Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what guidance his Department provides to the health profession on treating (a) pregnant women and (b) unborn children for carbon monoxide poisoning.
Answered by Nadine Dorries
Guidance on the management of treatment of pregnant women and unborn children for carbon monoxide poisoning is provided and accessible to healthcare professionals on TOXBASE and the United Kingdom Teratology Information Service (UKTIS) website.
If carbon monoxide poisoning is suspected, the initial management is the same as for a non-pregnant patient and consists of identifying and removing the patient from the source of exposure, followed by administration of high concentration oxygen. The patient’s carboxyhaemoglobin concentration should be measured initially and monitored. Treatment may need to be continued for longer in pregnant patients compared to a non-pregnant patient.
It is advised that all cases of carbon monoxide poisoning in pregnancy are discussed with the UKTIS.
Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to protect (a) unborn children and (b) infants from carbon monoxide poisoning.
Answered by Nadine Dorries
Long-term exposure to carbon monoxide gas can damage an unborn baby. Babies exposed to carbon monoxide during pregnancy are at risk of a low birth weight; stillbirth; death that occurs within the first four weeks of birth; and behavioural problems.
Women are tested for the presence of carbon monoxide at the antenatal booking appointment and as appropriate throughout pregnancy to identify smokers, or those exposed to tobacco smoke, and offer them a referral for support from a trained stop smoking advisor. Carbon monoxide testing may also highlight a household problem and the need to take measures to prevent further exposure.
Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of carbon monoxide poisoning during pregnancy on the unborn child; and if he will make a statement.
Answered by Nadine Dorries
Long-term exposure to carbon monoxide gas can damage an unborn baby. Babies exposed to carbon monoxide during pregnancy are at risk of a low birth weight; stillbirth; death that occurs within the first four weeks of birth; and behavioural problems.
Women are tested for the presence of carbon monoxide at the antenatal booking appointment and as appropriate throughout pregnancy to identify smokers, or those exposed to tobacco smoke, and offer them a referral for support from a trained stop smoking advisor. Carbon monoxide testing may also highlight a household problem and the need to take measures to prevent further exposure.
Asked by: Baroness Finlay of Llandaff (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many non-smoking pregnant women, who have their carbon monoxide levels routinely monitored, have been found to have raised levels of carbon monoxide.
Answered by Baroness Blackwood of North Oxford
This information is not held centrally.
Asked by: Barry Sheerman (Labour (Co-op) - Huddersfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to provide free carbon monoxide monitors to people in their first pregnancy to help protect pregnant people and their children.
Answered by Steve Brine
The Department currently has no plans to provide free carbon monoxide monitors to people in their first pregnancy.
Exposure to carbon monoxide presents a risk to pregnant women and can be caused by smoking during pregnancy or other environmental factors. The Saving Babies Lives Care Bundle includes an element for reducing smoking in pregnancy by following National Institute for Health and Care Excellence guidance. This will be achieved by offering carbon monoxide testing for all women at the antenatal booking appointment and as appropriate throughout pregnancy, to identify smokers, or those exposed to tobacco smoke, and offer them a referral for support from a trained stop smoking advisor. The NHS Long Term Plan and 2019/20 Planning Guidance sets out that the care bundle will be rolled out across every maternity unit in England in 2019.
For all pregnant women, carbon monoxide testing may also highlight a household problem and the need to take measures to prevent further exposure.
Asked by: Lord Blencathra (Conservative - Life peer)
Question to the Cabinet Office:
Her Majesty's Government whether they have any plans to commemorate in October the many millions who have died, since the October Revolution 1917, as a result of the actions of the governments of the USSR, the National Socialist government of Germany, the Communist Party of China, the Democratic Republic of Kampuchea, the Democratic People's Republic of Korea, the Democratic Republic of Vietnam, the People's Democratic Republic of Ethiopia, the People's Republic of Bulgaria, the German Democratic Republic, the Republic of Cuba, the People's Republic of Angola, the People's Socialist Republic of Albania, the Lao People's Democratic Republic, the Bolivarian Republic of Venezuela and other countries which established governments founded on Marxist-socialist principles.
Answered by Lord Young of Cookham
There are currently no such plans.
Asked by: Lord Jones of Cheltenham (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the Care Quality Commission’s new maternity inspection framework and NHS England’s new maternity commissioning guidance will explicitly refer to the need to demonstrate how providers are actively working to reduce the much higher risks of still birth, neonatal death and clinical negligence claims among multiple pregnancies.
Answered by Lord Prior of Brampton
The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England and has supplied the following information:
The current version of CQC’s core service framework does not refer explicitly to multiple births. CQC is currently reviewing the framework and they are working with organisations such as the Twins and Multiple Births Association to determine how best to ensure their new framework takes account of the risks associated with multiple births. As part of the existing inspection framework CQC expects maternity services to have due regard to existing advice and guidance, such as NICE Quality Standard 46 which refers specifically to multiple births and risk assessments. Going forward the CQC will expect trusts to provide evidence of their compliance with these recommendations.
NHS England has informed us that its new maternity commissioning guidance will explicitly refer to the need to demonstrate how providers are actively working to reduce the much higher risks of still birth, neonatal death and clinical negligence claims among multiple pregnancies and how it will achieve this.
The Department together with the parent’s support and campaigning organisation Stillbirth and Neonatal Death Charity (Sands) and a number of key organisations including NHS England, Public Health England, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists are working on an on-going stillbirth prevention work programme. This work identifies key messages which can be used to raise awareness among both pregnant women and health professionals of the risk factors for stillbirths and the actions that can be taken to minimise these risks.
The new maternity commissioning guidance will make reference to stillbirth prevention work and will focus on identifying the evidence based interventions which impact on reducing stillbirths and early neonatal death.
NHS England has been working with many stakeholders on collating a package of interventions and best practice models to reduce stillbirths which will result in recommendations for clinical practice and are likely to be included in future commissioning specifications for maternity. The NHS England – led “Saving Babies’ Lives” Care Bundle brings together a number of elements likely to impact on still birth rates including:
- reducing smoking in pregnancy by carrying out Carbon Monoxide test at antenatal booking appointment to identify smokers (or those exposed to tobacco smoke) and referring to stop smoking service/specialist as appropriate;
- identification and surveillance of pregnancies with fetal growth restriction;
- raising awareness amongst pregnant women of the importance of detecting and reporting reduced fetal movement; and
- effective fetal monitoring during labour.
The commissioning guidance will refer to sufficient provision of resource to support appropriate levels of these types of surveillance within the clinical practice environment.