> Competency 4: Prevention > 5f. Appropriate Preconception Planning Methods
Competency 4: Prevention
Addiction Disorders in Women
Appropriate Preconception Planning Methods
Prepregnancy counseling is critical for all women of childbearing age and is important
in preventing FASD.11 Many women
drink in the early stages of pregnancy, before they know that they are pregnant.
In addition, about half of all pregnancies are unplanned.12 Women
need to be encouraged to plan their pregnancies and to abstain from alcohol use
before and during pregnancy.11
Addiction professionals can help by talking to their clients about the dangers of
alcohol use during pregnancy. Discussing plans for pregnancy is also important to
promote a healthy, alcohol-free pregnancy. Women with alcohol problems may need
assistance with family planning to avoid pregnancy while they are drinking. Motivational
interviewing plus a
session can decrease the risk of an alcohol-exposed pregnancy in women in high-risk
Issues to discuss during preconception counseling include:
- The various methods of contraception and the attitudes of the woman, her significant
others, and her community regarding their use. The
might need to refer the client to family planning resources and to follow up with
- The impact of alcohol and other drug use during pregnancy on the woman and the
teratogenic impact of prescribed
medications, such as Antabuse and various anticonvulsants. Again, a referral might
be needed, since most addiction professionals are not trained in pharmacology.
- Alternative medications with reduced or no teratogenic potential for such common
problems as seizure disorder. An obstetrician or geneticist can recommend such medications.
Clients who temporarily require medications such as Antabuse, or those who choose
to postpone childbearing, may want an effective, reversible form of contraception.
Women who use substances and who have a history of irregular menses and involuntary
infertility need to know that sobriety or the successful initiation of a recovery
program may result in a resumption of ovulation and an increased risk of unplanned
pregnancy.14 Such clients need referrals
to appropriate specialists. Addiction professionals need to be familiar with available
specialists in their area.