Taking a relational approach: the importance of timely and supportive connections for women

Pregnancy is often described as an opportune time for service providers to support women in improving their health, including efforts to decrease or stop substance use. However, a number of factors prevent pregnant women, particularly those most marginalized, from seeking out support and treatment. For marginalized women who do access care, entry into treatment is often delayed and attrition rates are high.

The lives of women with substance use problems are often very difficult, requiring attention to myriad interrelated issues, such as: current and/or historic experiences of violence and trauma, poverty, mental ill health, polydrug use, malnutrition, housing difficulties, and physical health problems. Underlying these issues is often a lack of connection to an established support system that can help women respond to existing and presenting challenges.

Additionally, multiple barriers to care often influence women’s abilities and desires to access support. Given the depth and scope of these interconnected barriers and challenges, Fetal Alcohol Spectrum Disorder (FASD) prevention cannot be accomplished using reductive approaches that focus solely on achieving abstinence from alcohol. Rather, FASD prevention requires multifaceted responses focused on addressing the many interrelated issues and barriers to care that directly influence women’s and children’s health.

The following information sheet has been prepared for decision makers, health system planners and service providers interested in improving care for women at risk of having a child affected by Fetal Alcohol Spectrum Disorder. It has been prepared by members of the CanNorthwest FASD Research Network’s Action Team on FASD Prevention from a Women’s Health Determinants Perspective. This sheet describes the rationale for multi-faceted relational approaches, and extended timeframes for engagement and support, and finishes with ten recommendations for improved care that have implications for policy, system planning and practice.