Pregnant women should take 'smoking test': what do you think?

on the other hand they are catching a lot of smokers.

Catching? Like we're naughty school girls having a fag behind the bike shed?? Give me a break.

I'm in Scotland - not had this test, and I was handled by two different sets of HCPs.

I did smoke very occasionally while pregnant - maybe 1 fag every couple of weeks.. I often feel very guilty about it. But I never lied when asked in an appointment - in fact if I had lied, they would''ve been able to tell, I'm such a bad liar! I was always told 'not good for the baby, have some leaflets' but never ever felt like I was pressured or guilt-tripped into stopping. My GP said that if I wanted help to stop, it was there.

This is invasive. Yes, some women will lie. Some will tell the truth. Honestly, if someone asks me to do it next time round, I'm going to say NO. I am informed, I know the risks.

Yes I would, but does the MW give advice on that, or does she assume the patient is lying? They can't be offering a test for something (check your boiler isn't faulty) and then use the results for something different altogether and not provide the relevant info on getting your boiler checked.

GlaikitFizzog, well you'd know to get your boiler checked.

The UK is at risk of becoming a bit of a nanny state, isn't it? A bit like the HVs that never tell you that you do not need to see them and then monitor you like we are living "the lives of others" (I refer to that film about the former GDR). I don't smoke and never have but this is just not right. Perhaps teenage mothers might benefit from some more explanation (doubt it) but not really from a test. I just don't like the 1984 feel of it.

"utter meddlesome nonsense"

They've been doing this in our area for at least a year. DD's one and I had it. Maybe the midwife thought I looked like I was fibbing.

It's tricky as on one hand people are saying 'don't they trust us to tell the truth' and on the other hand they are catching a lot of smokers.

The midwives job is to look out for the baby and it probably helps them to know what risks they're dealing with re. how long the placenta might last and all sorts of complications that could arise.

All they can do is refer you to the cessation people anyway. It's just typical of the way things run nowadays - I know in my job we have to log everything, make the right referals etc: all arse covering.

I think this is an appalling waste of money. I don't smoke and have never smoked, and as it happens, I deplore the fact that anybody smokes during pregnancy because of the risk to the baby. However, this measure is not going to change anyone's behaviour whatsoever. No one is any doubt that smoking during pregnancy is "bad", and being harassed by the NHS isn't going to make anyone quit.

This is a waste of money that would be better spent employing more midwives or increasing the number of scans women are given - we need a better tool for assessing the health of the unborn baby between weeks 20 and 40 than a sodding tape measure. Let's not forget that Britain has one of the highest rates of stillbirth in the developed world. I know smoking can be a factor in stillbirth, miscarriage, prematurity, low birthweight etc etc and is therefore important, but this initiative is unlikely to make women stop, because they already know they shouldn't be smoking.

The number of women who lie about smoking country-wide is probably insignificant - ok, so allegedly 1 in 4 women in the west of Scotland lie about smoking in pregnancy, but what about the rest of the country? Glasgow isn't representative of Scotland, much less the whole of the UK. It is known for having areas of economic deprivation, poor education etc etc (Glasgow is a lovely city, btw! Not meaning to knock it) which are associated with poorer health and, in fact, higher levels of smoking, alcohol abuse and drug abuse. I also think there is a culture of smoking in Glasgow, much more so than in Edinburgh or Aberdeen, across all levels of society (although that's based on personal observation, so I can't substantiate it).

I think to devote money to catching women out in a lie is shocking, particularly when there is no proof that it actually makes them stop smoking.

On that point then, what do they do if the levels are high, the lady says she isn't a smoker, but does have a boiler at home? Is there a crack team of gas appliance engineers waiting to swoop? Or will she be assumed to be a liar about the smoking and sent off the quitting MW?

I have never smoked and no one in our home smokes, our Carbon Monoxide Alarm registers 0. Out of interest, if you live in a smoking household what does your alarm register?

PS to my previous post:

And if the MW DOES believe her explanation that she doesn't smoke and her CO level is due to eg passive smoking, or the MW goes on other evidence such as smell of smoke on clothes to conclude that the woman does in face smoke, then the test is useless!

It seems these tests are being touted as able to pick up CO problems in the home from dodgy boilers, etc, yet I assume that the results of said test on the day will not be able to differentiate between an elevated CO level due to smoke, an elevated CO level due to a dodgy boiler, and a CO level due to the effects of pollution (including exposure to second hand cigarette smoke).

Will a woman who scores positive on the test, no matter what the explanation for her elevated CO, still be pushed in the direction of smoking cessation services? Will the only NHS response be the disbelieve her if she says she does not smoke?

Another thought for the medics/science types amongst us: how long does CO hang around in the blood at the level that would score positive on this test? Could you just not have a fag a few hours before your MW appointment and obtain your negative score?

Can I also point you all in the direction of the NMC: Standards of conduct, performance and ethics for nurses and midwives

4 You must act as an advocate for those in your care, helping them to access relevant health and social care, information and support.
Respect people?s confidentiality

13 You must ensure that you gain consent before you begin any treatment or care.

14 You must respect and support people?s rights to accept or decline treatment and care.

15 You must uphold people?s rights to be fully involved in decisions about their care.

In particular number 13 & 14.

I've never been pregnant but have had a lot of dealings with gyne and have always been treated as though I had a lobotomy as I walked in to the waiting room. With both nursing and medical students been ushered in to the room as I was undressing with no warning. (As an ex HCP I understand the need for students to be involved, but you ask permission first, teach them the right way. . )

As so many people have pointed out above, this is being used to 'prove' women cant be trusted with thier own health.

if you smoke it may help you make an informed decision.

But how does the test inform the decision, Rubysmommy? If you smoke whilst pregnant you know that it is not recommended and the midwife could and should remind you of this and what options there are to help you stop.

The test proves you are smoking. Which by definition you already know, unless you smoke in your sleep or have severe amnesia, in which case you have other risk factors for the pregnancy to put it mildly!

The test is not aimed at showing whether the level of smoking or exposure to smoke is harmful or not (i.e. something you couldn't assess with your own knowledge). It's aimed at proving whether you're lying to the midwife. If I am lying to the midwife, how does proving it to me encourage me to want to stop smoking?

So beyond the fact that the test is being administered for reasons which are dubious at best, the way it is being administered, based on feedback in this thread, is unacceptable by the standards of care to which the NHS is held.

The NHS Constitution (for England) says "You have the right to accept or
refuse treatment that is offered to you, and not to be given any physical
examination or treatment unless you have given valid consent." Further "You have the right to be given information about the test and
treatment options available to you, what they involve and their risks and
benefits."

*assess!

I don't see the problem with it - if you smoke it may help you make an informed decision. Maybe it's a bit of a shock tactic. I'd imagine it would help the MW access things - smoking increases risks so if the level is higher, I'd presume it would result in heightened risk.
Smoking isn't recommended in pregnancy because it isn't good for baby - just like alcohol.
Alot of people would stop drinking but keep smoking.

I think its ridiculous. No one should be forced to have a test when a simple yes or no suffices. It's providing a job for someone though- creating a few stats to share on a lovely fact finding mission in the US maybe?

Perhaps the smoking cessation program isn't going so well after having all this money spent on it. It's a way of getting the numbers up and justifying continuing. My df wanted to give up and went along for a meeting but he said he couldn't sign up with all the fixed meetings ( work commitments ) and hoops he had to jump through, and it was easier just to go to boots and get some nicotine tablets. He said it was really hard to get the women to stop calling him and nagging to get back on the program. He called her a stalker(!)

People already know smoking is bad for you. They don't need a test or to be brow beaten by a Mw. The only reason I was asked, right before my emcs, was because I would have been more at risk with anesthetic.

Lying on the interweb! Never!

Thank you sunny :)

See, no test, risks highlighted a bit, could have done a better job but it's sooooo late, offer of support made. And if sunny was lying? Never on the interweb! Well making her take a test wasn't going to make her access cessation services if she didn't want to, was it?

I'm not a smoker k8, but thanks for the offer :)

This really gets my goat. In some areas, women don't get two ante-natal scans yet there is money to spend on this???

This is just a ludicrous waste of time and money!

Not in my experience Kate I have had ultrasounds sprung on me as we'll as other tests
I'm pleased with the NHS maternity care and trust that they are doing the best for me and moreover ( and I do feel more importantly) my baby

Next poster, please would you tell me if you are a smoker? if you are I can provide you with details of NHS services to help you quit because the dangers to your health are well documented.

Just to prove it to you, I will find out if the next poster is a smoker or not without using a gadget. Please bear in mind that the outcome of this test remains the same regardless of the answer.

Ready?

Because it's much harder to give someone an ultrasound against their will and because an ultrasound isn't testing for something a woman can know and tell you.

A woman knows for certain if she's a smoker. She has no way of knowing if her baby has spina bifida or another abnormality without a scan. Besides, the lead up to ultrasounds is much longer, the process for obtaining informed consent is much more robust (booklets, forms, separate appointments, explanations, seeing a sonographer instead of a midwife).

You are making the NHS sound like big brother- some Orwellian infrastructure trying to trap us somehow

I didn't really want HIV testing or a load of other stuff they asked me - I requested not to answer the odd question on the form and was told 'that's fine'

People are happy to have bloods GTT and ultrasound - why not this? I only know one person turn down an ultrasound.