Women who use substances in pregnancy and/or have children with Fetal Alcohol Spectrum Disorder (FASD) are highly stigmatized by the media, public, and health and social service providers. Social isolation, non-disclosure of alcohol and/or substance use, and not seeking or receiving the necessary support can be the result.
Stigma refers to the prejudicial attitudes, stereotypes, and discriminatory behaviours  toward a person or group. The impact of stigma on an individual or group usually results in failure to acknowledge their strengths . For mothers who use(d) substances during pregnancy or whose children have FASD, stigmatization can result in service providers or institutions taking a judgemental or punitive approach that often includes increased surveillance, child apprehension, and limited care options [2-4].
Many women may feel unsafe disclosing their alcohol use because of stigma, fear of judgement from health and social service providers, and fear of child protection involvement [5-8]. Health and social service providers who are judgemental, who adopt punitive approaches, or who insist on complete abstinence from substances, can limit women from accessing necessary harm reduction and support services, such as housing, nutritional supports, or substance use treatment programs . This is particularly true for women of colour, women from lower socioeconomic brackets, or those who experience other inequities [10, 11].
Moreover, when providers hold a belief that only certain ‘types’ of women can have a child with FASD, women from other groups who may need help to reduce their drinking may be deterred from asking for it, or may be incorrectly reassured that their drinking is not problematic .
The purpose of this issue paper is to explore the stigma experienced by pregnant and parenting women who use(d) substances during pregnancy. It will identify opportunities and resources to mitigate stigmatization and better support women who are accessing substance related and other support services for themselves and their children.
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