At Manchester University NHS Foundation Trust there is a specialist midwife and four maternity support workers who work at its specialist stop smoking service.

We spoke to the fantastic maternity support team to find out a bit more about their role in helping pregnant smokers to quit.

“Our role is very similar to a general smoking cessation advisor role as we provide the same support and advice as they do, but we specialise in supporting pregnant smokers to quit,” said Julie Brooks who has been a maternity support worker for three years.  

“Patients are referred to us via midwives and other agencies. We know that it’s sometimes hard for people to open up about smoking as they worry about being judged, but that’s absolutely not the case and we reassure them that we’re here to help.

“A carbon monoxide reading is taken so that we can check for raised levels of the poisonous gas, which can slow a baby’s development and increase the risk of birth defects.

“We speak to our patients about the risks of smoking during pregnancy. Smoking increases the possibility of miscarriage, premature birth, stillbirth and sudden infant death syndrome, so it’s very important that everyone is aware of how harmful it is for baby. We know this is hard to hear and every parent wants the best for their child, so if you ever have this conversation with us, we’ll put you at ease and talk you through the help available.

“Many of the women we see have been smoking since a very young age and are addicted to it. Some of them have never thought about quitting before, and even though they want to quit to protect their baby it is incredibly difficult.

“We encourage them to engage with the service, and we arrange to see them once a week for the first four weeks, and then once a month after that. However, they can ring or text at any time if they need to talk and we support them for up to twelve months in total.”

The team often support women who are in challenging situations and have various lifestyle barriers, which makes quitting smoking even more difficult, so developing strong relationships with everyone they see is important.

Jo Collier, who has been part of the team since November 2018, said: “As well as providing practical support to the women who use our service, we also provide emotional support as being pregnant is a stressful time. It is important to build a relationship with them and to really listen to what they say.

“For us, it’s not just about someone’s smoking status, it’s about taking an interest in their family life or the living situation, as sometimes women are of no fixed abode.

“We support women of all ages too, so we recognise the challenges of quitting whether you’re a teenage mum-to-be, or an older mum who has perhaps smoked through a previous pregnancy. We explain the evidence that shows how smoking can harm a baby, and that we’re there to help baby have the best start to life and mum to have a healthy pregnancy.

“It’s important to build trust with the women who use our service, as it helps them to open up. A lot of people have found it very difficult during the pandemic, so sometimes they just need someone to talk to. We also support partners to quit smoking and one thing that has worked really well for the programme is our incentive scheme. This encourages parents-to-be to make a quit attempt and those who quit smoking successfully are offered shopping vouchers to help them prepare for the arrival of their new baby.”

The pandemic has had a huge impact on the NHS and the services it provides and stop smoking services across the UK have had to adapt to new ways of working by delivering support over the phone where possible, instead of face to face.

Maternity support worker Richard Waller joined Manchester University NHS Foundation Trust’s service in April 2020 and has not yet seen any of his patients in person.

He said: “When a woman is referred to the service, I contact them to book their first appointment and give them an overview of the support we offer.

“During the first appointment we would usually do a face-to-face Carbon monoxide (CO) screening, which hasn’t been possible with the pandemic since we are providing support over the phone. However, we have been able to provide individual carbon monoxide monitors which link to an app and enable people to complete screenings at home and then we receive the results so we can track their quit journey.

“As part of the support we offer we discuss smoking habits and the different ways to quit, before prescribing nicotine replacement therapy (NRT) to help with cravings and withdrawal. At present, we are either posting this out to the woman or arranging for the prescription to be sent to a local pharmacy.

“We also explain the need to quit as soon as possible, but we recognise that stopping smoking is a challenge and it can sometimes take more than one attempt. While it’s never too late, if you quit before week 15, it provides the greatest benefits for your baby.”

Since its launch, the Greater Manchester Smokefree Pregnancy Programme has helped hundreds of babies be born smokefree and is helping future generations to lead happier and healthier lives.

Julie added: “Our advice for anyone looking to quit smoking is speak to your midwife and engage with the service. We know that smoking is an addiction, not a lifestyle choice, so don’t be hard on yourself. We’re here to help and want to give you and your baby the best start to life.”