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Element 1: supporting women to stop smoking in pregnancy
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Process
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Proportion of women who are asked about their smoking status at first antenatal care visit and at 28 weeks antenatal appointment.
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Proportion of women who undertake exhaled breath carbon monoxide analysis at first antenatal care visit and at 28 weeks antenatal appointment.
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Proportion of women, identified as smoking or recent quitters at first antenatal care visit, who are provided with advice on the benefits of quitting.
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Proportion of women, identified as smoking, with documented referral to smoking cessation service (e.g. Quitline).
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Impact
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Proportion of women, identified as smoking, with documented referral to smoking service who engaged with a smoking cessation service.
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Percentage of women who cease smoking between first antenatal care visit and birth
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Element 2: improving detection and management of FGR
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Process
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Proportion of women with documented risk assessment for FGR at first antenatal care visit.
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Proportion of women (at any gestation) identified as at risk of FGR whose care was escalated as per the FGR care pathwaya.
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Proportion of women with SFH measurement taken and plotted on growth chart at each antenatal visit from 24 weeks’ gestation.
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Proportion of stillbirths from 28 weeks’ gestation where substandard care for FGR detection or management are identified
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Maternity services impact
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Proportion of term births with undetected FGR defined as severely growth restricted singletons (less than 3rd centile) undelivered at 40 weeks’ gestation (missed FGR)
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Outcome
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Proportion of singleton babies delivered for suspected FGR at 37 weeks’ gestation or more who have a birthweight >25th centile.
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Element 3: raising awareness and improving care for women with DFM
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Process
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Proportion of women provided with DFM information by 28 weeks’ gestation.
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Maternity services impact
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Proportion of women with singleton pregnancies who have a CTG commenced within 2 hours of presenting (in person) at the maternity service with DFM, from 28 weeks’ gestation.
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Proportion of stillbirths from 28 weeks’ gestation where substandard care for DFM reporting or management are identified
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Percentage of women at 28 weeks’ gestation or more who attend a maternity service within 12hrs of DFM concern.
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Proportion of women with singleton pregnancies who present with DFM who undergo induction of labour or elective caesarean section before 39 weeks’ gestation for DFM as the only indication.
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Element 4: improving awareness of maternal safe going-to-sleep position in late pregnancy
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Process
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Proportion of women who, by 28 weeks’ gestation, were given the information brochure on safe going-to-sleep position in late pregnancy.
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Impact
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Proportion of women who report safe sleep practices after 28 weeks’ gestation.
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Proportion of women after 28 weeks’ gestation who can describe safe sleep practices (going to sleep on their side).
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Element 5: improving decision making about the timing of birth for women with risk factors for stillbirth
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Process
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Proportion of women assessed for stillbirth risk factors at first antenatal care visit
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Proportion of women reassessed for stillbirth risk factors at 34-36+6 weeks’ gestation
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Impact
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Proportion of women who report being involved as much as they wanted in decision-making about timing of birth
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Outcome
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Proportion of women with singleton pregnancies who undergo induction of labour or elective caesarean section before 39 weeks’ gestation.
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