FASD prevention: Making the links to woman abuse, substance use, and mental health Dr. Amy Salmon, Managing Director Canada Northwest FASD Research Network Clinical Asst. Prof., UBC School of Population and Public Health

Study of Birth Mothers of 160 children with FAS Of the 80 interviewed: ► 100% were sexually, physically or emotionally abused ► 80% met the diagnostic criteria for a “serious mental illness” ► 80% lived with men who did not want them to quit drinking when they were pregnant Astley, S. J., Bailey, D., Talbot, C., & Clarren, S. K. (2000). Fetal Alcohol Syndrome (FAS) Primary Prevention through FASD Diagnosis II: A comprehensive profile of 80 birth mothers of children with FAS. Alcohol and Alcoholism, 35(5), Violence against women and FASD prevention

“ I think it needs to be everybody’s responsibility. I don’t think it should just be put on the mothers. I think it should be the father’s job. I mean, his dad… made me drink a couple of times when I was pregnant with him, because he was… I mean, to try and make us not to fight, he would try to get me to drink, when I was angry, and that kind of stuff.”- Shannon

The Uterine Tradition: Woman as Vessel Matthews 1987

“Just Say No”: The Shame and Blame Approach

Maternal Substance Use as Fetal Abuse

Experiences and expectations of discrimination are barriers to treatment and care To just focus on Aboriginals, it makes you feel more … what’s the word? I don’t know if stigmata is really applicable, but there’s a lot all ready. Like, people talk about treaties, and people already think badly about Aboriginal people… Then they don’t want to go. You know, like they feel they don’t deserve help. And then people who are racially biased, they’ll be, “see look.” There are people who complain about “oh, they get all these things. You can see why they need it. They can’t not drink when they’re pregnant”. That what I mean about stigmata, like, the bad label. -Jo-Anne

…and barriers to care can entrench experiences and expectations of discrimination “When you don’t get health care, you don’t get the sense of belonging, you don’t get the sense of your importance” ~ Sharon

► The most important aspect of service provision is a supportive, non- judgmental approach -addressing fear, stigma, misinformation and discrimination -meeting women “where they are at” -helping women with related harms, especially harms from violence Welcoming, low threshold, and outreach services are key

For more information Dr. Amy Salmon