Research Update

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

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8.9 Culturally Appropriate Treatment for Aboriginal Women^xxxv

Although several studies have suggested that FASD is more prevalent among Aboriginal people than non-Aboriginals, the picture is not complete as there is little information about the prevalence of FASD in the general Canadian population.²⁹⁹ As Tait (2003) observed, alcohol use problems are an issue that need to be understood as a problem of certain individuals and sub-populations, rather than a problem of all Aboriginal people.³⁰⁰

In 2001, the Society of Obstetricians and Gynaecologists of Canada prepared a policy statement to guide professionals in addressing Aboriginal health concerns, including FASD.³⁰¹ The Aboriginal Healing Foundation (2003) also suggested best practices from an Aboriginal perspective, proposing alternative practices that are aligned with the culture and that fit with the reality in which Aboriginal peoples live in Canada. The report gives attention to the role of residential schooling and concludes that widespread use of alcohol and other substances among residential school survivors can be attributed to the residential school experience for many.³⁰² Aboriginal women participating in consultations leading to the report, Substance Use and Pregnancy: Conceiving Women in the Policy-development Process, spoke of the tremendous importance of cultural (re)connection as a means of facilitating healing, supporting recovery and preventing future problems.³⁰³

Holistic, community-wide interventions that see other persons in the community, as well as organizations such as Native Friendship Centres, as part of an extended family are favoured by Aboriginal communities.³⁰⁴ Programs that incorporate outreach, identification, referral and appropriate support into an overall preventive and early intervention strategy appear to make the most sense. Masis and May tested this approach and concluded that the high rate of client acceptance of referral was due to the initiative being presented as a prevention program rather than a social work or alcoholism program and because it was hospital-based with trusted professionals involved. Because there was no control group used in this design, findings need to be viewed as suggestive.³⁰⁵

xxxv. Cultural considerations encompass a wide range of issues, including sexual orientation, and it is critical that all programming for pregnant women with substance use issues, not just Aboriginal programming, be culturally sensitive.

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