Abstract
Half of all pregnancies in Canada are unintended. Whether a pregnancy is intended or unintended has a bearing on the risk of prenatal alcohol exposure. Research indicates that women who experience an unintended pregnancy are significantly more likely to consume alcohol while pregnant. Most fetal alcohol spectrum disorder (FASD) prevention frameworks in Canada have adopted a mid-stream approach focused on preventing alcohol consumption among women who are already pregnant. Yet there is a second approach, further upstream, that is rarely discussed as an FASD prevention tool in this country - preventing unintended pregnancy itself. Improving access to long-acting reversible contraceptives for women and girls who are experiencing cost and access barriers to these methods could do much to stem the incidence of FASD and the prohibitive health and social costs associated with this disorder in Canada.
Résumé
La moitié des grossesses au Canada sont non désirées. Qu’une grossesse soit voulue ou non a une incidence sur le risque d’exposition prénatale à l’alcool. Des études ont montré que les femmes qui vivent une grossesse non désirée sont de manière significative plus susceptibles de consommer de l’alcool lorsqu’elles sont enceintes. La plupart des cadres de prévention du trouble du spectre de l’alcoolisation fœtale (TSAF) au Canada emploient une approche à mi-parcours, qui vise à prévenir la consommation d’alcool des femmes déjà enceintes. Pourtant, il existe une deuxième approche, plus en amont, dont on discute rarement en tant qu’outil de prévention du TSAF dans ce pays: prévenir les grossesses non désirées. Le fait d’améliorer l’accès aux contraceptifs réversibles et à longue durée d’action pour les femmes et les filles qui n’ont pas les moyens de s’en procurer ou qui n’y ont pas accès contribuerait beaucoup à réduire l’incidence du TSAF et les coûts sanitaires et sociaux associés à ce trouble au Canada.
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Sanders, J., Currie, C.L. Looking further upstream to prevent fetal alcohol spectrum disorder in Canada. Can J Public Health 105, e450–e452 (2014). https://doi.org/10.17269/cjph.105.4692
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DOI: https://doi.org/10.17269/cjph.105.4692