In the room where Columbia County public health nurses Ali Hensel and Heather Stenberg confer with expectant mothers, there’s a poster of an infant who looks like he’s blowing a smoke ring.
The caption reads, “When mom or dad smokes, the whole family smokes.”
The success that Hensel and Stenberg have experienced in getting pregnant women enrolled in a program to stop smoking, or at least cut down, has earned them statewide acclaim.
Public Health Officer Susan Lorenz said the Columbia County site of First Breath/My Baby and Me — where Stenberg and Hensel work with expectant mothers on lessening their consumption of alcohol and nicotine — was the first such site in the state to be designated as a “Stellar Site” by the Wisconsin Women’s Health Foundation, an organization founded and headed by former Wisconsin first lady Sue Ann Thompson.
Lorenz recently told the Columbia County Board’s health and human services committee that there are 106 First Breath sites, in 59 of Wisconsin’s 72 counties, which offer help to pregnant women seeking to stop or cut down on smoking. Columbia County also is a Baby and Me site, with Hensel and Stenberg offering help to pregnant women who are trying to reduce or stop their consumption of alcohol.
Hensel noted that such sites exist not only in public health agencies such as the Columbia County Department of Human Services, but also at many private medical clinics — none of them, she said, in Columbia County.
Hensel and Stenberg work with the Women, Infants and Children program to provide prenatal care coordination, which is a benefit available through BadgerCare. The Columbia County program serves only women who are recipients of Medicaid or BadgerCare.
In 2011, 18 women participated in First Breath in Columbia County. This year, the number was 35 as of November, and the program is on track to double its 2011 enrollment.
This is a significant step, Hensel said, because Columbia County has a higher rate of smoking than the state in general, and because the health conditions for mothers and children that can result from prenatal smoking are, at times, very costly to treat.
Hensel said it has been her experience that most women who smoke want to quit smoking when they’re expecting, but they may not feel they can succeed.
Stenberg said the program does not utilize drugs or nicotine patches, because they can harm the gestating fetus.
Instead, each participant undergoes a motivational interview that includes questions about how old they were when they started smoking (most smokers in Columbia County started between the ages of 13 and 17).
On the first day, each participant gets a gift — a water bottle, filled with items that women can use when they get the urge to smoke, such as gum, mints, a nail file and a booklet with tips to manage those moments when the temptation to smoke is strong.
“There’s even an envelope,” Stenberg said, “to put in the money that they’d otherwise spend on cigarettes.”
Stenberg said the program requires that the nurses meet with participants at least three times, though many meet much more often.
The meetings include discussions of the dangers of smoking for pregnant women, including a higher risk for pre-term labor, babies with low birth weight and babies with higher risks for conditions such as asthma and ear infections.
Participants are invited to talk to the nurse about what they typically do, and where they go, when they smoke. Do they smoke with a cup of coffee in the morning? In their cars during a break at work?
People closest to the pregnant woman, such as her partner, parents or friends, are invited to learn how they can support her effort to quit or cut down, even if they also smoke.
Statewide statistics show that 35 percent of women who participate in First Breath succeed in quitting smoking altogether, and another 31 percent decrease their consumption of nicotine.
If there is a relapse, there’s no judgment.
“A relapse doesn’t mean you have to go back to what you were doing before,” Hensel said. “But we want to sit down and try to figure out why there was a relapse, and where do they go from here.”