Can support and education for smoking cessation and reduction be provided effectively by midwives within primary maternity care?
OBJECTIVE
To test the hypothesis that appropriate interventions delivered by midwives within usual primary maternity care, can assist women to stop or reduce the amount they smoke and facilitate longer duration of breast feeding.


METHODS
In a cluster randomised trial of smoking education and breast-feeding interventions in the lower North Island, New Zealand, midwives were stratified by locality and randomly allocated into a control group and three intervention groups. The control group provided usual care. Midwives in the intervention groups delivered either a programme of education and support for smoking cessation or reduction, a programme of education and support for breast feeding or both programmes. Sixty-one midwives recruited a total of 297 women.


METHODS
Structured programmes provided by midwives.


RESULTS
Women receiving only the smoking cessation or reduction programme were significantly more likely to have reduced, stopped smoking or maintained smoking changes than women in the control group, at 28 weeks and 36 weeks gestation. Women receiving both the smoking cessation and breast-feeding education and support programmes were significantly more likely than women in the control group to have changed their smoking behaviour at 36 weeks gestation. There was no difference in rates of cessation or reduction between the groups in the postnatal period. There was no difference in rates of full breast feeding between the control and intervention groups for women who planned to breast feed.


CONCLUSIONS
Education and support by midwives, as part of primary midwifery, can facilitate smoking cessation and reduction during pregnancy.
McLeod
Deborah
D
Department of General Practice, Wellington School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington South, New Zealand. dmcleod@wnmeds.ac.nz
Pullon
Susan
S
Benn
Cheryl
C
Cookson
Timothy
T
Dowell
Anthony
A
Viccars
Anne
A
White
Sonya
S
Green
Robyn
R
Crooke
Michael
M
D001942:Breast Feeding; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000379:methods / Q000592:standards; D009035:Mothers / Q000193:education / Q000523:psychology; D009042:Motivation; D009520:New Zealand; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods*; D012648:Self Care / Q000379:methods; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires; D016387:Women's Health