Is NICE going too far?

[Sal321]

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?

Ok, do you know they test you for HIV? Lets stop that, let's be PC, we don't want to be offended do we? How about stop all testing, stop scanning etc. Waste of money, save the NHS. They are only trying to help you make the right decisions.

I would not personally smoke whilst pregnant. But we cannot force women not to. The only possible justification is that it could make some diffence to how a woman should be treated clinically.

It is a well known fact that stress causes high blood pressure and high blood pressure causes intra uterine growth retardation. Therefore I suggest compulsory testing and constant monitoring of all midwives, health visitors and initiators of health care programmes to make sure they do not contribute in any way to raised blood pressure in expectant mothers. Now that would be a recommendation that would actually be useful.

Treating women as liars by default.

Treating women's bodes as publicly owned when they are pregnant.

women policing from the alcohol and bf thread.

Just wanted to repeat these key key concepts. We foster and nurture something dangerous when we allow these things to happen in our society.

Testing for HIV is not only for the benefit of the mother and baby but also for the health care professionals who treat the woman.

I think the salt police might come and get me!

Whiner - the point about HIV, syphilis and hep B testing in pregancy is that you might not know you have them and have been passed them by someone else or got them in a really unlikely way. I know I don't smoke. I don't think that DH holds lit cigarettes to my mouth in my sleep unbeknowst to me.

If I were pregnant, I would do the test, it wouldn't bother me. Human rights blah, blah, blah.

No, they OFFER to test you for HIV because it's one of a number of things you might not know you have, so may be worth teting for.

I know I don't smoke. People who DO smoke know that they do. It does not need to be tested.

Weetabix, that's really not the same thing now, is it?! Here, have a nice cup of tea and calm down...

Are you sure, cos Belgo and me thinks they do it anyway to protect health workers.

Weetabix - where did you get that link re smoking and autism? Which health body has said they are linked?

Actually, current advice is that you should feel free to eat nuts if you want them. So brie to you.

The trend in incidence of smoking has been pretty steadily downwards since 1970 (with a few tiny blips). The trend in cases of autism has been either (a) going up or (b) staying about the same but with better diagnosis over the same period. No one argues that cases of autism are going down, anyway.

So please do tell us more about your fascinating theory on the link between "there seems to be a lot of sn kids in schools" and smoking in pregnancy.

I did not say they do it just to protect health workers.

I said they do it for the benefit of mother, baby and health workers.

Please don't misinterpret what I say.

I've had my weetabix now and I'm on a roll. I'm only saying what a lot of folk think, to scared to say it, not PC. They must work for the council!

I screeched at the radio when this was mentioned on the news this morning. It increasingly seems to be the case that pregnancy makes it really clear that women don't own their own bodies, society does.

We "can't be trusted" to make decisions about the right amount of alchohol to drink, or whether or not we should smoke. And don't even get me started on this terrifying eugenics project.

HIV causes far more serious effects that the odd fag weetabix!!!!! plus as childbirth does involve a touch of blood I imagine the workers would want to know too. not even comparable

No, we can't be trusted, I saw a pregnant woman smoking like a trooper and drinking a large bottle of Lambrini and then lager at a BBQ not long ago. It's these women who need catching in the net.

I'm not going to do this at my booking-in (if it's suggested). I don't smoke and have never smoked; DH doesn't smoke and has never smoked. None of our parents smoke. None of our siblings smoke. No one smokes in our house. I can think of a handful of friends who smoke but they've never smoked around me and don't even smoke in their own houses. I am not encouraging the creeping institutionalisation of the idea that women can't be trusted and are in some way public property.

I was at this! How is this going to help smokers who are pregnant and having trouble quitting to give up?! Just more likely to make them defensive and not likely to attend appointments.

It's just another "women, know your place" tactic like the "no alcohol because you can't be trusted to know what a unit is" thing! In fact the more I think about it, the more it seems completely unbelieveable!

I think the Royal College of Midwives has said this is a really bad idea as it will put women off midwife appointments - or further tests which might actually be important.

Imagine NICE's logic is if you can show women what smoking does to the blood (how much carbon monoxide is in there) it might shock them into giving up. But giving up smoking is HARD. (I'm quite good at it, have given up loads of times... It's the staying stopped that is the hard bit.)

Would have to be handled very carefully though. Perhaps a neutral, carefully-phrased offer: 'If anyone in your household smokes, would you like a carbon monoxide test? It will show the concentration of CO in your blood .'

You are of precisely the same mindset as I am, Prof.

Oh, and I am pregnant for the second time but have private care. Needless to say, I strongly imagine private patients won't be compelled to puff into a tube...well, I certainly wasn't. NHS patients should be accorded the same flamin' courtesy!

and do what with the Weetabix

Given the response from most people then, why did NICE suggest it? Are there no sane people at NICE to say "hold on a minute, this might not go down well"?

Yes.

Being offered to women who smoke or who have concerns, I can see. So if a woman says "yes, I smoke, but I've cut down to half a pack a day and I'm really not sure I can give up altogether" being able to offer her a CO reading may be helpful in showing what effect there is. Or if a woman doesn't smoke but her partner does and she's concerned about passive smoking, offering a CO reading will show up how much passive smoke she's being exposed to.

But for all women, regardless of circumstances, and as a "you shall do this unless you very specifically refuse"? Pure arsery.