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Smoking in Pregnancy Project Report: June 2012 10. Annex C: Labour ward CO guidelines* MATERNITY SERVICES GUIDELINES CARBON MONOXIDE (CO) TESTING PREGNANT WOMEN ON ADMISSION TO THE LABOUR WARD 1.0 Introduction Smoking in pregnancy remains a key public health concern; it contributes to a wide range of health problems for expectant mothers, their unborn babies and their families. It is a significant risk factor in infant mortality. It can cause serious problems including complications during labour, increased risk of miscarriage, premature birth, low birth weight and stillbirth. Women who smoke during pregnancy have an increased risk of: ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Low birth weight baby (
Smoking in Pregnancy Project Report: June 2012 2.2 Objectives ■ ■ ■ To implement CO testing as part of the routine assessment for pregnant women presenting in established labour on admission to the labour ward To verify smoking status of the pregnant women in labour To provide biochemically validated prevalence rates for reporting smoking at time of delivery (SATOD) within the local area 3.0 Scope and Principles 3.1 Scope This guidance applies to all midwives caring for women who choose to have their babies at [name of organisation] 3.2 Principles To ensure evidence based information and best practice guidance is available to all midwives working within the maternity services when caring for a woman during pregnancy. 4.0 Procedure for CO Testing 4.1 CO test The CO test will be offered to all women admitted to the labour ward in established labour by the midwife as part of the midwife’s assessment of the woman’s health and wellbeing. The CO test will be carried out as a routine part of the midwife’s admission procedure unless the client specifically declines consent. 4.2 CO test consent declined – non- smoker /smoker ■ ■ ■ If the woman declines consent for testing, the midwife should document that she has declined the test and reason why in the hand held notes and in the maternity records as applicable. The midwife should ask the patient if she smokes and the smoking status should then be recorded [exactly where to be agreed]. If the patient self-reports as a smoker, the midwife should inform the patient of the implications of continuing to smoke and benefits of stopping for her and her unborn baby. 53
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