • Most children with an FASD have an IQ within the normal range. • Children with an FASD are often misdiagnosed with Oppositional Defiant Disorder (ODD). • Alcohol passed through breastfeeding is not dangerous to the baby. • Approximately 1 out of 100 children have an FASD.

3. Some more data (just felt like I needed to give you more stats, sorry ) There is a lot of drinking going on among women of childbearing age* in Texas! 10.9% binge drink (more than 7 drinks on any occasion) 3.9% chronically drink At risk for binge/heavy drinking: large metro areas: 19.8 % Rural areas: 6.2% Some of them may be pregnant and don’t know it. * Childbearing age defined as 18-44 years.

4. We know that lots of pregnant women in TX are drinking One month before delivery, pregnant women admitted: • 9.3% alcohol use • 2.2% binge alcohol use • 1.1% admitted heavy use • In TX the number one reason women are admitted to treatment… Alcohol!

5. Another factor…unplanned pregnancies Although specific data on unplanned pregnancies is hard to come by, we can draw some conclusions: • Texas has the 5th highest teen pregnancy rate in the country. (mostly unplanned) • 70% of the pregnancies of college students in Texas are unplanned. • Texas ranks 38th in the nation on prenatal care (may partially be because so many don’t know they are pregnant.) If many women didn’t plan to be pregnant and didn’t know They were pregnant, they wouldn’t have felt the need to take any special precautions related to their health or diet. There is no reason to believe that they aren’t drinking as usual.

6. A perfect storm in Texas Social messages and norms:

7. Option 1: The Conversation I often start these conversations with • An affirmation about the client and then: • An “I was surprised to learn” statement. With the affirmation statement, I try to find something specific about the client… or about the hopes and dreams the individual has about her family and her life. Then the “I was surprised to learn” statement is a way of leveling the playing field with the client and sharing a piece of information about alcohol and child development.

8. Practice Break up into small groups and just work on the first 2 pieces, an affirmation and the bridge statement, which for me is the surprise statement. If you have other ways of beginning the Conversation, you can use them and share!

9. Option 2: The 4 Ps: Parents, Partners, Past and Present Developed by Dr. Ira Chasnoff • Did either of your parents have any problems with alcohol or drugs? • Does your partner have any problems with drugs or alcohol? • Have you ever drunk beer, wine, liquor? (past) • In the month before you knew you were pregnant, did you smoke cigarettes? (present) • In the month before you had any idea you were pregnant, did you drink? (pregnancy)

10. Option 3: Comparison of Drinking High risk= More than 7 drinks per week or more than 3 drinks in a day. Low risk= No more than 7 drinks per week and no more than 3 drinks in a day. Drinking Comparison Note that this chart is for the general population, not pregnant women.

11. Discussion: • health of your child Not Important Very Important

12. More discussion • Your health in relation to your child, baby, unborn child… Not Important Very important

13. How its going… Taking care of my health Not taking care of my health Define together all of what taking care of health means: mental health, positive relationships, eating, sleeping habits, reproductive health, substance use-alcohol, tobacco, other drugs, exercise.

14. The Peacock Challenge: Taking stock • I take pride that I am doing ___ for my health. • I take pride in avoiding these things _____ that can hurt my health. • I can make my health and my baby healthier by _________________.

15. Are you ready? To improve your health (and the health of your baby) ? I am working on it. Not now I am committed to it. Okay, I am thinking about it I am planning on it.

16. What you see Throws fits Breaks rules Learning problems Doesn’t sit still Lying Why its happening Constantly frustrated Can’t remember rules, can’t generalize from one situation to another, can’t understand underlying concept Unable to interpret instructions, retain information, understand cause and effect, deal with abstract concepts. Experiencing sensory overload, neurologically based need to move while learning. Doesn’t recall, can’t sequence, trying to figure out what others want to hear. The look and feel of FASD behavior

17. What they need • Consistent environment-minor changes can impact child. • Repetition • Visual, kinesthetic, along with verbal • Rephrasing • Rhyming • Small chunks of information

18. On Line training April 29th Drinking before Birth: The Truth and the Consequence By Janet Sharkis and Natalie Furdek, Lead Program Specialist Women's Substance Abuse Services Coordinator This training will focus more on the specifics around FASD and the brain and include more specific information about referral resources.

19. Resources • www.topdd.state.tx.us • www.thearcoftexas.org • www.depts.washington.edu/fadu • www.cr-triangle.org • http://ntiupstream.com/MCHBproject/ • http://www.guttmacher.org/statecenter/ • http://www.fasdcenter.samhsa.gov/ If you or someone you know would like information about substance abuse treatment or prevention, please visit: • http://www.dshs.state.tx.us/sa/