[Smoking and pregnancy: the role of the gynecologist-obstetrician and the obstetrical team].
Pregnancy is a particular period of life which changes the woman's smoking behavior. One-third of smoking women stop smoking spontaneously during this period and a large proportion request help with smoking cessation. Gynecologist-obstetricians who are concerned by the technical aspects of the pregnancy and other classical risk factors (gestational diabetes, hypertension) play an indispensable role, but together with the entire obstetrical team they must become more involved to fully take into account this toxic disease in their everyday practice. We report the experience of a level 1 maternity supported by the Lorrain Perinatal Network, the Association for Perinatal Prevention, Research and Information, and the work of our midwife anti-smoking team. The first step was better awareness. We shared our knowledge about the profile of the smoking mother and her expectations and about the usefulness of CO monitoring (prenatal consultations, hospital stay, delivery room). We then established a strategy for our entire healthcare facility involving minimal training for all categories of personnel, definition of screening and prevention modalities, and obstetrical care for smoking mothers. We also organized a smoking cessation supportive care program. Applied during outpatient consultations and hospital stays and in the delivery room, the program also included a smoking-cessation consultation with two midwives in the unit in cooperation with a physician and a dietitian working with smoking patients. A survey conducted in 24 maternity wards participating in the Lorrain Perinatal Network and five Perinatal Care Centers enabled an assessment of their participation in the smoking-cessation program and to evaluate their needs. Perinatal indicators are not satisfactory in France and it will be interesting to observe what changes can be achieved in each maternity ward after application of the smoking cessation care and support program.
Maternité du Centre Hospitalier François Maillot, 31, avenue Albert-de-Briey, 54150 Briey Cedex.
M-L
ML
Bertrand
M-P
MP
Vegezzi
R
R
Ecoe
J
J
Dietsch
D005260:Female; D006176:Gynecology; D006801:Humans; D009774:Obstetrics; D010348:Patient Care Team; D018743:Perinatal Care; D011247:Pregnancy; D000074606:Smoking Prevention