Aboriginal women, alcohol and the road to fetal alcohol spectrum disorder

Lorian G Hayes
Med J Aust 2012; 197 (1): 21-23. || doi: 10.5694/mja11.10390
Published online: 2 July 2012

“The girls don’t drink much; ’bout the same as the fellas”

I am an Aboriginal woman, with traditional connections to the Bidjara people from central western Queensland and extensive experience in working with Aboriginal women who consume alcohol during pregnancy.

During several decades of working in the health field, I have asked myself and others why Aboriginal people drink alcohol at such dangerous levels.

As I have reported earlier,1 I believe that the historical and political background and the cultural aspects of drinking have been insufficiently considered. There is an entrenched expectation of Aboriginal community members that to drink is an expression of identity and culture.

It is unrealistic to expect that individuals can take responsibility for their own actions outside the context of their cultural environment. Programs aimed at changing individual risky behaviour fail to acknowledge the way in which the person is inextricably tied to the culture in which he or she exists.

In many communities, alcohol use is a familiar and embedded practice that spans generations as well as individual lifetimes, from before birth to death. Its consequences are difficult to escape, whether a given person actually drinks or not.

Some years ago, with input from a number of Aboriginal community members, I constructed a framework to assist in understanding the development of identity and the resulting changes of emotions and physical boundaries across the lifespan.2

Using this framework, I have proposed an expanded view on the use of alcohol in Indigenous communities,2 formulated through interviews and discussions with members of remote, rural and urban Aboriginal communities in Queensland. This was originally done in the context of trying to better understand fetal alcohol spectrum disorder and early life trauma.

In this essay I use a narrative format to display dialogue, because objectivity of the “interviewer” and distance from the respondents’ responses is not consistent with Aboriginal ways of knowing. Understanding the intersubjectivity between the author as an Aboriginal woman and the people whose input contributed to this report made possible the interactions and insights that follow. The impressions and conclusions should not be rejected on the grounds that the approach varied from more Westernised sociological research methods.

For many Aboriginal women, alcohol, like pregnancy, is a normal part of the life cycle.

During my research, young women and young men spoke honestly about the perceived relationship between alcohol and pregnancy, alcohol and drugs, and alcohol and crime, violence and abuse — all of which they associated with their families, relationships, friends and daily environment.

Within this life cycle the relationship between alcohol and pregnancy was revealed to be more complex than the physical effects of either. Young people strongly confirmed their connection with their toxic social environment and were aware of the hardships and disadvantages that confront them daily. The issues they identified were family breakdown; community disharmony; family and community dysfunction; alcohol and drug addiction; teenage pregnancy; peer pressure; violence within the home and community; unemployment; shame, pain and anger within; a sense of isolation and not belonging; lack of trust and respect from family, friends and peers; the high incidence of rape and sexual abuse; and the lack of opportunities to gain education and training within the community.

My proposed life cycle framework or model broadens the Western approach and integrates with cultural constructionist theories to give a clearer understanding of alcohol use.2

The following story-lines provide examples of how interview respondents conceptualise their own or others’ health status in terms of historical, cultural and systemic impediments.

The disappearing childhood (age 3–5 years)

It is during the ages of 3–5 years that children begin to retain strong memories that continue to provide background to their emotions in later life. Generally, children develop responsibility for self-sufficiency between the ages of 3 and 5. An important aspect of this is the development of trust. Trust in adults and their ability to ensure one’s safety in a crisis is the earliest form of faith. If caregivers are inconsistent in satisfying a child’s needs, the child will not develop this sense of trust, faith and hope.3

Children whose needs are not met feel that they have been abandoned by their carers, as depicted in the story below.

The cycle continues (alcohol and pregnancy)

The reasons why women continue to drink alcohol while pregnant are varied and complex. The pregnancy itself is a validation of adult status, as is the consumption of alcohol. At the same time, the pregnancy, often at a young age, is an additional determinant of social disadvantage.

Story 6. Violence causing harm

I don’t think they know if anything can happen to the baby. Something might happen when they drink if they are pregnant. Drinking alcohol is a way women try to kill their babies. Some young women get drunk and even try to commit suicide, not just because they are pregnant — there is other abuse too. The person drinks alcohol — becoming angry — and then picks a fight with another woman or a man and becomes involved in a fight — killing the baby one time.1

In this example, fetal death removes full responsibility from the mother. A community elder told me that removing fault is common, with the woman claiming she does not remember or that it was beyond her control, as she was drunk. Members of the community will in turn come together to support the young woman go through grief at the loss of her child.

Both young women and young men whom I interviewed felt that the practice of drinking alcohol when pregnant is seen as a way to kill the baby, either directly or indirectly (by initiating a cycle of violence in the hope that it will cause a miscarriage). They did not otherwise implicate or acknowledge toxic side effects of the alcohol consumed, and the concept of fetal alcohol syndrome or other fetal alcohol effects was not of concern to them.

A whole range of factors contribute to a cycle in which alcohol is accepted as an inevitable part of life and death. The community does not perceive a special problem with women’s drinking, either in amount or in the drinking patterns, manifestations and toxic side effects. Drinking is the expected community norm.

Being a drinker is not equivalent to being an Aboriginal. When Aboriginal people enter into a drinking cycle, even the unborn child is affected.

If the cycle of drinking in Aboriginal communities is to be broken, a more effective model for health promotion would be to aim towards acknowledging children who are continually exposed to examples of the negative adult behaviour associated with alcohol. It should be designed to enhance skills in developing positive patterns of behaviour for later life and negating the effects of witnessing irresponsible adult behaviour.

Provenance: Not commissioned; not externally peer reviewed. This essay was an entrant in the 2011 Dr Ross Ingram Memorial Essay Competition. It is adapted from an article published in the Aboriginal and Islander Health Worker Journal.<a href="#0_CHDFIEFA" class="SupXRef">1</a> Quotes are reproduced with permission

  • Lorian G Hayes

  • Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, QLD.


  • 1. Hayes LG. Grog babies: where do they fit in this alcohol life cycle? Aboriginal Islander Health Worker J 2001; 25: 14-17.
  • 2. Hayes LG. Children of the grog [unpublished honours thesis]. Brisbane: University of Queensland, 1998.
  • 3. Erikson EH. Identity: youth and crisis. New York: Norton, 1968.


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