Helping South West expectant mums quit smoking in Stoptober and beyond

At the South West Academic Health Science Network (SW AHSN), we are tackling the issue of smoking in pregnancy by playing a key role in the regional Maternity and Neonatal Safety Improvement Programme (MatNeoSIP).

To mark the Stoptober campaign, Tracey Sargent – Maternity Improvement Adviser at the SW AHSN – talks to a young mum, who quit smoking with support from the programme.

In the decade up to 2019, the number of pregnant women in England who were smoking fell by a third – to 61,399.

While important strides have been made in recent years, there’s still much work to be done in helping women and families to achieve a smoke-free pregnancy and maintain this beyond the postnatal period.

Smoking in pregnancy has been shown to disproportionately affect disadvantaged groups and geographical areas with higher levels of deprivation leading to unwarranted variation in outcomes for mums and babies. Nationally, more than one in ten pregnant women were still smoking at the time they gave birth. The numbers were even higher for the South West – with Kernow, Devon and Somerset CCGs reporting figures of 12.9%,11.2% and 11.7%, respectively.

The health risks behind these statistics are why smoking cessation in pregnancy remains a key focus of the SW AHSN’s Patient Safety programme.

Smoking in pregnancy is associated with significantly increased risk of miscarriage, ectopic pregnancy, placenta praevia and deep vein thrombosis. It also raises the risk of stillbirth, premature birth, low birth weight, foetal growth restriction and sudden infant death syndrome (SIDS), otherwise known as ‘cot death’.

What’s more, children born to mothers who smoke are more likely to experience behavioural issues, including attention and hyperactivity problems, learning and respiratory problems, including asthma.

Passive smoking during pregnancy carries many of the same risks, which is why partners have an equal responsibility to stop smoking, and why healthcare professionals in maternity and neonatal services support the “whole-family” approach to achieving a smoke-free pregnancy.

The SW AHSN helps women and their families give up smoking by supporting the Maternity and Neonatal Safety Improvement Programme (MatNeoSIP) as a key member of the South West Patient Safety Collaborative.

The MatNeoSIP aims to improve maternal and neonatal care by providing high-quality healthcare for all women, babies and families. The programme contributes to the national target of reducing the rates of maternal and neonatal deaths, stillbirths, and brain injuries that occur during or soon after birth by 50% by 2025.

The South West Patient Safety Collaborative works with teams across Somerset, Devon, Cornwall and the Isles of Scilly to progress the aims of the MatNeoSIP through local improvement projects. This includes quality improvement coaching, connecting maternal and neonatal staff and hosting activities to give teams the opportunity to learn from each other and make system-wide progress. These efforts have continued during the pandemic; a quick and important shift to virtual educational webinars has been made in order to maintain connections in the region and allow teams to continue to learn and share best practice.

Working with midwives and the local authority health team at Cornwall Partnerships NHS Foundation Trust, Katie-Jo and Michael – both long-term smokers – both went smoke-free and have continued this way since the birth of their daughter, Hope.

Jill Lees, Cornwall Council’s Healthy Lifestyle Delivery Advisor for Healthy Cornwall, was put in touch with Katie-Jo after her first midwife appointment.

“We see all pregnant women at the 12-week scan,” said Jill.

“This is to make sure we can get the message across about passive smoking to partners and women who may have declined or not declared they are smoking to the midwife at booking”.

Michael found it harder to quit than Katie-Jo, which is often the case for partners, as they don’t have the reminder of the bump to motivate them.

“Even so, it’s also vital for partners and other members of the household to quit, because of the dangers of passive smoking – to mum and baby. Plus, having a smoker in the house makes it tougher for the other person to quit.

“We continued to offer Michael help over the phone, including taking him through the risks to mum and baby, letting him know about nicotine replacements and giving advice about changing behaviours and routines.

“And it’s been a real success story. For a couple to quit like they have is great.”

Twenty-year-old Katie-Jo had smoked between 20 and 30 cigarettes a day since she was 17. However, when she found out she was pregnant, she was determined to give up and found it reassuring to know that she could count on support from midwives and advisors.

“It was great to know the support was there if I needed it. My midwife gave me advice and information at all my appointments and Jill was always available to speak to on the phone if I needed to.

“Once I saw the baby on the screen at the 12-week scan, it was more real, and I knew then that I wouldn’t start smoking again. I don’t want to be responsible for anything that harms Hope.

“Michael took a little longer to give up than me, so Jill’s advice and support was really useful.”

Stories like Katie-Jo and Michael’s are extremely encouraging and highlight the importance of the MatNeoSIP in encouraging expectant mums and their support networks to give up and stay smoke-free.

Programmes such as this are clearly helping push numbers in the right direction but, with around 12% of women in the South West smoking during pregnancy, there’s still a long way to go.

This is why, at the SW AHSN, we work to progress the aims of the MatNeoSIP and want to thank all of the incredibly hard-working teams across our region who continue to make this happen.