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!

[SchroSawMargeryDaw]

K8 and Vinegar I wasn't a non-smoker, just allergic to the NRT (brings me out in rashes, feels like it's horribly burning and I struggle to breathe easily if it's an oral NRT treatment), it said it in my notes I told them too and I was told to take it anyway.

[Signet2012]

They already do this. They did it to me with I went for my booking in at 9 weeks

[OrbisNonSufficit]

Schro that's horrible, I can't believe they were so incredibly rude. If it's an optional test then it should absolutely be optional, in every sense. In other words, no pushy manipulative bollocks.

If they ask me next week at my booking in if I want to do this CO test I'm going to refuse. How unnecessary. Why would I need a test to tell me if I smoke or not, surely everyone knows if they are or are not a smoker?

[SchroSawMargeryDaw]

Tbh I think she just didn't realise the extent of how bad it was even though she made me take the first one in front of her. She kept telling me that after the first couple of times it would stop. Funnily enough it didn't!

I'd be totally honest with them asking me questions, I do not like feeling pushed into stuff I don't want and being made out a liar even after I have been honest!

[Aoifebelle]

I had my booking in in Hackney on Saturday and wasn't tested. The lovely mid-wife quite rightly took me at my word that I have not had a ciggie since NYE, long before i got up-duffed. If this test had been sprung on me, I don't think i would have taken it very well.

If a mid-wife suspects a pregnant lady is smoking and lying about it, insisting on a test that will expose the lie is unlikely to help mum quit smoking. It will only cause friction and distance her from the mid-wife, so you will end up with a smoking mother less likley to access services. Genius.

What next - being frisked for soft cheese and lattes?

This is what happens when you put Jeremy Hunt in charge of the NHS. Utter idiocy

[JanePlanet]

When I went for my booking in appointment a couple of months ago I was asked if I smoke, I said no. I was later asked to blow into something without being told what it was. I asked if it was a carbon monoxide test to check if I was lying. Seemed quite underhand to me. Wasn't sure how to feel about it afterwards.

[tribpot]

It seems that Jasper Fforde's vision of the Cheese Enforcement Agency may not be so far-fetched after all!

It almost makes you want health services to have to follow the same kind of self-declaration model as financial advisors, who have to spell out the fees they will make from particular products if you choose to take them. "I"m asking you to stop smoking and that will bag me 20 quid in the QOF bingo this month". Etc.

[Featherbag]

What was the MW's answer Jane?

[ShadowStorm]

I thought that this test was already used as an optional test.

When I had my booking in appointment with DS, the midwife asked if I smoked. I told her (truthfully) that neither me or anyone I live with had ever smoked, and she said that she had a carbon monoxide test that she was supposed to ask pregnant women to take, but given what I said about not smoking, there wasn't any point getting me to take it.
Carbon monoxide test wasn't even mentioned at my booking in appointment with DC2 a month or two back. Same community midwife - guess I'm lucky to have one who'd happy to take women at their word about whether or not they smoke.

I have no objection to it being offered, but I've got reservations about it being compulsory. And I don't really see how being made to take a carbon monoxide test and being given advice on quitting smoking will stop pregnant women who are set on continuing to smoke continuing to smoke.
I'd have thought that those pregnant women who do smoke and who want to stop for the sake of the baby will surely be voluntarily confessing to smoking and asking for help anyway.

[coffeeinbed]

Jane surely they can't do that?
I thought they had to explain and have your consent for every test they do?

[feelthis]

I thought this was common practise everywhere. I has been done in Glasgow for years - since 2006 that I know of.

I have no issue with it - as I see it the midwives are there to protect the health of the foetus and I just assumed it was done because people do indeed lie and they want to be sure that they have done all they can for the baby.

I was not offended at taking the test even after telling them I didn't smoke as I know it did not reflect on the fact they felt I was lying, but to catch the small % who do.

[JennySense]

I did one of these too - I think it was in Glasgow - I didn't mind as I don't smoke - I had the same experience as feelthis above

[runnerblade]

I am no lawyer, but isn't it a criminal offence to force someone to take any medical test/receive any medical treatment without consent? Wouldn't it constitute assault? Upthread somebody mentioned being coerced into an HIV test and not being 'allowed' to leave the clinic until she'd given consent. Isn't this false imprisonment? My understanding is that consent has to be secured for all medical treatment; we are free to accept or decline services as we see fit. I don't think pregnant women are legally required to access any ante-natal service if they don't want to. Healthcare professionals cannot force pregnant women (or anybody else for that matter) to do anything they don't want to do (in law, anyway).

[rambososcar]

"... it did not reflect on the fact they felt I was lying, but to catch the small % who do."

"Catch", feelthis?

Catch, as in apprehend a criminal? As in "catch out" a naughty child?

I'm sure that's not how you meant it but that's how it makes me feel. Grown women who have a legal right to do something don't need to be "caught". This is not a police state, nor should it be a nanny one.

I'd refuse this test but even so I'm in no doubt whatsoever that if it becomes the norm there will be medical staff out there who exceed their responsibilities by coercing women into it, telling them that they "have to" have it.

[rosieposey]

This was done at my booking in visit with DS1 4 years ago and again with DS2 last year - i thought it was routine everywhere.

I do think though that if you say you don't smoke and get asked to blow in it anyway ( like i was) its a bit

[feelthis]

They ask you, do you smoke and then regardless of what you say, you do a carbon monoxide test - it definitely felt that they were trying to catch you out to check if you were lying!

[StarlightMcKenzie]

Shocking!

[cardamomginger]

I was 'strongly encouraged' to consent to the HIV test at my booking in when I was pregnant with DD. I'd refused it (and possibly some other ones for STDs - can't remember) and the MW sternly told me that if I refused, all sorts of questions would be asked about me and I'd be making trouble for myself.

[tribpot]

Given statistically there must be a far greater percentage of smokers who lie about it to their GPs, I wonder this stealth-test isn't being applied there as well.

[TeWiSavesTheDay]

I'd like them to screen for slapped cheek/parvovirus B19 immunity.

I am not immune and didn't know. Now facing all kinds of complications. If I'd known I would have been more cautious about where I took my older kids and infection control when they were ill.

[Themilkywoman]

I had this breathalysing at every sodding antenatal appointment last year despite telling them countless times that I didn't smoke.

I eventually declined (politely) and said that it was affecting my relationship with them. The midwife told me it was nothing to do with smoking but that she was checking my gas central heating for carbon monoxide leaks and she pretty much refused to let me leave till I did it

[runnerblade]

This authoritarian turn in the NHS is very worrying. It is very worrying that women are being 'encouraged' to consent to tests they do not want. It's profoundly unethical and potentially damaging to the patient/professional relationship. I think we need to educate ourselves on the legal situation vis-à-vis medical treatment and be prepared to complain when professionals overstep the mark.

[StarlightMcKenzie]

I wouldn;t do it. I don't get on the scales either at booking in (3 times) and I refuse the HIV test (though once they did it without consent).

[StarlightMcKenzie]

Ask the significant question: What does the government get out of women eathing nicotine instead of inhaling it?

[rosieposey]

Cardamom