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Monday, 29 July 2019
Page: 1007

Senator GRIFF (South Australia) (16:18): Today I speak about an insidious, serious public health problem. It is one which will have lifelong consequences for those with the condition, and it impacts almost every part of our community in some way. But it is entirely preventable. I'm talking about fetal alcohol spectrum disorder, or FASD for short.

FASD is an umbrella term for a range of physical, mental, developmental and behavioural problems suffered by a child whose mother drinks alcohol while pregnant. FASD has no cure. It can be severe or it can be mild. The baby can often seem healthy at birth, and only a minority of babies will have telltale facial deformities that can form when their mother drinks in the first trimester only. Babies born with FASD might look healthy but the wiring in their brain will be scrambled.

They are destined to have varying problems with memory, learning, impulse control and understanding consequences. They may struggle with emotional regulation, and struggle to plan and organise themselves. They may have difficulty with speech and language, and they might even have sight and hearing problems. In the worst cases, the baby will, tragically, be robbed of the ability to realise their full potential simply because their mum drank while pregnant.

I do want to stress I do not say this with any blame. Often this drinking is done in ignorance or because of peer pressure from a partner or others close to the woman. Research shows us that one in four pregnant women in Australia continue to drink alcohol after they have learned they are pregnant—one in four. Many of them are well educated too, but they're not educated about the effects of FASD. Usually, they don't know about the risks of drinking while pregnant, or they are misinformed about the risks because they received outdated advice from well-meaning friends and relatives, or even, incredibly, from medical professionals. Australia desperately needs a national information campaign to tell women and their loved ones the dangers of alcohol during pregnancy. If we want women to stop drinking during pregnancy, we all need to empower them to make this safe and necessary choice. The entire community needs to be informed of the dangers so we can collectively support the women in our lives.

We are still learning a lot about this disease. The fact that one in four women drink during pregnancy doesn't mean one in four babies are born with FASD. It seemed genetics may play a part in who is impacted and how severely, and the condition is more severe in children whose mothers are sustained and heavy drinkers. Estimates are that FASD affects up to five per cent of the Australian population. The important thing to remember is that, when a pregnant woman drinks, her baby also drinks. In fact, the developing baby will have the same blood alcohol level she does; it might even be higher because the baby's developing liver will struggle to process the alcohol. The alcohol crosses the placenta and enters the baby's blood, where it can damage the developing brain and other organs.

The consequences for affected children are lifelong. Again, there is no cure for FASD. Most children who are later diagnosed with FASD might seem utterly normal when born. Most will have a normal IQ. It won't be until that little boy or girl starts school and starts falling behind and gets into trouble for being disruptive and for not completing their work that the truth of their condition will start to emerge. Even then, their FASD may be mistaken for naughtiness, or misdiagnosed, meaning they won't always get the help that they desperately need. Without intervention, they will struggle to finish school and will be more familiar with truancy, suspension and expulsion than with good grades. Through no fault of their own, children with FASD will quite likely have poorer life outcomes than other children. They will struggle more than others with unemployment, homelessness, mental health issues, and alcohol and drug abuse. They are disproportionately represented in the criminal justice system. A 2018 study found that 36 per cent of juveniles in detention in Western Australia had FASD. Think about that for a moment. What would the criminal justice system look like if we managed to dramatically cut the number of children born with FASD?

This is why I'll be proposing a wide-ranging inquiry into FASD, to pick up on the good work done by the 2012 House of Representatives inquiry into FASD and go further, to look at what the research now tells us; the awareness and handling of FASD in schools and the criminal justice system; the prevalence of FASD in vulnerable populations, such as children in state care; and world's best practice in diagnosis, intervention and prevention.

As it is, FASD costs Australia an estimated $1.18 billion every year. Despite this massive burden on our communities, the government is not doing anywhere near enough to combat this issue. It is tinkering around the edges at most and, actually, its actions are really quite inadequate. Its national FASD Strategic Action Plan follows a recommendation from the 2012 inquiry that was appropriately titled FASD: the hidden harm.

The 10-year strategic action plan on FASD sounds good, but it is currently being funded with peanuts—just $7 million over two years to tackle a public health issue which is entirely preventable and yet has such a widespread impact on individuals and society.

A three-year FASD clinical network to support diagnosis and data collection was funded with just $10 million. All up, the government has spent a measly $20 million on FASD since 2014. The efforts have been so paltry that the alcohol industry's own lobby, DrinkWise, has been granted federal funding to promote awareness about drinking in pregnancy. This was such a stuff-up last year that thousands of posters destined for GP offices had to be recalled after the AMA complained because the messaging was inaccurate and misleading. The recalled posters actually stated:

It's not known if alcohol is safe to drink when you are pregnant.

But it is known: it is not safe.

The DrinkWise posters are limp-wristed at best. The messages include:

It's safest not to drink while pregnant.

Note the word 'alcohol' isn't used. And what do they mean by 'safest'? Is there some sliding scale of safe drinking that we don't know about? Then there is the confusing message: 'When mum drinks, the baby drinks.' That doesn't tell the woman anything about the lasting harm alcohol causes and it leaves it open for people to assume that, if mum doesn't suffer any lasting harm for a night of drinking, maybe the baby doesn't either.

This is the danger of leaving awareness campaigns in the hands of vested interests. If we want to tackle FASD, the messaging has to be clear. It has to be uncompromising. The Foundation for Alcohol Research and Education puts the message this way:

Alcohol and pregnancy:

No safe amount.

No safe time.

No safe type.

Its other messages include:

If you are pregnant or planning a pregnancy, experts advise no amount of alcohol is safe.

It knows from its focus groups that this message works.

We need to treat FASD with much more urgency. I think we should treat it as a national health emergency. How many of us have heard someone say, 'It doesn't matter if you have an occasional drink in the third trimester because the baby is already cooked or finished baking'? As long as there are men and women, and health professionals for that matter, who still think it is okay to drink during pregnancy, it means there is serious work to be done. As long as this type of attitude exists, it means that we are failing to tackle this invisible but entirely avoidable scourge.