MHM Magazine

28 | MENTAL HEALTH MATTERS | 2025 | Issue 5 MHM as hyperactivity, difficulty concentrating, and impulsive behaviour, which frequently lead to misdiagnoses such as Attention Deficit Hyperactivity Disorder (ADHD). Infants may present as small for gestational age, with feeding difficulties and irritability, but many symptoms only emerge once children enter structured environments like schools. Teachers often identify difficulties with focus, social interaction, and following instructions. Without proper understanding and intervention, affected children are at risk of poor academic performance, behavioural problems, and early school dropout. These developmental disruptions often continue into adolescence and adulthood, contributing to cycles of unemployment, substance misuse, and conflict with the law. The Lifelong Impact and Adult Outcomes FASD is not a childhood condition; it’s a lifelong disability. Adults living with FASD may experience persistent difficulties in managing daily responsibilities, maintaining employment, and navigating interpersonal relationships. Impulse control problems are common, leading to volatile emotional responses and challenges in social and workplace environments. Many adults go undiagnosed throughout their lives, often misunderstood as being difficult or unmotivated rather than recognised as individuals with neurodevelopmental disabilities requiring tailored support. Access to diagnostic services remains severely limited in South Africa. At present, the Foundation for Alcohol Related Research (FARR) operates South Africa’s only dedicated diagnostic service, based in Cape Town, with ongoing partnerships to expand access nationally. Without widespread diagnostic capacity, countless individuals remain unidentified and unsupported. Prevention: Supporting Women and Communities Preventing FASD requires more than simply telling women not to drink during pregnancy. It demands a compassionate, community-driven approach that addresses the root causes of alcohol use and supports women before and during pregnancy. Research has shown that factors such as unplanned pregnancies, anxiety, depression, social pressure, and limited access to reproductive health services significantly increase the risk of alcohol consumption during pregnancy. In South Africa, alcohol use is deeply embedded in social and cultural practices. Celebrations and communal gatherings often involve alcohol, and pregnant women may face stigma or social isolation when abstaining. Peer and partner pressure is a critical contributing factor, with many women reporting that they continued drinking because their partners, friends, or families encouraged it. To counter these challenges, FARR implements a whole-of- society approach grounded in community engagement and social support. This strategy emphasises that preventing FASD is not the responsibility of pregnant women alone. Partners, families, and communities all play vital roles. Encouragingly, community-based interventions, where fathers, grandparents, and peers collectively support pregnant women to abstain from alcohol, have demonstrated remarkable success in reducing FASD prevalence rates in high-risk regions. The saying “it takes a village to raise a child” holds true. In South Africa, it also takes a village to protect an unborn child. Supportive networks that foster shared responsibility, empathy, and awareness are key to prevention. Instead of isolating or judging pregnant women, communities should empower them with information, practical support, and non-alcoholic social alternatives. Addressing Stigma and Misconceptions Several persistent misconceptions continue to hinder progress. One widespread belief is that FASD only occurs within certain racial or socioeconomic groups. This is unequivocally false; FASD can affect any population where alcohol is consumed during pregnancy, regardless of cultural or economic status. Whether it’s wine, beer, or champagne, alcohol poses the same risk. Another misconception is that FASD is curable. While the damage caused by prenatal alcohol exposure is permanent, early diagnosis and intervention can significantly improve outcomes. With appropriate educational support, behavioural therapies, and family guidance, individuals living with FASD can lead meaningful, productive lives. Lastly, stigma and blame prevent many women from seeking help. Shame and fear of judgment discourage open discussion about alcohol use during pregnancy. By reframing FASD as a public health issue rather than a moral failing, society can create the understanding and compassion necessary to drive prevention and support. A Call to Collective Action South Africa currently bears the world’s highest recorded rates of FASD. The World Health Organization estimates global prevalence below 1 percent, while local studies indicate rates exceeding 11 percent, with some regions reaching as high as 28 percent. These statistics underscore a national emergency demanding urgent attention from healthcare providers, educators, and policymakers alike. Preventing FASD is entirely achievable, but it requires unity, empathy, and sustained public education. Every woman of childbearing age who drinks alcohol while sexually active and not using contraception is at risk of conceiving a child affected by FASD. By fostering awareness, supporting women, and reducing stigma, we can break the cycle and give every child the chance to thrive. References available on request. MHM | 2025 | Volume 12 | Issue 5 | Under tanding Foetal Alcohol Spectrum Disorders: The Epidemic in South Africa H