Quit smoking advice for pregnant women in NHS drive to prevent stillbirths

Pregnant women are to be offered specialist stop smoking referrals as part of NHS action to reduce stillbirths, which has already resulted in at least 160 babies’ lives being saved.

Following the success of a programme introduced in 2015 which saw 20% fewer babies dying at birth, NHS England has today confirmed that the scheme will be rolled out across the country as part of its Long Term Plan for the health service.

All of England’s maternity services will be instructed to take up the new Saving Babies Lives toolkit which helps mums-to-be and NHS professionals look out for the warning signs of problem pregnancies, as well as offering specialist stop smoking help.

For the first time, following expert advice and parents’ experience, there will be a dedicated focus on reducing preterm births, a common complication of pregnancy which is strongly linked to lower rates of survival, and higher chances of health problems later in life.

The move has been welcomed by patient groups and health professionals, with Sands – a stillbirth and neonatal death charity – calling the package “essential knowledge” to prevent parents experiencing grief and loss.

NHS England chief executive Simon Stevens said: “No parent should have to endure the heartbreak of stillbirth, and NHS action, delivered through the skill and professionalism of our midwives, nurses and doctors – means an even greater number of parents and babies experience a healthy birth.

“The NHS Long Term Plan set out a clear and ambitious plan to improve England’s maternity services, which alongside even more expectant mums taking action themselves by stopping smoking, will make having a baby as safe as possible”

With carbon monoxide poisoning from smoking causing serious harm and even death for babies, as well as leading to complications in adulthood, NHS action will mean that from July this year:

  • All pregnant women will be offered an electronic carbon monoxide test at their antenatal appointments.
  • Any woman referred for specialist advice to quit will get it.
  • Any expectant mum who smokes or has recently quit will be offered specialist support throughout pregnancy, including as late as 36 weeks into the baby’s development.

Professor Jacqueline Dunkley-Bent, chief midwifery officer for England, said: “Having a baby in this country is now safer than ever before, but for some mums that’s not the case. The NHS Long Term Plan commits to help all families receive excellent maternity care and offering more support to stop smoking is an important part of this .”

Clea Harmer, Chief Executive of Sands, said: “It’s good to see that the NHS are offering specialist stop smoking help in the Care Bundle, as we know pregnant smokers and their partners need more help to quit. More than one in ten women in England are still smoking when their child is born with a real cost in babies’ lives.

“The NHS Long Term Plan commitment to fund intensive support is therefore very welcome and will provide much needed additional funding for existing services. This is investment the Smoking in Pregnancy Challenge Group have long been calling for.

“Sands welcomes the latest Saving Babies Lives Care Bundle as the next step towards meeting the Government’s commitment to halve stillbirths and neonatal baby deaths by 2025. This second version carries essential information for every healthcare professional who supports and works with pregnant women, and will help provide safer care to protect babies’ lives and ensure fewer families suffer grief and loss.”

Matt Hancock, Health Secretary said: “I want the NHS to be the best and safest place in the world to give birth – and today’s plans are a vital part of our commitment to halve stillbirths, infant deaths and serious brain injuries in new-borns.

“The number of women smoking in pregnancy is at a record low – but too many women still suffer the tragedy of a stillbirth as a result of smoking. Today’s important plans are about our continuing commitment to do everything in our power to address this, by supporting mums-to-be to quit, in pregnancy and for good.”

Alongside support for a healthy lifestyle, the introduction of the toolkit across England means midwives will be better equipped to spot the warning signs that are linked to stillbirth, including a foetus growing slowly, of reduced movement by a baby later in pregnancy.

In areas trialling the Saving Babies Lives package over the past year, there was a 59% increase in detection of growth problems, putting doctors and midwives in a better position to protect an at-risk baby.

As well as a dramatic impact on the families affected, preterm birth leads to extra need for care, putting strain on parents and their children and requiring extra NHS care worth an additional £3.4 billion per year.

Although only a tiny minority of pregnancies – just four out of every 1,000 – results in a stillbirth, and maternal death during labour is rare, any death related to birth or pregnancy causes devastation.

The NHS Long Term Plan sets out steps which will see a 50% reduction in stillbirths by 2025, building on progress in care which will contribute to a 20% decrease by the end of next year, and 827 fewer stillbirths during 2017.

As well as the expert toolkit for healthcare workers, the NHS has committed to ensuring most women receive continuity of carer – meaning they get seen by the same midwife and team during pregnancy, labour and postnatally, which makes mums-to-be 16% less likely to lose their baby.

Commenting, Clare Livingstone Professional Policy Advisor at the Royal College of Midwives (RCM) said: “The RCM welcomes commitments in the NHS Long Term Plan to fund smoking cessation services to support women to stop smoking during pregnancy.

“Reducing smoking in pregnancy is one of the key things that has to be done to reduce the UK’s stillbirth rate, but this cannot be achieved successfully without significant investment in specialist services. So the RCM is pleased that NHS England has confirmed today it will offer every pregnant woman referred for specialist advice to stop smoking support within 24 hours of referral.

“There is a need for support services to work with the whole family. Second hand tobacco smoke is also harmful in pregnancy, so the pledge to support and encourage pregnant women’s partners who smoke to also stop is particularly welcome.”