This study highlights a promising and practical approach to reducing alcohol-exposed pregnancies by integrating a simple four-question pregnancy intention screening (PIS) tool into routine care for women accessing substance use treatment services. The tool was embedded into electronic medical records and completed by all women to whom it was offered, demonstrating both feasibility and high acceptability.
Despite most women in the study indicating they did not plan to become pregnant, 67% were not using contraception, and 74% expressed interest in learning more. These findings reinforce what many of us already know—women who use substances often face multiple barriers to accessing reproductive health care, yet they want the opportunity to make informed choices.
While this study was conducted in Australia, it raises important considerations for our work in Alberta. As FASD Prevention Facilitators, we can reflect on how screening for pregnancy intention could be meaningfully integrated into our own programs and conversations. More importantly, we can consider how to ensure the women we support are given consistent, stigma-free opportunities to reflect on and act upon their reproductive goals.
Reflection Questions for Practice:
1. How are we currently exploring pregnancy intention and contraceptive needs in our prevention conversations? Are these discussions consistent and comfortable—for both the facilitator and the participant?
2. What barriers do health and social service professionals face in having conversations about reproductive health and pregnancy intention with clients who use substances? How can our training better prepare and support them to navigate these conversations with sensitivity and confidence?
3. What barriers do women face in accessing contraception in our communities, particularly in rural or remote areas? How can we better advocate for or facilitate those supports?
This research reminds us that prevention is not about making assumptions—it’s about offering informed choices in a safe, consistent, and empowering way. Let’s keep exploring how we can innovate and adapt these learnings to strengthen our own practice in Alberta.