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

Oh so it's young mothers you have issues with iclaudius. May I ask what evidence you are referencing that says younger pregnant women are more likely to be smokers and still be smoking at booking in?

Do you know how many women lie about being smokers?

Do you know that even if women are pregnant and smoking you cannot make them stop

Just out of interest what do you consider to be young? Under 18? Under 21? Under 30?!

I knew my gas hadn't leaked because I have a CO2 monitor in my home for that purpose.

My last appointment was with the MW who might actually be delivering my baby, it lasted 45 minutes so I guess I am lucky in that.

I already feel a lot safer with her than I did at booking in, she's nice and she listens and for the first time a MW actually tried to make me aware of my options and actually ask how I was and get into the reasons why I was down.

That is the way it should be.

dont see enough of midwife these days to build up 'trust' tbh - its a quick 'in and out'

i was pleased to know my gas fire didn't leak

"just suck it up- theyre trying to help not 'bully'"

Wow. No, I wont (and hopefully many others) just suck it up because you "might" have needed a push.

iclaudius, it might well have a positive effect on some women smokers which has proven to be the case on some study.

But at what price? Do they measure the damage it has on non-smokers? Or on the relationships between patients and HCP in general over a longer time frame. I doubt it, because the only thing they will measure is the number of smokers.

I would suspect the reaction on this thread alone, should be reason enough to question whether on balance its really a good idea to take this approach.

There must be other ways to encourage the cessation of smoking which have decent success rates. I suspect they aren't encouraged as they require more staff resourcing to implement well... I bet if women simply had more access to a midwife they had a good relationship with on a regular basis rather than struggling to get any appointments or always seeing someone different would probably be a good place to start...

...it does seem that understaffing and the shortage of midwives in general is ALWAYS forgotten in favour of idiot ideas like this, that are inevitably dreamt up by paper pushers with no concept of human interaction in health.

I am utterly fed up of the NHS and its utter shortsightedness on the issue of trust in general. And I am aware that this is a subject that has caused a great deal of concern within the profession itself too.

when i was younger and pg i might have needed a 'push' to give up the odd last fag

theres a load of stuff dragged up in the midwife room id rather not - i dont get in a pickle about it though

just suck it up- theyre trying to help not 'bully'

iclaudius I think you're missing the point a bit.

The being asked to be spoken to on your own - fine, refusing to speak to you unless you're on you're own - not fine.

Asking if you would like a CO test - fine, pressuring you/making you feel like a liar/or making out that you have no other option - not fine.

Just because you are pregnant does not mean you should suddenly give up your right to consent and allow HCPs to bully you into doing things you don't want, regardless of what they are.

Are there really many women so stupid that they have to have a test to tell them they are smokers?

Now I'm not a smoker, but I'm reasonably sure I would notice if I were.

You don't have to be shamed into it.
You need yo take full responsibility to your actions rather then rely on someone to say " bad girl! No more fags"

i would feel crap about smoking when pg but maybe im alone in that

20 years ago your partner was asked to leave the room for some questions too - this isnt new

They shouldn't be shamed though. It isn't illegal and is that persons choice, regardless if it's a bad one.

It's a disgusting attitude to think it is okay to shame anyone into doing anything, especially by people she will have to trust!

Have you read the thread iclaudius?

i would argue that many women WOULD be shamed into not having the odd fag if they knew they'd be found out when pg ... i for one would

Just another thing in the long line of matters in which pregnant women are not to be trusted:

1. When they got pregnant (doctors refused to believe me either time that I ovulate late in my cycle and got all worked up about how the embryo was measuring 5 days 'behind' based on my LMP);

2. Who the father is (I'm Rhesus negative: they didn't care about the blood group of DH since 'he might not be the father' of my babies. Nice.);

3. Whether or not they have an STD (I realise a lot of STDs go unnoticed but even so...)

4. What they eat

5. What they drink

6. Whether or not they dye their hair / repaint the house blah blah...

I'm surprised babies aren't removed from their parents at birth, since we're clearly all unfit to parent and don't give a stuff about the health of our children.

ramboscar - why do YOU suggest these tests are being introduced then?

Help how, IC?
No one's given up smoking by bring bullied into it.
It's harmful for baby and mother, but the midwife has to explain that, not force you undergo tests.

It's counterproductive, the way it's being done.

If they mistrust us how can they expect us to trust them?

The 'greater good' is something a deeply despite as a justification for this type of thing. The single more important thing in healthcare is having a good relationship based on trust between HCPs and patients.

This can not be achieved by coercion. It can only be achieved with clear communication, respecting the patient as being capable to make their own decisions and live with the consequences even if they don't agree with the patient, respecting the wishes of patients and their right to refuse certain things, and building up a situation where patient feel listened to and can ultimately trust those caring for them.

Anything less, has knock on effects further down the line that may effect their health at a later date - it couple be as simple as putting off a call to the doctor when they find something slightly out of the ordinary.

'Enforcing' tests may well have short term benefits, but I seriously question their longer term benefits. It might not be obvious, but pressuring patients and the break down of trust from patients is a killer.

"i think people should see the bigger picture
women are being helped by these measures - i might feel put out for a minute but its for the greater good"

Can you explain exactly how it's helpful to spend a considerable amount of the already overstretched, overworked and underfunded NHS's - no, taxpayer's - money on an initiative which will be used to patronise and bully women, treat them like idiots and liars, alienate them and, as our experiences of the "you have to" and "you have to or else" contingent prove, in some cases cause a breach in UK laws regarding medical consent?

And then can you explain quite what you mean by "the greater good" in this instance, please?

iclaudius A lot of people are just being put in situations they don't want to be though, pressured into doing things they don't want to, for whatever reasons.

To me that is the bigger picture here.

Thanks Red, I know I can refuse anything that I want to, it's just sometimes some people make it so hard to do so and when you are sat in a room with just that other person putting pressure on you, it can be really hard to be as assertive as you would like.

For that one person at the booking in, I should have complained and I immediately complained to my Consultant when I went into see him after her. At the time I was just too emotionally messed up to complain or do anything about it seriously.

Mostly everyone else has been lovely, I realise that not all the staff are like that and some are just not very nice people.

She did refuse to see me, she said she "couldn't" if I didn't go on my own. I tried arguing that one for over 10 minutes, in the (full) waiting room but was getting no where.

Presumably contacting the police wouldn't be a bad idea either

Schro,

The whole thing is Here if you want to read it in full.

The thing is you have the RIGHT to refuse anything, and they are not allowed to put you under pressure to make a decision as its consent under duress which by its very nature isn't consent.

Also, if you are being told they will refuse to see you if you don't do x, y or z they are very clearly breaking the rules. They aren't allowed to withhold access to healthcare or other treatments even if you refuse something, unless they have a very good medical reason.

This is certainly the case if she really is refusing to see you because you want your partner there because you have anxiety over appointment because of previous experiences and a lack of trust in HCPs.

Even if they do suspect domestic violence they can not do this - you theoretically MORE at risk, and therefore need MORE contact with them, rather than creating a situation where you are actually LESS likely to attend.

This is why I would encourage you to report as you might not be the problem; it might be the other patient she has who does have an abusive partner...

i think people should see the bigger picture
women are being helped by these measures - i might feel put out for a minute but its for the greater good

Red I think I might just print that out and take it to all my appointments with me, just incase.

Thanks for posting that.

The number of people who are saying things on this thread that are quite clearly in conflict with the rules on consent is highly alarming.

For the record the following are paragraphs directly from the GMC's guidelines on consent:

42. You should do your best to make sure that such patients have considered the available options and reached their own decision. If they have a right to refuse treatment, you should make sure that they know this and are able to refuse if they want to.

43. You must respect a patient?s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational. You should explain your concerns clearly to the patient and outline the possible consequences of their decision. You must not, however, put pressure on a patient to accept your advice. If you are unsure about the patient?s capacity to make a decision, you must follow the guidance in Part 3.

Some of you on this thread would be well within your rights to report your HCPs and I'd encourage you to do so.

I had the test this pgy - am a "never smoked" but she shrugged and said you never know if you've got a dodgy boiler or something.

They've been nagging pregnant women about smoking for years without properly explaining why it matters. It's just another thing in the list with alcohol, Mr Whippy and blue cheese.