New training for midwives to help mums become smokefree
New clinical training for midwives to help more Kiwi Mums become smokefree
New Zealand midwives will be better equipped to help pregnant women protect themselves and their unborn babies from smoking, with the launch of the new Te Hapū Ora clinical training programme for midwives.
The Te Hapū Ora programme will replace all previous smoking in pregnancy training, for midwives nationwide. The programme recognises the unique, close partnership between a midwife and a pregnant woman as well as addressing gaps in existing knowledge and training about smoking in pregnancy.
One in three pregnancies are affected by smoking, says programme Service Coordinator Kelsey Stewart. Yet many midwives don’t feel confident approaching the topic of ‘smoking while pregnant’ or recommending a referral to a cessation service as part of their clinical practice. “How do we have a conversation with a woman about smoking while being mindful that we don’t want to judge her for smoking during her pregnancy?” Recent research highlights how smoking is an addiction, not a social choice. “We have clear research that details the known risks of smoking in pregnancy, and the negative outcomes that can occur in infancy through to adulthood”, she says.
For some women, however, smoking while pregnant is considered ‘normal’ and the effects are minimised. “It may be that a woman has a premature baby but that’s happened for her previous pregnancies so she sees that as ‘normal’.” It’s not a normal experience for babies to spend time in the Neonatal Intensive Care Unit (NICU), and better education about the serious risks of smoking is urgent in pregnancy. “Midwives and pregnant women can’t see a baby except during a 20 week scan so it’s easy to dismiss it as not real and underestimate the harm caused.” The new Te Hapū Ora programme uses a peertopeer training model. A team of 15 practicing midwives will be recruited, trained, resourced and supported to deliver the Te Hapū Ora workshops to practicing midwives. These specially trained midwives will be known as Clinical Link Champions (CLCs). Workshops will be available in each District Health Board (DHB) region over the next three years. Midwifery practices and hospital midwives will be advised of training dates as local deliveries are confirmed.
The new programme will see that midwives are clinically trained about smoking in pregnancy, and how to apply the ABC approach to provide best smokefree care to women who are pregnant and smoking. This model encourages health practitioners to Ask about and record smoking status, provide Brief smokefree advice (including information about cessation options); and recommend referral to a Cessation service.
“It is not the role of the midwife to provide multisession behavioural support to pregnant women who smoke. The skills and time required to support someone to become smokefree and to sustain that change sits outside the midwifery scope of practice,” says Mrs Stewart. However, a midwife could be the person who empowers a woman to make changes, by informing her about the effects of smoking in pregnancy, the benefits of being smokefree and referring them for cessation support. The training also ensures that a midwife is clinically informed about unexpected pregnancy and birthing outcomes, where smoking is likely to have been a key contributor.
As well as learning about the ABC approach, the Te Hapū Ora workshop comprises of group activities, discussions and the use of multimedia. Midwives will be enabled to share their experiences and best practice methods with each other. As part of the workshop training, midwives will be given exclusively designed resources to support their midwifery practice post training. Any ongoing support can be accessed via their local CLC.
CLCs are still being sought in Taranaki, Waikato, Capital and Coast, Wairarapa and Dunedin with payment provided for each workshop delivered. It is preferable that CLCs are practicing midwives with a passion to inspire their colleagues about smokefree pregnancies.
The Te Hapū Ora Programme will begin in the Upper North Island and South Island early this year before being rolled out into the rest of the country. Mrs Stewart says above all Te Hapū Ora aims to not only inform but inspire midwives to actively support women who are pregnant and smoking.
Te Hapū Ora Programme Service Co-ordinator
P O Box 33 459
Barrington, Christchurch 8244
M: 027 252 2013