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Susan Pourier thanks the women who brought the Denver program to Pine Ridge. PHOTO BY/Christina Rose
Risky choices: Drinking and getting pregnant
A non-judgmental way to prevent FAS and FAE
By Christina Rose
Native Sun News Associate Editor
RAPID CITY — Drinking and becoming pregnant is a risky business for both mother and child. However, a new program in Pine Ridge and Rapid City is helping women decide how much they want to drink and what they can do to guarantee a healthy pregnancy. The Choices Project prevents an alcohol exposed pregnancy even before a woman becomes pregnant.
At a Mental Health Conference last week, The Choices Project was introduced in a panel discussion. Speakers from the original Choices Project in Denver provided information about the effectiveness of the program.
One of the presenters, Katana Jackson (Oglala) of The Choices Project in Kyle described her interview process with women who are binge drinkers and not yet on any birth control. During the first session, Jackson asked, ‘Do you know anyone who is FAS or FAE?’ Jackson said she has not had one patient say no. “One said, ‘Hey, my cousin was pregnant and she drank through the whole pregnancy.’ I work in special education and I see these children struggle day in and day out with this,” Jackson said.
According to Jackson, the program is very flexible and not judgmental. “When women come they can choose to drink or take birth control without judgment,” she said.
Choices originated as an urban program in Baltimore and Denver and it is now in place in Kyle and Sioux San Hospital in Rapid City. This is the first time Choices has been made available to a tribe. Program Director Susan Pourier explained that after consulting with the elders, “We adapted the curriculum to meet our own needs.”
At the conference, Pourier introduced several women involved in the program who are completing their first grant cycle and have already begun to see results. Florence Janis has been working with the Choices Project in Sioux San since October 2011, and she has since met with over 160 women between the ages 18 and 44. “We tell the women things about drinking and they make the decisions.”
The program educates women about the effects of Fetal Alcohol Syndrome (FAS) and provides birth control for those women who want to continue drinking. Katana Jackson, who provides the program at the Health Clinic in Kyle said, “ I have young ones come in and they don’t want to quit drinking, so we divert them to getting on birth control. It’s harm reduction.”
Jackson said that in many cases women are not aware of how drinking can harm a baby or even that they are drinking excessive amounts. A Sanford Researcher for Choices, Jessica Hanson defined risky binge drinking as four or more drinks in a day or seven in a week. However, two drinks can become ten if a woman is drinking the popular, large size malt liquor “Joose,” which Hanson said is binge drinking.
“About 10-26 percent of women are at risk for alcohol exposed pregnancy because they are drinking at risky levels but not using contraceptives,” Hanson said. “That’s a pretty high number.” Hanson added that about half of all pregnancies are unplanned, and if a woman is drinking at risky levels, she is likely to expose her baby to alcohol.
For Florence Janis, the biggest surprise was learning that the standard of binge or risky drinking was considered four drinks a day and seven or eight a week. “It surprised me because I am a recovering alcoholic.”
Janis said the clients were really surprised to see how much they were drinking. They asked her questions such as, ‘You mean I drank that much?’ or ‘I had six beers,” ‘I had two shots, or we had a liter of vodka or whiskey.’ Janis said, “They were surprised at how much they were drinking. So, if they don't want to quit, they can cut down. Hardly any of them wanted to cut out drinking altogether. They said, ‘I don't want to quit, but I’ll cut down and if I get pregnant I’ll quit.’
Choices wants to be sure that any woman who needs the program can access it. The program provides women with a $25 gift card for each of the three or four sessions they attend. Appointments are short and can be made whenever the woman can get there. Janis said, “I see changes going on in them, even if they don't quit drinking altogether.”
Describing the effects of FAS or FAE (Fetal Alcohol Exposure) Hanson said that heavy drinking during first three months of pregnancy is often associated with certain facial features such as a smaller brain, thin upper lip, and “the thing between nose and mouth, called the fulcrum is missing.”
Hanson explained during a power point presentation that FAS or FAE babies may have heart problems, clef lips, and may be missing lines in their hands. “There are also hidden disabilities, such as delinquency, not understanding cause and effect, anxiety. Some of these things are pretty difficult to diagnose.”
Some studies have also shown that 60 percent of FAS children are arrested as teenagers.
“This is really about saying to a woman, ‘Do you want a healthy pregnancy?’ What woman doesn't want a healthy pregnancy,” asked Dr. Karen Peterson from the Denver Choices program. While a woman might not know how to have a healthy pregnancy, Peterson said, “But if you are drinking heavily, you are not going to have a healthy pregnancy. Alternatively, if you don't think you can stop drinking, then put off the pregnancy. That is why it’s called Choices, because in the end, she can have what she wants.”
Katana asked women who were involved in the program to write out their thoughts about their experiences with the program.
Some of the letters from the women are printed here:
“It’s not good to have an alcohol exposed pregnancy on the reservation. Our Lakota people wouldn’t want us to bring a child into this world filled with alcohol. I learned from this program not to drink without being on birth control. Come to think of it, I was never on birth control until this program. I am thankful now to know about alcohol exposed pregnancy and how it affects us. I am currently on birth control and when I do decide to have a child, he or she will not be exposed to alcohol.”
“My alcohol use affects a lot of aspects of my life. It affects my health, my financial stability and my family. I found out that if I cut back on my drinking, I can do a lot of positive things with my children. I could save a lot more money if I am not buying alcohol. I don’t have to worry about saying things while I am drunk and impaired. I have learned I can control my own actions and my alcoholism if I really want to.”
“I have learned to control my habit and to be more realistic about goal setting. To be more careful about my sexual activities. Alcohol is a bad habit for me, and I need to slow down because I am always the one hurting myself, and it doesn’t allow me to be active with my daughter. I hope that maybe in time I will be alcohol free.”
Jackson said, “After they write these, we talk about what it means to them. They felt the program was educational, and they even say, ‘Maybe if someone spoke to me like this before, maybe I wouldn’t be in the situation I am in.’ Some admit, ‘I didn't know I was pregnant and drank “Everclear” through my fifth month.’
“People are only human, and the Choices program is non-judgmental,” Jackson said.
At the end of the Mental Health Conference, star quilts were presented to the two women from Denver as well as the facilitator Jessica Hanson. OST Health Administrator Lisa Shrader, MSW, said, “We want to thank these ladies for giving us this support and allowing us to be the first tribe to implement these Choices. When Susan said we met with 161 women that's like saying they saved 161 babies from being exposed to alcohol; and that's remarkable. We wanted to honor these ladies for the investment in our future and in our children, so thank you.”
(Contact Christina Rose at Christinarose.firstname.lastname@example.org)
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