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Smoking in pregnancy

Smoking in pregnancy poses significant health risks to the mother and baby. In addition to all the health risks associated with smoking for the general population, some risks to the mother are specific to pregnancy, including ectopic pregnancy, placenta praevia, and pre-eclampsia. Pregnant women who smoke are also at increased risk of deep vein thrombosis (DVT).

Risks to the fetus are also increased in women who smoke: these include spontaneous abortion, miscarriage, stillbirth, premature birth, low birth weight, intrauterine grown restriction and neonatal death. Babies born to mothers who smoke are also twice as likely to die from Sudden Unexplained Death in Infancy. Children of mothers who smoke are more likely to have behavioural problems, learning difficulties, reduced educational performance and are at increased risk of respiratory disease and other upper respiratory tract infections.

Although some women will stop smoking before becoming pregnant or as soon as they know they are pregnant, others will need considerable support to quit. Nicotine in cigarettes is highly addictive and smoking is a chronic relapsing condition.

Midwives have an important role to play in encouraging women to stop smoking in pregnancy (and to quit permanently) and offering very brief advice on smoking has been shown to be effective. The midwife should offer referrals to local Stop Smoking services, and discuss the use of nicotine replacement therapy with women who are having difficulty in quitting. Carbon monoxide screening (to detect smoking) should be carried out routinely on all pregnant women.

The Practising Midwife featured articles

Smoking in pregnancy, where are we now? 2013; 16(7): 12 - 15 Authors: Cathy Ashwin, Jayne Marshall, Penny Standen

Cut it out! Smoking and pregnancy 2012; 15(5): 35 - 39 Author: Mandy Galloway

Further reading

Public Health England. National Centre for Smoking Cessation and Training (NCSCT). (2015).

Smoking cessation: a briefing for midwifery staff.

NICE (2010). Smoking: stopping in pregnancy and after childbirth. Public health guidance 26.

NHS Smokefree: Pregnancy and smoking.


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