Belfast Telegraph

Pregnant smokers in Northern Ireland facing a postcode lottery as not all can get expert help to quit

Only three of Northern Ireland's health trusts have a stop smoking specialist midwife to help expectant mums kick the habit. Stock image
Only three of Northern Ireland's health trusts have a stop smoking specialist midwife to help expectant mums kick the habit. Stock image

By Lisa Smyth

Only three of Northern Ireland's health trusts have a stop smoking specialist midwife to help expectant mums kick the habit.

Pregnant women living in the Belfast, Southern and South Eastern trusts can access specialist services to help them give up.

Around 15% of local woman smoke during pregnancy, according to the South Eastern Trust.

Last year there were 23,154 births here and around 3,473 of them were to women who smoked in pregnancy.

However, the specialist stop smoking midwives are not available at Altnagelvin, Antrim, Causeway or South West Acute hospitals.

The risks of smoking during pregnancy are serious, from premature labour to an increased chance of miscarriage, stillbirth or sudden infant death.

While only three of the trusts have specialist stop smoking midwives, the Public Health Agency (PHA) funds tests to help identify women who smoke.

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The PHA said: "The PHA has provided funding to each of the five health and social care trusts to ensure all pregnant women are offered carbon monoxide testing when they book in at the early stages of their pregnancy, followed up with another test for those women who have tested positive when their baby is born.

"The women who test positive are given immediate advice and offered referral to smoking cessation services. Comprehensive stop smoking support is available for pregnant women in all health and social care trusts."

However, official figures show that the Northern and Western trusts, where no stop smoking specialist midwives work, had the worst cessation rates in 2017/18.

According to Department of Health figures, 88 women set a quit date in the Western Trust in 2017/18, while 145 women in the Northern Trust set a quit date over the 12-month period.

This compared to 194, 192 and 286 in the Belfast, South Eastern and Southern trusts respectively. Fifty-two percent and 57% of women in the Northern and Western trusts respectively had successfully quit smoking four weeks later, while the success rate was 63% in the Belfast and Southern trusts and 70% in the South Eastern Trust.

Alliance Party health spokeswoman Paula Bradshaw said the figures show a direct correlation between the availability of stop smoking specialist support and the success of stop smoking efforts.

She added: "What we have in effect is a postcode lottery which ultimately affects the health of children depending on where they happen to be born, as well as their mothers.

"There can be no question that specialist smoking cessation support should be available to mothers on the same basis across all trusts."

The Royal College of Midwives (RCM) has called for better services to help pregnant women stop smoking.

It has revealed that almost 70% of heads of midwifery have reported that they are without a stop smoking specialist midwife in their maternity team.

The RCM has shared the findings from its annual heads of midwifery survey as it publishes a new position statement on 'Support to Quit Smoking in Pregnancy'.

It has called for specialist stop smoking support to be available to all pregnant women on an opt out basis. It also wants all NHS staff to be supported to stop smoking.

RCM chief executive Gill Walton said: "Smoking significantly increases the risk of miscarriage, stillbirth, and sudden infant death and birth abnormalities. Smoking also damages a mother's health and is associated with maternal risks in pregnancy, such as placental abruption and eclampsia.

"Evidence shows that stopping smoking early in pregnancy can almost entirely prevent adverse effects and we need to be doing all we can to support women and their families to stop smoking.

"If we are serious about tackling smoking rates in pregnancy what is needed is specialist stop smoking advisors who are closely aligned with and contain members of the maternity team."

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