Warwickshire Stop Smoking in Pregnancy Service team (left to right): Lynne Lewis, Annette Lloyd,
Bev Avis-Dakin, Dawn Powers, Debbie Hammond and Kelly-Ann Bullingham
When figures revealed that some 12 per cent of mothers-to-be were still smoking at time of delivery, Warwickshire Stop Smoking in Pregnancy Service asked midwives how they could help ensure all women were CO tested at booking in line with NICE guidelines.
Midwives said they were worried about the time it took to do the test, what to say to clients about the result, and how to construct a simple, quick and effective way to explain to women what the risks were before referral.
The team developed a schedule of midwife training in small groups over a number of days, sharing knowledge about the nature of addiction and how to deliver a brief intervention, and increasing awareness of stop smoking support available locally.
Midwives were issued with easier to use CO monitors and local advisors made themselves available for individual support as needed.
Since then the CO test rate has risen from 69 per cent in 2015 to 79 per cent this year and is still rising.
The midwives also wanted a more visual tool, that didn’t entirely focus on the CO reading, that would help them to discuss smoking in pregnancy. The team came up with a poster, now used across the county’s maternity units and children’s centres, with simple graphics designed to get the message about the risks of smoking in pregnancy across and give midwives more confidence in discussing them.
Midwives also received diary covers and pens with the team’s Quit4Baby logo and the local free stop smoking service helpline for urgent referrals or queries. The diary cover contained a mini CO chart with a quick and easy to remember acronym: TAR (Test, Ask, Refer), and included guidance on what to say when a woman had her CO test result. Fiona Dobbie commented that it was ‘nice to see specific engagement with midwives’.
Jo Glasscock said she ‘loved the poster’, and that the team showed ‘great insight’ in partnering with midwives to increase CO test rates.