Smoking and pregnancy

The adverse effects of smoking in pregnancy include miscarriage, ectopic pregnancy, stillbirth and birth defects (Royal College of Obstetricians and Gynaecologists, 2015). According to NHS Digital (2018), around 11% of pregnant women in England were known smokers at the time of giving birth in 2017/18, down from 16% in 2006/07. The Royal College of Midwives (RCM) (2019a) also noted that 15% and 16% of pregnant Northern Irish and Welsh smokers, respectively, continued to smoke in pregnancy, while in Scotland, 29.8% of pregnant women in the most deprived areas were smokers at booking, compared to 6.0% in the least deprived areas.

The guidance from the National Institute for Health and Care Excellence (NICE) (2010) for midwives to identify pregnant women who smoke and refer them to NHS Stop Smoking Services, from which they can opt out, is welcome. Midwives should ‘[a]ssess the woman's exposure to tobacco smoke through discussion and use of a carbon monoxide (CO) test. Explain that the CO test will allow her to see a physical measure of her smoking and her exposure to other people's smoking’ (NICE, 2010: 9).