Sec. 2. Findings

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A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Congress finds as follows: Fetal Alcohol Spectrum Disorders (referred to in this section as FASD ), is a serious and complex public health issue impacting individuals, families, and communities throughout the United States, regardless of race, sex, culture, or geography. This Act provides an opportunity for our Nation to explore strategies to not only prevent the adverse effects of prenatal alcohol exposure (referred to in this section as PAE ) but heal individual, historical, and cultural traumas.

Exposure to alcohol has long-lasting consequences for a developing fetus, which may lead to a range of life-long physical, mental, social, and emotional problems. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including all wines and beer. The most recent prevalence study identified as many as 1 in 20 first graders across the country are affected by PAE.

Given that nearly 45 percent of pregnancies are unintended and women often don’t know that they are pregnant until they are 6 weeks along or more, it’s easy to understand how a woman could drink alcohol while expecting. Research shows that solely focusing on individual women’s behavior as FASD prevention strategy perpetuates stigma and blame on biological mothers, individuals impacted by FASD, and the condition itself. Although research shows that White, college-educated, middle- to upper-class women are the most likely group to drink during pregnancy, one of the common misnomers about FASD is that it is an indigenous issue .

Continued surveillance, stigmatization, and stereotyping of Indigenous populations may contribute to the misbelief that FASD is over-represented in these communities. In their recent landmark survey, Lay of the Land: Equality vs. Equity , the FASD Changemakers, comprised of young adults with FASD, documented the social determinants of health that lead to the detrimental health disparities people with FASD often endure, including victimization resulting in incarceration, homelessness, reduced access to health care, vulnerabilities to substance misuse, and unemployment.

The higher prevalence of FASD in criminal justice and foster care systems has been documented. Nearly 1 out of 4 children in juvenile corrections has FASD, and prevalence estimates among children in the foster care systems range from 23 percent to 60 percent. Prevalence in adult corrections ranges from 11 percent to 25 percent. The National Academy of Medicine recommendations for a broad Federal response formed the basis of the Fetal Alcohol Syndrome and Fetal Alcohol Effect Prevention and Services Act of 1998 that authorized $27,000,000 for a National Task Force on Fetal Alcohol Syndrome and grant programs at the National Institute on Alcohol Abuse and Alcoholism, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration.

In 2009, the National Task Force on Fetal Alcohol Syndrome reported FASD diagnostic capacity and FASD-informed services insufficient in the United States, resulting in countless individuals with FASD remaining unrecognized or misdiagnosed. Despite PAE remaining the leading preventable cause of birth defects and neurodevelopmental disabilities in the United States, the authority for the National Task Force on Fetal Alcohol Syndrome expired, SAMHSA funding for FASD ended in 2015, and other Federal and State FASD-related funding declined.

FASD is preventable. Although there is no cure for individuals impacted by FASD, research shows that intervention services and supports that include social, environmental, and educational strategies can prevent subsequent trauma to the individual, the individual's caregivers, and society. Building coordinated State and Tribal FASD systems of care that offer integrated culturally appropriate services and supports grounded in best practices can mitigate the harms created by historical and cultural trauma.