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

[RowanMumsnet]

Hello

There are reports in a couple of papers today (here and here - paywall) that NICE has recommended that all pregnant women be given a carbon monoxide test by their midwife in early pregnancy - effectively, a smoking test. If they test positive, the idea is that the midwife will signpost them to NHS smoking cessation services. The Royal College of Midwives is quoted as saying that they think the idea will adversely affect the relationship between women and their midwives.

We're getting asked what you all think about this - so do please let us know!

[EurusHolmesViolin]

A timely reanimation though, as it's been in the news today.

www.theguardian.com/society/2017/feb/26/nhs-test-all-pregnant-women-for-smoking-nice-rcm

Shit idea then, still a shit idea now.

[PencilsInSpace]

This thread is almost 4 years old

Pregnant women who smoke find it incredibly difficult to admit to, and if they don't admit it they can't get support to quit. So, if they test everybody, they can pick up on the women who are deeply ashamed smokers and help them give their babies the best start in life, not to mention improve their own health.

Also yes it can sometimes pick up on carbon monoxide from other sources. CO is bad for the health of both mother and child, wherever it comes from. Why wouldn't you want to know that, given how quick and non-invasive the test is?

Of course you should be allowed to refuse though, informed consent to tests and treatment is a fundamental right.

[beargrass]

No no no. Don't smoke and would refuse.

Instead of a creeping lack of consent and choice, NICE might do better to put money into things that might actually help us, such as a far less medicalised and interfering approach to birth, and help with all things post-birth such as the nightmare of BF

[watchingitallagain]

A widowed is obviously a midwife

[watchingitallagain]

I had my booking appointment 4 weeks ago and a carbon monoxide test was part of it. To the point that my widowed said she couldn't click through the screen on the computer without a result....!

I maintained that I didn't smoke but was told they'd know if my central heating boiler was dicky from the test. In the end I just did it. I scored 3. Apparently my boiler is probably ok.

[pixiehollow]

I was given a test after seeing my midwife and telling her I was a none smoker at 8 weeks they have never done this before!

[amazingmumof6]

5madthings my boys were late and over 9lbs (except ds4 who was early ELSC but still 8lb 8, if 40+ he would've been the same)

dd was also late and 8lb 3

so very similar, but I don't smoke.
interesting

[5madthings]

Re birth weight, my babies were 8lb 7oz, 9lb 3oz, 9lb 5oz, 10lb 13oz (all boys) then I had dd 8lb exactly, whether she was small because of the occasional cigarette I had when pregnant or just because she wasa girl (girls are statistically smaller at birth) and I was not as 'overdue' with her as the others. No way of knowing, she is tall for her age at 2.5. I am not proud that I smoked in oreg but having discussed it with midwives, consultant and cpn they all agreed the occasional fat and prioritizing my mental health was more important than stressing over quitting. The consultant actually joked that given the size of my previous babies having a smaller baby would be no bad thing.

[HorryIsUpduffed]

Yes, smoking is linked with low birth weight which can cause problems. Glad he has caught up now!

[Mand1980]

I have 3 kids, 14,13 & 5. And over my eldest 2 I didnt smoke or drink I did everything by the book & over the youngest 1 I did the complete oppisite & to be quite honest, the older 2 are extremly different than the youngest at his age he is calm,laid back well behaved at home & school, only diference was birth weight big ones were 7lb13oz & 7lb6oz & youngest was 5lb15oz & he is a big 5yr old he is the same height as the average 7-8yr old. So I carnt see why they want to interfere, smoking mums have been having healthy babies for decades.

[ParsingFancy]

So I wonder what sort of commute would show up?

Especially given Mumsyblouse's post of Mon 13-May-13 10:02:31: "If you do a test on a smoker, say on 10-15 a day, you'll get a score between say 10-30... If you test non-smokers who cycle on polluted roads, it comes up between 1-2 absolute max"

Or is the commute one just another lie?

[ParsingFancy]

Out of interest Fuckwittery, what was your test result, given you commute?

(If you don't mind saying.)

[Snog]

So would the test be optional then?
How does that work?

MW: do you smoke?
Pregnant woman: no
MW: would you like me to test your breath to see if you are lying or would you prefer for me to believe what you just said to me?
Pregnant woman: why don't you go ahead and spend nhs time and money on seeing if I just told you the truth
We both know that I have nothing better to do with my time than participate in tests I do not need and that it is reasonable to assume that I tell lies. Afterall I am an adult woman who is pregnant.

I don't want to live in a country that treats women like this.

[amazingmumof6]

snog "Because we all know that women cannot be trusted and should not be treated with respect by healthcare professionals."

at that. well, they are right, aren't they? I mean how could they trust us, after all we were stupid enough to get knocked up in the first place - haven't we all heard of condoms?

smoking test - they should test us right now, I'm fuming!

[keelo123]

Good idea to have the choice, like for someone who is seeking help with quitting smoking whilst pregnant - but being mandatory is a stupid idea! Why not legalise canabis and amphetamine, it will create a better public environment and lower the governments spendature. Well, thats comparing that to all the offended pregnant women with raging hormones running around after stressed out midwives! Can you imaging all the mayhem!?

[Snog]

yeah fairplay kinda like a lie detector then
I wonder if they would doubt the word of the father?

[youaintallthat]

if people don't want it just say no...i really don't think if i was offered this test it would adversely affect my entire relationship with my midwife and the health care establishment in general. Its just another guideline that is enforced on the people who work for the nhs to reduce the risk of complications and subsequent litigation against nhs trusts.

[Teaandflapjacks]

I replied a while back on this but couldn't help dipping in again. Futterby is clearly overzealous - but I suspect this is to with life experiences lacking and wishing whole heartedly to do the right thing - partic since she was drinking, smoking and smoking weed early on in her pg (up to week 8 or more from what I read) - here
I'm 18 years old and as you can imagine I had been drinking regularly (more often than I'm proud of - verging on an alcohol addiction), chain smoking and I even tried weed in the two months I was pregnant without knowing it.
....which of course would worry her, since the embryo was already feeding from her blood stream and taking in whatever she was doing at that stage. It would worry me TBH. I did hear recently that some research suggests up to 8 weeks babies are unharmed in anyway by what the mother has done (a move forward from the original 4-6 weeks cut off point) but I don't have a link to that research.

Back to the issue - I just find the whole thing disgusting. I am sure it is to do with tobacco companies being in bed with the government to some degree (since quitting smoking stuff always involves nicotine which just keeps you in the same loop of addiction - I think Alan Carr or Hypnosis is more effective longer term TBH). Any pregnant woman knows perfectly well she shouldn't smoke - but she is addicted. Cigarettes are more addictive than heroin (I believe). Women who continue to smoke in pregnancy deserve support and compassion and understanding, not vilification. I think stressing them out would make them smoke more - not less and achieve the opposite effect anyway. I also think this causes all women (myself as a non smoker included) to say stuff all the advice then - to some degree - and you would feel like you are back in the early 1900's!

This is actually more worrying to me than anyway having a cigarette - because what do you then chose not to do - that could have an impact later - such as with vaccinations for the child for example, which could in turn affect a whole load more things? It is a very slippery slope. I also would worry about such info being kept on file, and I am sure parts of the creaking NHS will end up privatised, then insurance companies would see this and fiddle your insurance accordingly, or even refuse to pay out, even if you got a false positive, i.e. from living in London. And anyway, for arguments sake - if you know that such a test would be conducted, and it has been proved how to skew the results (12 hours or 24 hours etc) would you not just not smoke upfront to avoid being bossed about in such a way? I live in Germany, such a ridiculous test does not exist here, and if it did I would tell them firmly where to stick it, and yes I am a non smoker.

To keep us all a bit more cheerful - women 'know your place'....

[Snog]

Most women don't smoke and would answer truthfully "no" to the question "do you smoke".
At which point the midwife effectively calls them all liars by suggesting/forcing a test to prove if they were lying or not.
Because we all know that women cannot be trusted and should not be treated with respect by healthcare professionals.
Damn right this would alienate me from healthcare services,

[5madthings]

And what black swan said, tho as you have already said you are pro forced birth flutterby your attitude doesn't surprise me.

[5madthings]

Ofgs women know smoking during pregnancy is not OK, offering the test is fine as long as a woman can make an INFORMED choice, but often in pregnancy I found that things weren't offered in that way, its just presented as a done deal, bit like when you get to 10-14 overdue and they book you in to be induced like you have to/its the only option. You often have to have a very determined mind set to question what you are told when pregnant or do anything different from 'norm' and that is not right.

women have bodily autonomy and anything against that is a VERY slippery slope.


BTW fluterby I got preg at 19, didn't realize for eight weeks etxmbut once I did I stopped drinking etc, fast forward nine year and I started smoking again after having post natal psychosis after ds4. When I got oreg with dd I was then still smoking occasionally, never more than three or four a day is that. I was honest with my midwife and consultant and cpn who I was still seeing and they actually all agreed that maintaining my mental health was more important than trying to quit totally. My living children needed a mum in good mental health and my baby needed a mum without ante natal depression and one that was less likely to get psychosis again MORE than she needed me to give up the occasional fag whilst pregnant.


Its a balance of risks, you have no idea what is going on in a woman's life so do stop being so judgemental as you will never make a good nurse with that attitude tbh.

[BlackSwan7]

Let's just make one thing very clear. It's the woman's body and her choice. She can do what she likes while she is pregnant and she can give birth however the hell she wants. Nobody has the right to stop her or patronise her.