Baby Loss (Public Health Guidelines) — House of Commons, 2017-03-21
Topic: Health
William James Quince (Conservative, Centre-right): I thank my hon. Friend for that intervention. He, too, has done a huge amount of work in this area and is hugely supportive of the work of the all-party group on baby loss. He is quite right to highlight the regional variation that exists, and to which the Department is very much alive. I had not intended to focus on the specific demographics, in terms of race, but the figures do show that certain demographics have a higher propensity towards stillbirth. The honest answer is that we do not really know why, so there is a huge need for research in this area. I am not going to discuss that issue, but only because I want to focus specifically on smoking. My hon. Friend is quite right about that particular demographic, and the reasons behind higher stillbirth and neonatal death rates may well be a public health issue. I hope that the Minister and the Department will look into that independently of this debate Secondly, communication to pregnant women must be sensitive and non-judgmental. Qualitative findings from the babyClear programme found that pregnant smokers found the interventions unsettling, but they were receptive to the messages if they were delivered sympathetically. To do that, healthcare professionals must feel able to have conversations about harm and have clear evidence-based resources and support for pregnant women Thirdly, the Government should ensure the implementation of guidance from the National Institute for Health and Care Excellence. NICE guidelines recommend that referral for help to stop smoking should be opt-out rather than opt-in. Research published by Nottingham University in April 2016 on opt-out and opt-in referral systems found that adding CO monitoring with opt-out referrals doubled the number of pregnant smokers setting quit dates and reporting smoking cessation Further, a recent evaluation of the babyClear programme in the north-east of England found that it delivered impressive results. BabyClear is an intervention to support implementing NICE guidance on reducing smoking in pregnancy. Let me give some background. BabyClear began in late 2012. Since then, smoking at the time of delivery has fallen by 4.0% in the north-east compared with 2.5% nationally. That equates to about 1,500 fewer women smoking during pregnancy in the north-east than in 2012. The cost of implementing the core babyClear package over five years is estimated at £30 per delivery Fourthly, we should embed smoking cessation across the maternity transformation plan. There are nine workstreams altogether and smoking cessation is central to achieving success in most of those. As an example, the workstream, "training the workforce", should include training midwives on CO monitoring and referral, but there is a risk that smoking cessation is siloed into the workstream focused on improving prevention. It is vital that that does not happen Finally, the Nursing and Midwifery Council is updating its standards in relation to nurses and midwives. This training must be mandated and have smoking in pregnancy as a key part. These are all steps that can and should be taken by the Department of Health to help maintain the momentum on reducing smoking during pregnancy rates. However, there is one other suggestion that I would like the Minister to take away and discuss with his colleagues in other Departments. All alcohol bought in the UK carries a warning sign making it clear that pregnant women should not consume this product, yet only one packet of cigarettes in six carries a warning about the danger of smoking while pregnant. It is not unreasonable or unrealistic for all tobacco products to carry a similar warning to that seen on alcohol. I would be grateful to the Minister if he looked into the feasibility of introducing such a scheme. I understand that it falls under European law and European regulation, but that may, in the very near future, not be a problem This debate is absolutely not about criticising or demonising women and their partners who smoke during pregnancy. I fully appreciate that tobacco is highly addictive and that it is difficult to stop smoking. We also know that all parents want to give their baby the best possible start in life. We want a message to go out loudly and clearly that no matter what stage a woman is in her pregnancy, it is never too late to stop smoking. Yes, that can be difficult, but smoking is much more harmful to a baby than any stress that quitting may bring. Most importantly, we and the Department of Health will give parents all the support and tools to help them to quit.