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Réunion Island: A Pioneering Model for Fetal Alcohol Protection – An Inspiration for France, Europe, and the World
At the 9th International Conference on Research on Fetal Alcohol Spectrum Disorders (FASD) held in Seattle from March 20-23, 2025, SAF France presented the findings of a 2023 study conducted by OpinionWay. This analysis provides an in-depth overview of awareness levels and alcohol consumption behaviors during pregnancy among parents of children under three, both in mainland France and the overseas territories.
The presentation was delivered to conference participants from around the world, gathering to discuss advancements in FASD research and prevention.
Unparalleled Awareness in Réunion Island
The study highlights a striking contrast between Réunion Island and the rest of France in terms of awareness and behaviors related to FASD. Parents in Réunion Island demonstrate a significantly deeper understanding of Fetal Alcohol Spectrum Disorders (FASD) compared to those in mainland France and other overseas territories. Furthermore, alcohol consumption during pregnancy is markedly lower on the island.
The data reveals that 27% of pregnant women in mainland France reported consuming alcohol while aware of their pregnancy, compared to just 7% in Réunion Island. Conversely, in other overseas departments, this figure rises to approximately 30%. These behaviors persist despite widespread recognition of alcohol’s harmful effects on fetal development, even in minimal quantities.
Additionally, overall awareness of FASD is relatively high in France: 74% of respondents in mainland France and 78% in the overseas territories reported having heard about it. However, Réunion Island stands out with an 86% awareness rate, demonstrating also not only broader recognition of FASD but a deeper understanding of its cognitive and behavioral manifestations.
Some regions in France continue to report particularly high alcohol consumption rates during pregnancy, exceeding the national average: Île-de-France (38%), Martinique (36%), Grand Est: (33%), Guadeloupe (31%).
By contrast, regions such as Centre-Val de Loire (16%) and Occitanie (18%) report lower rates, highlighting significant regional disparities.
Underlying Causes and Support Initiatives
Addiction is identified as the primary reason for alcohol consumption during pregnancy, affecting 57% of pregnant women in mainland France and 64% in the overseas territories. A lack of knowledge about prenatal alcohol exposure consequences is another significant factor (52% in mainland France and 62% in the overseas territories). This underscores the need for increased public awareness about FASD.
To address this issue—particularly for women struggling with alcohol dependency—SAF France (formerly RÉUNISAF) established the « Cœur de Réseau » program. This initiative, awarded the National Academy of Medicine’s Prize for Alcoholism Prevention in 2005, provides localized support for families vulnerable to alcohol consumption during pregnancy. Thanks to this comprehensive support, 75% of women in the program have successfully reduced or ceased alcohol consumption.
The « Cœur de Réseau » was also recognized in 2004 with the Ministry of Family and Childhood’s Bien-Traitance Award (DGAS).
Additionally, social pressure plays a role for 26% of respondents, as some pregnant women report difficulty refusing alcohol, particularly in early pregnancy before announcing their condition or in professional settings. Alcohol consumption remains deeply embedded in social customs, making it difficult to abstain.
The Need for Effective Information and Prevention
The study highlights an essential demand from respondents: better information about the risks of alcohol consumption during pregnancy.
Healthcare professionals remain the primary source of information on FASD in mainland France, Martinique, Guadeloupe, and Guyana. Around 70% of parents in mainland France and 64% in the overseas territories rely on them for guidance on the topic.
Paradoxically, a 2021 OpinionWay study for SAF France revealed that nearly one-third of general practitioners do not systematically address alcohol consumption during prenatal consultations.
In Réunion Island, doctors appear to be a secondary source of information. Instead, residents rely on personal testimonies and media coverage. This finding aligns with Réunion Island’s approach to FASD prevention, which began with firsthand accounts from biological mothers.
The study also underscores the need for early intervention: 75% of parents in mainland France and 90% in the overseas territories believe that schools should play a key role in FASD education from primary school through high school.
SAF France meets this need through public awareness campaigns (SAFTHON, Tables Jaunes) and specialized training sessions for professionals and youth in schools. The study also confirms the effectiveness of using personal testimonies and media as key prevention tools. These methods form the core of SAF France’s communication strategy, driven by the belief that firsthand experiences are the most powerful means of raising awareness.
This approach also helps break the stigma surrounding alcohol addiction in women, often linked to domestic violence, which increases the likelihood of FASD-affected births. For this reason, SAF France actively leverages media, testimonies from biological mothers, and ambassadors living with FASD to shed light on the magnitude of this public health issue.
The Role of Family Support and Alcohol-Free Alternatives
The study also highlights the importance of partner support:
- 53% of partners in mainland France and
- 49% in the overseas territories
reduced their alcohol consumption during pregnancy, while - 30% provided alcohol-free alternatives for their pregnant partners.
In mainland France, 50% of women who were aware of such alternatives consumed them, compared to 34% in the overseas territories.
A Long-Term Prevention Model
Despite the legal requirement since 2007 to display warning labels on all alcohol bottles and ongoing awareness campaigns, more than one-quarter of pregnant women in France continue to consume alcohol, often due to a lack of information about the risks.
For the past 30 years, Réunion Island has implemented major initiatives aimed at changing behaviors and mindsets. The results speak for themselves: once the most affected region in France by Fetal Alcohol Syndrome (FAS), Réunion Island has now become a model for prevention and fetal protection.
This unique model has already prevented approximately 1,000 cases of FAS in just seven years, based on three levels of prevention:
- Primary prevention: Raising awareness among the general public, professionals, and schools with clear, accessible information.
- Secondary prevention: Supporting vulnerable families through the « Cœur de Réseau » program, helping them with the medical, social, educational, and judicial systems.
- Tertiary prevention: Developing TCAF Resource Centers dedicated to diagnosis, training, and support for affected individuals.
Through this comprehensive strategy, Réunion Island has become a global benchmark in the fight against fetal alcohol exposure, proving that sustained efforts and targeted actions can significantly reduce this public health issue.
Methodology
This study was conducted among:
- 1,001 parents of children under three in mainland France
- 505 parents of children under three in the overseas territories
The sample is representative of the evaluated regions. Self-administered online questionnaires (Computer Assisted Web Interview) were conducted from July 18 to August 1, 2023, for the mainland sample, and from July 18 to July 26, 2023, for the overseas sample.
