The Greater Manchester Smokefree Pregnancy programme is helping maternity staff identify smokers and educate them about the potential harm being done to their unborn child. Christine Bassett, a tobacco specialist midwife in Tameside, explains how expectant mothers are being supported to quit smoking.

It’s a momentous event in any woman’s life when they find out they are expecting a baby, it’s a time to expect change, to prepare and to consider new responsibilities – including how actions and choices made during the pregnancy could affect the unborn baby.

If a mother-to-be is also a smoker one of the very best things they can do for their  baby is give up smoking.

Now, that’s easy to say but I’d like everyone to remember that smoking is a serious addiction, not simply a life-style choice.

Giving up takes work and commitment, which is why we don’t want women to have to do it alone. In fact, someone trying to give up is four times more likely to succeed if they have professional support.

I’ve been a midwife for 40 years and have seen first-hand the problems that smoking causes.

Smoking is a major factor in babies being born early, unwell or in the worst cases stillborn. And the risks don’t end after birth – babies in homes where someone smokes are more likely to die from cot death or sudden infant death syndrome.

However, I also know that all expectant mothers want the very best for their babies.

Pregnancy can be complicated, so there are no guarantees but if a mother quits smoking, they can be assured they’ve done their best.

That’s why I work with pregnant women who smoke, advising and supporting them in giving up tobacco.

If a woman stops smoking before the sixteenth weeks of her pregnancy it is likely their baby will be born as fit and healthy as if they had never smoked.

We also know that someone facing social problems, like unemployment or an unstable homelife, is more likely to smoke.

That’s why it’s so important we have a system to support and encourage pregnant women in our area to tackle nicotine addiction.

There has been a significant drop in the number of women smoking in Tameside at the time of birth, from 19.8 per cent in 2013 to 13.9 per cent at the end of 2019. This is why, we welcomed the Greater Manchester Smoke free Pregnancy programme which enables us to reduce the number of women who smoke in their pregnancies even more and so improve the health of their babies.

Every pregnant woman takes a carbon monoxide test at their first appointment with a midwife, normally within the first 10 weeks of the pregnancy. 

If the test shows a high amount of carbon monoxide, we explain the problems it can cause, reducing the amount of oxygen and food an unborn baby is receiving.

We then ask if they are a smoker. Smoking is not the only cause for a high carbon monoxide reading, though it is one of the most likely.

If the woman is a smoker she’s referred to the midwife-led stop smoking service. This allows us to meet with the mother-to-be and explain the risks of continuing to smoke and the damage she’s inflicting on her unborn child.

This is not about blame, most people already understand that smoking is not good for their baby. However, they are not aware of exactly why and the level of damage continuing to smoke can cause.

That first smoke free pregnancy meeting can last up to an hour.

We can really get to know a person, their life and the challenges they’re facing.

This helps us tailor the support offered to best suit the person’s circumstances – like the type of nicotine replacement that’s best for them.

This is followed by three follow-up appointments, with the same midwife or specialist midwifery support worker – again this means we’re looking at an individual’s issues.   There’s also a phone number so they can ring for support in-between appointments.

If we’ve been unsuccessful in getting someone involved with the programme – if they’ve failed to attend appointments, not answered phone calls or been out when we visited their home – then we try again at their 12-week scan.

At the appointment for the scan expectant mothers have another carbon monoxide test. This time the test is linked to a computer displaying an image of an unborn child.

If the test shows a raised level of carbon monoxide it turns red.

This visually reinforces the impact smoking is having on the baby. The mother is then referred to my team again – we are often able to see them straight away.

Finally, we also offer shopping vouchers as an incentive to give up. Some people may be aghast at this tactic, wrongly thinking we’re rewarding smokers. I would remind those people that smoking is an addiction not a choice, and that the technique has been shown to produce effective results.

Research also shows that a supportive partner can make the difference between a woman giving up smoking or not. So, vouchers are also available to partners if the mother has quit smoking at the time of birth.

So, if you are pregnant, or planning a pregnancy, it’s important you set a ‘quit date’ – cutting down isn’t enough. Seek out support, it’s there and you’re much more likely to be successful with help and much more likely to have a healthy baby if you stop smoking.

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