By Clare Livingstone on 31 May 2019 Smoking

As midwives caring for women we have all listened to these sheepish confessions: ‘I know it’s bad… but I only smoke one or two in the evening… once the kids are in bed… it really is one of life’s few pleasures… something just for me….’.

At which point we intervene with further questions, asking ladies to blow into a machine which resembles a breathalyser, making referrals to the stop smoking services, documenting in the woman’s notes that she smokes and how many.

We complete the history taking, filling in the context with details about this woman’s family circumstances, possible relationship problems, chronic housing and financial pressures, general lack of support and a whole lot of stress.

In all honesty it is not always the most comfortable encounter, and some of us might even go home and light one up ourselves.

So how do midwives support women to quit smoking in pregnancy; clearly the best measure anyone can take for their own health and future generations. The RCM’s new position statement on support to quit smoking in pregnancy sets out some of the actions that are needed to help this to happen. 

Smoking is a major cause of health inequality. Strongly linked with deprivation, it increases the risks of miscarriage, stillbirth, prematurity, low birth weight and birth defects. Mothers are more likely to suffer serious complications such as placental abruption and eclampsia.

Sadly, these poor birth outcomes disproportionately affect socially disadvantaged women and because of this, smoking is a major public health challenge and a priority for improvement.

Pregnancy is a window of opportunity for change. It is generally a positive time of looking forward to the arrival of a new baby, and that incentive is a very strong one.

Midwives have a unique and trusting relationship, working in partnership with women and their families. They are able to offer support and effective resources that really can help. Nicotine Replacement Therapy is safe in pregnancy and e-cigarettes are increasingly popular as a quitting method. While research into these products is ongoing, we know for certain that they contain far fewer toxic ingredients than tobacco and certainly no carbon monoxide, which is so harmful to the unborn fetus.

High quality healthcare depends on a workforce that is well, and we believe that employers have a responsibility to support health improvement initiatives in the workplace. It makes absolute sense and it is the right thing to do. The RCM’s Caring for You campaign continues to promote staff wellbeing as a fundamental part of professional practice.

What support would help you quit, if cigarettes are your poison? Time off to attend stop smoking sessions of your own? A workplace that is genuinely smokefree? The RCM asks of the NHS to put staff wellbeing front and centre, to ensure the care is there for the staff who care.