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By Helen Baston; Jennifer Hall

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Products containing controlled amounts of nicotine are available over the counter in the form of chewing-gum, patches and lozenges. They were previously contraindicated during pregnancy and breastfeeding and not available on the NHS. However, the National Institute for Health and Clinical Excellence (NICE) has undertaken technical appraisal of the use of nicotine replacement therapy (NRT) and the drug Bupropion (amfebutamone) (NICE 2002). It concluded that NRT could be prescribed (free of charge) to pregnant women following discussion with an appropriate healthcare professional with careful consideration of the risks and benefits.

What advice can the midwife offer Jessica to help her achieve a home birth? Conclusion The booking interview presents a unique opportunity for the woman and midwife to form a relationship and develop mutual respect. It may be the first time that the woman has come across a midwife and she may be unclear about her role and what to expect from antenatal care. Ideally she will come away feeling that she has met someone who is competent and caring and with whom she can discuss her hopes and fears. 35 Midwifery Essentials Antenatal Resources Department of Health: http://www.

It is, however, a recommendation that adults do not consume more than 6 g of salt daily, to reduce the risk of hypertension and associated vascular disease (Food Standards Agency 2008b). Caffeine The Food Standards Agency (2008) recommends that women should not 44 consume more than 300 mg of caffeine per day (3 mugs of coffee) as excessive intake has been linked to low birthweight and miscarriage. A study by Cnattingius et al (2000) found an increased risk of spontaneous abortion at levels of caffeine consumption above 100 mg.

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