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!

I've worked in this field for years, and the stuff about being able to detect a faulty boiler or pollution is absolute guff.

If you do a test on a smoker, say on 10-15 a day, you'll get a score between say 10-30, if they smoke a great deal it can go even higher (that's parts per million).

If you test non-smokers who cycle on polluted roads, it comes up between 1-2 absolute max, and usually 0 for everyone else.

So- a smoker will test at 24, your non-smoker will test at 0 or 1. What does 1 or even 2 tell you? Nothing, you can't attribute it to living by a busy road at all, because there's a margin of error/picking up tiny amounts for most people, and you are not sitting next to an exhaust pipe inhaling it. Even going in a busy pub in the days of smoking didn't cause it to rise above the non-danger zone.

Inhaling smoke directly into your lungs is not the same as living on a busy road in terms of carbon monoxide inhalation- it is not good for you it may well have some health effects, but it just isn't in the same order of magnitude whatsoever.

As for the faulty boiler gubbins, this is rubbish, because the best place to put a carbon monoxide check is in the rooms near the boiler, there's no point in testing the mother and not, say, other children if their bedroom is near a faulty source. I have never ever found anyone with an alarmingly high reading who genuinely doesn't smoke- it's vanishingly rare and they are actually, as someone else said, offering false reassurance about something for which this monitor is not best designed to test.

This monitor tests whether the individual who is blowing into it has smoked in the past 12/24 hours. That's all, and the rest is misinformation to protect themselves.

Just say in the slight chance this has anything to do with Faulty Boilers, how can they tell a Smoking Pregnant woman from a Pregnant woman that has been exposed to a Faulty boiler or Air pollution from high traffic for that matter?

I believe it's another attempt of taking control of the human population so we all adire to the idealistic view of the Perfect woman.

I don't smoke, never have and it would be a waste of people's taxes to make me have a test which i assume has little to do with Boilers and more to do with Smoking. Just say this is to do with other Co2 sources, how can they tell what or how it has been exposed to you and if so do woman with faulty boilers get accused of smoking or those that do smoke get noted to have a faulty boiler

See a simple £20 carbon monoxide detector and a simple yearly gas check is quite sufficent, so i believe this Boiler excuse is absolutely ridiculous because they would'nt be able to differenciate from the two.

They should ask pregnant mothers if they smoke and also if they are in passive smoke and if any other children they have are in secondhand tobacco smoke. There's no need for a test as it's as though they don't believe what the person is saying.

Am also completely against the test, just another example of women being patronized in pregnancy.
I don't smoke and wasn't even offered the test up here in Aberdeen, I did have a good relationship with my midwife though.
When I was two weeks overdue and desperate to avoid induction I made some quip about needing a glass of wine before she gave me a sweep, she laughed but then felt obligated to say that she would pretend she hadn't heard that....Crazy as I was on tramadol and co-codemol daily at that point and about to be pumped full of pethidene etc, surely all of which are way worse for the poor baby than a measly glass of wine at 42 weeks.

When we have enough MW to actually do all the current tests as well as deliver the babies around them, we can add on more stuff. Until then, FFS, just give them a leaflet and let them get on with it.

I have no issue about smoking expectant mothers being judged, its awful!

I was a smoker, I stopped as soon as I found out, I don't think there is an alternative in my view.

BUT i don't like this idea, it implies women can't be trusted to be honest,
although I understand there frustration,
I used to work with women who stank to high heaven of smoke but would swear blind they haven't.

the midwives job is to look out for the baby err no no no! The midwoves job is to care for the pregnant WOMAN, that involves making sure the baby is ok as well.

Trust between a midwife and her patients is fundamentally important and this test can undermine that... 'catching smokers' ffs.

Advice and support is fine, unnevessary tests that dont show much amd are easily 'cheated' ie by not smoking for twelve hrs beforehand are pointless, a waste of money and they undermine the relationship betweeen midwife and patient.

Gosh, that's a rather shocking way to treat women isn't it ?

How about you ask her if she smokes, and then, depending on answer, offer information and support to reduce or give up smoking ?

I only used to smoke occasionally on high-days and holidays (OK sometimes one in the garden after work) but gave up drinking and smoking before I got pregnant, as many women do, or once they know they're pregnant.

I think you've got to start out on the midwife/woman relationship trusting in the woman. I wouldn't be at all happy with the messages I'd be picking up from this approach.

I think it's appalling.
Are they also going to check what every expectant mother is eating every single day? or if she drives carefully?

Any woman is free to assess her risks. I have a friend who went on her motor bike until she was 8 months pg.

I think there's a difference between motor biking and smoking , well slightly.

I do genuinely wonder why some one who has chosen to get pregnant would then choose to tank them up on carbon monoxide before they are even born, these kids don't have chance.

Its become far too lenient on smoking/drinking mothers, and before I get called unsupportive, support comes in many forms, I'm simply being honest as an ex smoker who went cold turkey, I do understand how hard it is,
But I don't think patting on the back 'there , there I know love have another cigarette' is a good approach.

Not every woman choses to get pregnant though do they. I find your post quite inflammatory and well, down right wrong.

And I'm a non smoker, never have smoked, hate smoking but I would never have the opinion you have.

This has angered me.

I have never been offered this test (I have a 14 month old DS and am 24 weeks pregnant), but I would absolutely refuse to do it were it offered to me. I don't smoke, but I find it utterly offensive. All pregnant women are asked if they smoke and are given access to smoking cessation services. We all know how damaging smoking can be to an unborn child. What this is, however, is a public funded lie detector test, which reduces women to being treated like children. If a woman smokes and does not intend to stop whilst pregnant, nothing the NHS does or offers will make her. That is her choice, regardless of whether society regards it as a bad one. Being coerced into taking a test to check whether she is telling the truth is a gross breach of trust and a waste of public money.

I have also heard women say that they have been offered the test on the basis that it will check whether they have any faulty appliances in their house, masking the real reason behind it. This is, at worst, a state sponsored lie, and at best extremely misleading and is sure to undermine trust between patient and supposed carer.

What's next? Tagging to track alcohol consumption? Drugs testing? Unpasteurised dairy products and shellfish testing?

I didn't choose Glaikit, I was a teen but I took some responsibility ,

Why is it down right wrong, urgh why do people bend over backwards to support something that is poisonous to an unborn child.

I will no doubt get flamed, that's fine my view is concrete though.

Chunderella, when I got pregnant it was 'you are pregnant, stop drinking, smoking now!'
and people went cold turkey and stayed that way,
now its 'well I have the odd one here or there'.

What bread said

It's wrong that, in your opinion, because a mother smokes, her children have no chance. No chance of what exactly? It's a bit of a sweeping statement.

There are mums on here who have posted abut the stresses they were under during pregnancy and for you to come here and be so god damn rude is uncalled for.

Sometimes all people need is a kick up the backside, but not everyone. Sometimes they need the softly softly approach.

Anyway, this isn't what this thread is about, it's about a test to prove whether or not you are lying to your midwife about smoking. In my opinion, the test is wrong. It has feck all to do with faulty boilers or any other guff they try and say its for, it's to "catch out" smokers.

I was never told to "stop smoking now" when I got pregnant.

Are we testing the Fathers to see if they're smoking too? If not, why not?
After all they are also responsible for the environment that the Mother is living in.

What an absolute waste of already overstretched NHS resources.

We'll be having the midwives doing spot visits to check that there's no blue cheese or shellfish in the fridge and that pregnant women are all in bed by half past nine with a hot milk next

Where does it end? Intelligence tests and 'voluntary' education classes for those designated numpties? Cooking exams once junior is due to wean?

I had this done as part of my booking appointment at my local hospital - I've never smoked in my life....I didn't mind though - because it picks up on your carbon monoxide levels so if you have a faulty gas meter or carbon monoxide leak in your house which is potentially fatal it will also be picked up on as part of this test. I know the carbon monoxide thing sounds far fetched but as one of my friends died from this and me my husband and baby recently got admitted to hospital with carbon monoxide poisoning from a faulty boiler I was more tham happy to have my levels checked. I do agree with the comments above though the nhs do seem to think you have handed your body over to the state as soon as you find out your pregnant.

I'm not being rude, I'm not name calling

Like I said , I've been there and took control, there are no victims here,

You have your opinion I have mine, the soft approach is too enabling imo.

It is outrageous that women would refuse a test for carbon monoxide levels that can indicate if your baby is at harm. Bet most of these women who say they would refuse do not refuse other tests eg, protein in urine, high blood pressure etc. It costs the NHS over £220,000,000 per year to treat babies who have been harmed due to women smoking during pregnancy. The tobacco industry has a lot to answer for, listening to the levels of addiction from women who are prepared to sacrifice the health of their unborn child in order to satisfy an addiction which lines the pockets of multi millionaires! The NHS has to do everything possible to ensure a safe and healthy baby is the end product, collusion is not acceptable from midwives!

You joke about cooking classes ankle biter, we had one enforced on us at our new mums group(I think it as a sure start thing). Only it wasn't for weaning, it was for adults. Complete with little bags of fat, sugar and salt to show us how "bad" things were for us . All presented by a woman who clearly didn't follow her own advice!

I was offered this test and I don't really see the problem with it. If it encourages at least one expectant mum to stop smoking then it's a good idea in my book. Just refuse it if you don't want to take it - no need to cause such a fuss.

Its about balance of risks and the fact that a woman has rights and whilst we can encourage women to be responsible we cant force them and rightly so!

The advice on alcohol was a drink ie one/two units a week was ok when i had ds1 that has now changed and they do say that they recomend no alcohol now. But the advice and evidence is variable. Some studies say a drink every so often is ok, others say no. Everyone advises on moderation, some abstinence.

Re smokng i was a smoker when i got preg as a teen with ds1, i gave up immediatelt but nine yrs later after having ds4 i had post natal psychosis and started smoking again. I recovered from the psychosis and pnd and got preg again but was still smoking occasionally ie two a day or none for a week etc i was honest with my midwife, consultant and my cpn who agreed that the priority was to moniter my mental health and ensure i stayed well and therefore they said given the amount i was smoking to not stress myself out trying to give up.

They said smoking less than five a day the affect was minimal and that they are concerned with heavier smokers.