International Midwifery Partnership to Reduce Smoke Exposure in Pregnancy

The World Health Organization (WHO) and the International Confederation of Midwives (ICM) are working together to:

  1. Translate recently-published WHO recommendations on prevention and management of tobacco use, and secondhand smoke exposure in pregnancy, into a competency-based tool
  2. Share the tool with midwives

The partnership furthers the WHO’s global commitment to reducing tobacco use and ICM’s mission to globally strengthen Midwives Associations, advance the profession of midwifery and enhance the reproductive health of women, their newborns and families.

At a historic meeting at the July Asia-Pacific ICM Congress in Yokohama this year, delegates had the opportunity to contribute to testing and shaping the tool, to ensure effective implementation.

Frances McConville

Frances E. McConville

Frances E. McConville, technical officer for midwifery at the WHO, set the scene by offering an overview of “Tobacco-Free During Pregnancy and Beyond: A Global Action Strategy.”  She discussed WHO’s commitment to tobacco-free pregnancies and reducing non-communicable diseases, the harms of smoke-exposure in pregnancy, the benefits of quitting, the recommendations in the new WHO document and three draft tools.

Of particular note were that “pregnancy is a unique teachable moment,” and the three-step call to midwifery action with every smoke-exposed pregnancy: “Ask – Assist – Connect.”


Grace Wong presented “New Zealand: A country case study of midwifery practice and smoking cessation.”


Nestor T. Moyo

Nester T. Moyo, senior midwifery advisor for ICM, discussed the ICM process of developing and accepting competencies, the development of two tobacco competencies, how they fit into ICM, and where and how they will be available to the wider community.

Kathleen Kennedy led the group work with 20 delegates from 10 countries. They provided feedback on:

  • Three WHO draft tools to facilitate midwives implementing the WHO recommendations on prevention and management of tobacco use and exposure to secondhand smoke in pregnancy.
  • Two ICM competency documents to support the WHO recommendations and tools

Feedback emphasized developing communication skills to reduce smoke exposure from partners’ and elders’ smoking, a major issue in the Asia-Pacific region. An interesting recommendation was furthering the alignment of the tools with the story of “Mrs X,” whose story begins a widely used WHO community midwifery education module. Her story links safe childbirth practice, women’s needs and the place and value of women in society.


Presenters (left to right): Kathleen Kennedy, Grace Wong, Nester T. Moyo, Frances McConville