Mark Allen Publishing Ltd
Faculty of Health, Engineering and Science
School of Nursing and Midwifery / Clinical Nursing and Midwifery Research Centre
Background: Papanicoloau (Pap) smear screening has helped to reduce cervical cancer rates significantly through the detection of premalignant cells (Bray et al, 2005). Uptake among women who use alcohol and other drugs (AOD) is known to be low (Chau et al, 2002) so they are at increased risk of being under-represented in the adequately screened population. AOD-using women experience disproportionately increased morbidity and mortality from cervical dysplasia and cancer (Nogara et al, 2013). Pregnancy may provide the midwife an opportunity to offer this vital screening test. Objective: The audit investigated Pap smear uptake and results among AOD-using pregnant women. Setting: Pregnant women cared for by an obstetric AOD service based in a tertiary hospital in Perth, Western Australia, were eligible for inclusion in the study. Results: Across a period of 12 months, 333 childbearing-aged AOD-addicted women were audited: 142 had a Pap smear in the previous 3 years; 80 had not had a Pap smear in the previous 3 years; 80 declined a Pap smear; and 31 were either illegible or no record was available. Conclusion: This audit emphasises the importance of Pap smears being offered and followed up among the population of AOD-using pregnant mothers. Encouraging early booking and access to early antenatal care with midwives who are proficient in Pap smear collection is essential in order to provide optimal care.