Abstract
Introduction
Physician Champions from the American College of Obstetricians and Gynecologists (ACOG) and trained women Speakers from FASD United, who have given birth to a child with a fetal alcohol spectrum disorder (FASD), co-present to healthcare providers (HCPs) in medical residency programs as part of an educational intervention. They present FASDs as a biological and social problem surrounded by stigma that prevent pregnant women from talking openly to their HCPs about their alcohol use or alcohol use disorder (AUD) and getting the medical help they need.
Methods
Semi-structured interviews were conducted with 10 ACOG Champions and nine FASD United Speakers and a thematic analysis assessed how the co-presentations can enhance HCPs’ understanding about FASDs and address stigma associated with alcohol use during pregnancy.
Results
Interview findings indicated that both Champions and Speakers emphasized the need for HCPs to be nonjudgmental and create a safe space for open dialogue. They reported that residents were moved by mothers’ personal stories, wanted to understand AUD better, and asked about the type of help HCPs can offer women.
Discussion
Combining physicians’ expertise with mothers’ personal stories of lived experiences of FASDs directed at residents, who are more reflective and open at this phase of their careers, moved them from a fact-based to an empathy-based approach to learning that is critical to address the stigma surrounding women who may be using alcohol or struggling with an AUD during pregnancy. Collaboration between national organizations allowed this intervention to be widely implemented across the country.
Significance
Alcohol screening and brief intervention by health care providers (HCPs) is effective at reducing excessive alcohol use and preventing fetal alcohol spectrum disorders (FASDs). However, HCPs are not always comfortable discussing alcohol use with their patients. The stigma surrounding women who consume alcohol during pregnancy further prevents them from talking openly to HCPs about their alcohol use. An educational intervention combining facts from medical experts and narratives of women with children who have FASDs can move HCPs to an empathy-based learning approach to view alcohol use during pregnancy both as a biological and social problem associated with stigma and encourage HCPs to discuss the problem nonjudgmentally with patients.
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Data Availability
Not applicable.
Code Availability
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Funding
Centers for Disease Control and Prevention to FASD United (Federal Award Identification Number NU84DD000003) and to American College of Obstetricians and Gynecologists (Federal Award Identification Number NU84DD000007).
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SS conducted the interviews and the analysis and conceptualized this paper. KM and TM reviewed the paper and provided feedback.
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Westat’s Institutional Review Board (IRB) exempted this research from IRB review as it involves a program evaluation.
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Sapru, S., Mitchell, K. & McFadden, T. Combining Physician Expertise and Women’s Lived Experience to Educate Health Professionals about Preventing Fetal Alcohol Spectrum Disorders. Matern Child Health J 28, 229–239 (2024). https://doi.org/10.1007/s10995-023-03786-2
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DOI: https://doi.org/10.1007/s10995-023-03786-2