Aboriginal and Torres Strait Islander men should be supported to become more involved in the prevention of foetal alcohol spectrum disorder (FASD), according to Australian researchers from the Telethon Kids Institute and University of Sydney.
Australia exhibits high rates of prenatal alcohol exposure compared with other countries and according to data collected through the National Drug Strategy Household Surveys, around one-third of pregnant women and half of breastfeeding women continued to drink alcohol—much higher than the global prevalence of alcohol use during pregnancy, which was 9.8%.
And while data from the National Drug Research Institute showed that Australian women who continued to drink while pregnant ‘tended to be older, to have higher incomes, education, and socio-economic status, and to live in rural and remote regions,’ there is no good data available on drinking among Indigenous Australians.
Some experts believe that the current published data is ‘out’ by more than 700% and note that Aboriginal communities and health services lack an effective way of monitoring how well they are going with efforts to prevent or treat alcohol problems, an FASD is a notifiable birth defect in West and South Australian communities.
According to The Senate Community Affairs References Committee 2021, while Australia still lacks reliable data on prevalence, FASD is the leading cause of preventable birth defects and intellectual disability nationally.
Lead author, Dr Michael Doyle, from the NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, noted that contributing factors for FASD occurrence among Indigenous Australians include intergenerational trauma from colonisation, and the associated ongoing experiences of discrimination and racism – which on an individual level could contribute to poorer mental health and increased risky alcohol consumption.
“A systematic review of FASD prevention research in Indigenous communities internationally found 10 peer reviewed studies ever published till 2017, with there being just 1 Australian study, and none of the studies were specifically related to men,” he said.
There has been a call internationally for more effort towards including men in FASD prevention but in Australia, the cultural separation between women’s and men’s business which is a commonality across our many Indigenous cultures may mean men are reluctant to be involved with FASD.
“In general, men have not traditionally been targeted for education on preventing FASD, and this is especially the case among Indigenous men, in part because of this cultural separation between the genders,” Dr Doyle explained.
“However, men’s alcohol consumption before conception can impact the health of potential children, and their drinking habits can also influence how much their partner’s drink, and men should be included in conversations around alcohol and childbirth, including FASD prevention, to encourage them to be more involved in caring for their partners during pregnancy.”
The researchers highlighted that more needs to be understood about the alcohol consumption of couples to inform the development of health promotion resources and campaigns and suggested that a research project led by men, using yarning and other culturally safe research methods, could provide insights into perceptions of alcohol consumption during pregnancy.
The Australian Guide to the diagnosis of FASD, first published in 2016, was updated in 2020 and is currently being revised by a team from the University of Queensland in collaboration with a wide range of key stakeholders around Australia and is due to be released later this year.
FASD can be considered as a ‘whole body’ condition and the most common features are neurological, affecting areas such as brain structure, cognition, language, memory, and impulse control; and a small proportion of children also have characteristic facial features: a smooth philtrum; a thin upper lip and small palpebral fissures.
Prenatal alcohol exposure can also impact all the developing organs and systems of the body, with research demonstrating a wide range of physical health problems for children, young people, and adults with FASD.
“The effects of FASD are irreversible and, in some cases, generate a need for lifelong support,” the authors said.
“We believe, the way forward for these areas is bringing together experts and Indigenous community members to co-design FASD prevention initiatives and encourage further engagement of Indigenous men in this work.”