Research Update

Alcohol Use and Pregnancy: An Important Canadian Public Health and Social Issue

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8.11 Recommendations and Implications

Priorities for research, programming and policy arising from this review of the evidence in support of indicated prevention measures are:

Evaluation Research

• Conduct Canadian research on the effectiveness of gender-specific and -sensitive treatment in comparison to mixed gender treatment.
• Evaluate the effectiveness of motivational interviewing in a Canadian setting in supporting high-risk women to choose contraception and/or reduce or stop use of alcohol to prevent an alcohol-exposed child.
• Conduct a scientific (i.e. with control or comparison group) evaluation of a Canadian one-stop service for high-risk women and their children and of comprehensive care provided by perinatal service networks in smaller communities (where one-stop services are not feasible).
• Conduct a scientific evaluation and cost-effectiveness study of a Canadian intensive case management program as implemented in the one-stop or birth-tothree models of programming.
• Conduct research into the effectiveness of tailoring substance abuse treatment for individuals affected by FASD.

Policy and Program Implications

While awaiting the results of Canadian studies, priority should be given to these promising practices:

• Promote the development of respectful, flexible, comprehensive and harmreduction- oriented programming for pregnant women with substance use issues.
• Promote the one-stop model of service delivery for high-risk pregnant women and their young families and of comprehensive care provided by perinatal service networks in smaller communities (where one-stop services are not feasible).
• Promote outreach and intensive case coordination for moderate- and high-risk pregnant women and mothers.
• Greatly expand the capacity of the Canadian health care system to identify and diagnose individuals who may have FAS and other alcohol-related birth defects and developmental disabilities.
• Promote easily accessible and free emergency contraception for all women.
• Make funding available to incorporate child care and children's programming into women's substance abuse treatment services.
• Promote policies that require priority admission for pregnant women to substance abuse treatment.

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