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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Is NICE going too far?

430 replies

Sal321 · 24/06/2010 09:49

This BBC news story is about a suggestion by NICE (national institute for clinical excellence) that all pregnant women should be breath tested for smoking at their first MW appointment. I know I don't smoke, why should I be tested? I appreciate that I could refuse, but isn't this a bit of a weird recommendation?

OP posts:
posieparker · 25/06/2010 13:38

TSC....you have just proven yourself wrong. You gave birth without drugs because you really wanted to but you couldn't give up smoking....because you didn't want to enough.

It's as simple as that.

thesecondcoming · 25/06/2010 14:21

This reply has been deleted

Message withdrawn at poster's request.

TheCoalitionNeedsYou · 25/06/2010 14:57

LittleSilver - Read the advice it is evidence based. Naturally the effects of universal testing are specualative. That is why we need to do it and measure the results.

TheCoalitionNeedsYou · 25/06/2010 15:02

The Advice

TheCoalitionNeedsYou · 25/06/2010 15:09

In general, there is a strand of puritanism applied to pregnant women which is excessive and unhelpful.

The risks of problems resulting from drinking alchohol in moderation, the odd cigarette, soft cheese and rare meat are FAR lower than the ones you have avoided by living in a developed country.

The possible risk to the child needs to be weighed against the wants and needs of the mother.

However, cigarettes have NO UPSIDE unlike alchohol, parma ham or crack.

posieparker · 25/06/2010 15:34

TSC Your GP also sounds like a stupid twat saying it's okay to smoke because his wife did, did he purchase his MD in Asda?

And I wouldn't be fecked arguing with me either, you have no case.

notalways · 25/06/2010 15:56

Giving up smoking is as hard as you think it is going to be.

NICE and the NHS are attempting to support and assist pregnant mothers with giving up an addiction to cigarettes. Not just cos they are nice people but because cigarettes can be harmful to both mum and baby. They are willing to throw some resources at this problem at an early stage as the long term cost benefit makes it worthwhile.

The denial smokers inhabit is quite difficult for non smokers to understand. You will note that despite the wealth of information to the contrary, smokers will pick out the one doctor or midwife who confirms its safe to smoke while pregnant. It is ridiculous.

The booking-in appointment is intrusive anyway - but the intrusion is there to avoid pain and suffering later on.

It really is none of the MW's business if my husband beats me but I know why I'm being asked and I can tolerate the intrusion while understanding the wider social good.

And six years on I have no desire to smoke at all, however, on a warm balmy evening, while sitting in the street seats of a vibrant bar in the city of my partying youth, sipping on a nice white wine and laughing with old friends, the smell of smoke and memories in the air - yes, I think, if only I could have one, and I get a vague notion of whether anyone still knows any dealers, but then I remember I've got to get up at 6 the next morning to look after my toddler, get kids to school and clean up my house before heading to work. Life moves on, smoking and having kids shouldn't mix just as taking drugs or getting drunk in front of kids is just rubbish.

BexieID · 25/06/2010 17:22

I had this test at my first ante natel appt when pregnant with Erin last year. I was asked if I smoked or anyone in the house did. They said it was for passive smoking as well.

CakeandRoses · 25/06/2010 21:29

I'm now puzzled as to why I wasn't given this test (now 35 weeks pg) - is it still being rolled (unintentional pun there) out? My son is 20 months so I assume it came in after that pregnancy.

Maybe my midwife knew better than to try it on?

I'm so surprised that this test has any support from people on here. I just see it as such an infringements of rights with no benefits at all.

If you're exposed to passive smoking then I can see the test is useful but it still should be optional.

If you're a smoker then what's the point? You already know you're a smoker!

If you're never exposed to passive smoking (which is the case for me) then what is the test going to reveal?

CakeandRoses · 25/06/2010 21:32

Also, I think its a bit much attacking TSC when she was honest enough to offer her experience.

NumptyMum · 25/06/2010 23:23

In my area we're tested routinely for carbon monoxide when booking in. Both times I've had this, scale has shown that I've got higher than 'non-smoker' levels, despite being non-smoker and living with a non-smoker. So had to deal with a mw being assigned to me to advise me on quitting smoking! Was just a quick phone call:

Me - but I don't smoke
Her - do you live with anyone who smokes
Me - no
Her - do you work with anyone who smokes
Me - yes, but they go outside the office to smoke
Her - well, smoke can cling to people
(at which point I wonder just how much it can cling to them, given they've just had to walk back into the office and are sitting the opposite side of the room from me, around 5m away).
Me - I think the main reason is that we have a heavy smoker living downstairs from our flat, but I can't exactly tell HIM to quit...

To be honest I can't remember her response, but it did seem to be a bit of a waste of time. Did make me worry for DS's health though...

CakeandRoses · 25/06/2010 23:36

Is it actually carbon monoxide they test for then? Seems incredible that you could have shown positive on the test just by having a neighbour that smokes!

I presume you've checked its not your car, CH boiler etc?

NumptyMum · 25/06/2010 23:56

Pretty sure it's carbon monoxide that's tested. I only share a car (and at that time was still cycling to work rather than driving) and we have a new carbon monoxide alarm that's not giving any concern about our boiler, which was new 3yrs ago.

So it's more likely to be our downstairs neighbour (we live in an 1870s converted townhouse so there's only layers of wood/gunk between flats - and sometimes ours really does smell smokey; he is a heavy smoker) OR the fact that we live in the city, near two busy roads. But I doubt very much that it was due to my colleagues at work...

natalia88 · 26/06/2010 08:39

If you read what i said, I actually stated that i dont 100percent agree with the test. HOWEVER i do think something needs to be done. When i was pregnant, i did not smoke, drink more than one glass of wine on a special occassions and tried my best to follow guidelines from the midwife about foods i can/cannot eat. In my mind i think your stupid not to? Your carrying a life, why wouldnt you want to do everything possible to protect it?? When smoking your just putting its life at danger?
I think that a lot of women smoke when they are pregnant, and its not fair to the unborn child.

And ONGNAR - yea there are car fumes etc but why add to it????

natalia88 · 26/06/2010 08:43

Oh and for the record - my weight is fine, im 22, i dont eat fish (PHOBIA, and i dont drive a big truck that i do not need for small Britain roads

SugarMousePink · 26/06/2010 11:11

This reply has been deleted

Message withdrawn at poster's request.

annatw9 · 26/06/2010 11:32

ok so what is the answer to the problem of women continuing to smoke during pregnancy? refuse them the health in maternity grant (whilst its still being offered)?; there is no other way of 'encouraging' those pregnant smokers to stop.. perhaps if society was less accepting of things which are clearly selfish and wrong, those women might feel a little more embarrassed about doing it. at the end of the day though, women have been smoking during pregnancy for years and years, and honestly, i dont think there is a way to stop it.

stripeyknickersspottysocks · 26/06/2010 14:09

I think it needs to be optional. A mum who wants to stop smoking may find having her carbon monoxide levels measured helpful. A friend of mine had this done through a smoking cessation programme and said it was good to see the levels dropping as she cut down.

nottiredmum · 26/06/2010 14:26

All tests given at the first appointment are for you and your babys own good, I dont have a problem with it. at all. I could stamp my feet and say I was grossly offended as I dont smoke, but what would be the point. Many women do lie and say they dont smoke and then try to quit on their own and I would think this would be doubly hard, with no support. There is help out there, you just have to accept you need to stop smoking and accept the help offered.

tellnoone · 26/06/2010 15:40

It is optional just like the HIV test etc that every pregant woman is offered. It's about the health of both the mother and baby - that's what the national health service is there for.

link to the actual guidance

stripeyknickersspottysocks · 26/06/2010 16:55

The difference is that most women couldn't say hand on heart whether they're HIV positive or not, not 100%. However people do know if they smoke or not, but NICE are saying that even non-smokers should have the test. Why? Incase they're lying? Wouldn't be so bad if it was an opt in test, but its opt out. So women who do opt out feel that they're risking the disapproval of their midwife, etc.

stripeyknickersspottysocks · 26/06/2010 16:57

I'm loving the official guidance. It says "use the CO test".

Not "ask the woman if she would like a CO test".

violethill · 26/06/2010 17:01

I can't see the point of it.

The dangers of smoking are widely known, there is absolutely no way anyone these days can not know that, so if they are smoking while pregnant, then clearly a simple test is not going to stop them. It is not telling anyone anything that isn't already known. A non smoker knows they don't smoke, and a smoker knows they do. Just ask the question, if the information is needed for medical purposes. People could always lie, but what's the point? Quite frankly, the only thing the test might tell us is that someone who claims not to smoke actually does. So then what? Like I say, if they are doing it while pregnant they are choosing to take that risk for themself and for their baby.

odisco · 26/06/2010 17:28

Perhaps the point of the test is that if you talk to 100 people who smoke about how to quit about 10 will manage it. Getting any 10 people to quit is an achievement and even more so if it helps protect the child, pre and post birth. The long term advantages outweigh the 'offence'.

I do think there are people who don't truly recognise the dangers of smoking, is that a choice if you don't spend some time with that person?

violethill · 26/06/2010 17:34

But why do you need to have the test to be able to achieve that? What does it add, that isn't already known/talked about/widely advertised?

I am a teacher. I can hand on heart say that every one of the teenagers in my school, from the highest ability down to those with fairly complex learning difficulties, know the information that smoking is really bad for your healthy, and that if you are pregnant it harms the baby. It really ain't rocket science! So who are these people who 'don't realise the dangers'? I think they do - they just exercise their choice to continue to do it. I can't understand why, particularly when your child has no choice in the matter - but I can't see how this test will change anything.