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Increased referrals following routine carbon monoxide in antenatal clinics
Ann Fitchett, Stop Smoking Specialist Nurse Advisor, Pregnancy and Child Health, Public Health, Birmingham
Abstract
Smoking during pregnancy is linked with major adverse consequences for both the mother and baby. The risks of pre-term birth, low birth weight, perinatal death and sudden infant death are all reduced if the woman stops smoking when pregnant (Lumley et al 2003). The risks of ectopic pregnancy and miscarriage are also greatly reduced by smoking cessation during pregnancy (Lawrence et al 2003). The West Midlands region unfortunately has one of the highest perinatal death rates in the United Kingdom; consequently reducing smoking during pregnancy is high on the public health agenda.
There had been a steady flow of referrals into the South Birmingham PCT specialist pregnancy stop smoking service since it was first established in 2003. However there were many pregnant smokers not being referred into the service who if given the opportunity may successfully stop smoking. The specialist service offers individual tailored intensive support with accurate information on the use of Nicotine Replacement during pregnancy if required.
So how could we get more referrals into the service?
Two community midwifery teams were contacted by the pregnancy specialist advisor. Following very successful and positive meetings they agreed to undertake a 4 month pilot project of inviting every pregnant woman, smoker and non smoker alike, attending any antenatal clinic appointment to have their carbon monoxide level recorded.
Evaluation of the project revealed that carbon monoxide monitoring in the antenatal clinic was very well received by both midwives and patients alike. The outcome of the project was a dramatic increase of referrals into the specialist service from 60 successful contact referrals during 2004-2005 to 112 during 2005-2006 and 178 during 2006-2007.
Biography
I worked for 14yrs as a Practice Nurse in General Practice. In 2002 I began working for the Stop Smoking Service. During 2003 I started to work as the pregnancy stop smoking advisor in close collaboration and co-operation with the local maternity hospital.
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