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MNHQ

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

489 replies

RowanMumsnet · 12/05/2013 10:39

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!

OP posts:
lalalalalal · 12/05/2013 23:25

Just another thing in the long line of matters in which pregnant women are not to be trusted:

  1. When they got pregnant (doctors refused to believe me either time that I ovulate late in my cycle and got all worked up about how the embryo was measuring 5 days 'behind' based on my LMP);

  2. Who the father is (I'm Rhesus negative: they didn't care about the blood group of DH since 'he might not be the father' of my babies. Nice.);

  3. Whether or not they have an STD (I realise a lot of STDs go unnoticed but even so...)

  4. What they eat

  5. What they drink

  6. Whether or not they dye their hair / repaint the house blah blah...

I'm surprised babies aren't removed from their parents at birth, since we're clearly all unfit to parent and don't give a stuff about the health of our children.

iclaudius · 12/05/2013 23:26

i would argue that many women WOULD be shamed into not having the odd fag if they knew they'd be found out when pg ... i for one would

K8Middleton · 12/05/2013 23:26

Have you read the thread iclaudius?

SchroSawMargeryDaw · 12/05/2013 23:27

They shouldn't be shamed though. It isn't illegal and is that persons choice, regardless if it's a bad one.

It's a disgusting attitude to think it is okay to shame anyone into doing anything, especially by people she will have to trust!

iclaudius · 12/05/2013 23:29

i would feel crap about smoking when pg but maybe im alone in that

20 years ago your partner was asked to leave the room for some questions too - this isnt new

coffeeinbed · 12/05/2013 23:29

You don't have to be shamed into it.
You need yo take full responsibility to your actions rather then rely on someone to say " bad girl! No more fags"

K8Middleton · 12/05/2013 23:29

Are there really many women so stupid that they have to have a test to tell them they are smokers?

Now I'm not a smoker, but I'm reasonably sure I would notice if I were.

SchroSawMargeryDaw · 12/05/2013 23:34

iclaudius I think you're missing the point a bit.

The being asked to be spoken to on your own - fine, refusing to speak to you unless you're on you're own - not fine.

Asking if you would like a CO test - fine, pressuring you/making you feel like a liar/or making out that you have no other option - not fine.

Just because you are pregnant does not mean you should suddenly give up your right to consent and allow HCPs to bully you into doing things you don't want, regardless of what they are.

iclaudius · 12/05/2013 23:35

when i was younger and pg i might have needed a 'push' to give up the odd last fag

theres a load of stuff dragged up in the midwife room id rather not - i dont get in a pickle about it though

just suck it up- theyre trying to help not 'bully'

RedToothBrush · 12/05/2013 23:36

iclaudius, it might well have a positive effect on some women smokers which has proven to be the case on some study.

But at what price? Do they measure the damage it has on non-smokers? Or on the relationships between patients and HCP in general over a longer time frame. I doubt it, because the only thing they will measure is the number of smokers.

I would suspect the reaction on this thread alone, should be reason enough to question whether on balance its really a good idea to take this approach.

There must be other ways to encourage the cessation of smoking which have decent success rates. I suspect they aren't encouraged as they require more staff resourcing to implement well... I bet if women simply had more access to a midwife they had a good relationship with on a regular basis rather than struggling to get any appointments or always seeing someone different would probably be a good place to start...

...it does seem that understaffing and the shortage of midwives in general is ALWAYS forgotten in favour of idiot ideas like this, that are inevitably dreamt up by paper pushers with no concept of human interaction in health.

I am utterly fed up of the NHS and its utter shortsightedness on the issue of trust in general. And I am aware that this is a subject that has caused a great deal of concern within the profession itself too.

SchroSawMargeryDaw · 12/05/2013 23:37

"just suck it up- theyre trying to help not 'bully'"

Wow. No, I wont (and hopefully many others) just suck it up because you "might" have needed a push.

iclaudius · 12/05/2013 23:38

dont see enough of midwife these days to build up 'trust' tbh - its a quick 'in and out'

i was pleased to know my gas fire didn't leak

SchroSawMargeryDaw · 12/05/2013 23:41

I knew my gas hadn't leaked because I have a CO2 monitor in my home for that purpose.

My last appointment was with the MW who might actually be delivering my baby, it lasted 45 minutes so I guess I am lucky in that.

I already feel a lot safer with her than I did at booking in, she's nice and she listens and for the first time a MW actually tried to make me aware of my options and actually ask how I was and get into the reasons why I was down.

That is the way it should be.

K8Middleton · 12/05/2013 23:41

Oh so it's young mothers you have issues with iclaudius. May I ask what evidence you are referencing that says younger pregnant women are more likely to be smokers and still be smoking at booking in?

Do you know how many women lie about being smokers?

Do you know that even if women are pregnant and smoking you cannot make them stop

Just out of interest what do you consider to be young? Under 18? Under 21? Under 30?!

iclaudius · 12/05/2013 23:43

no K8 you've jumped to a very wrong conclusion there

RedToothBrush · 12/05/2013 23:45

You can justify doing anything without consent, with the phase "they trying to help" within healthcare.

It doesn't make it right.

It has a psychological impact on the patient.

Let me be clear here. There IS emerging evidence out there that bullying patients on smoking, obesity during routine check ups for other things, instead of having the desired effect can have a negative effect on patient relationships, and can make patients less likely to seek medical attention for other things, which is highly concerning.

So 'trying to help' is actually doing exactly the opposite, because the HCP is frankly too arrogant and too lazy to build up a relationship with the patient and to understand and fully recognise their needs and concerns in each particular case. One size fits all approaches like this do not work. They may benefit some, but they have a terrible effect on others.

K8Middleton · 12/05/2013 23:47

I apologise. If you are do stupid you need a hand held carbon monoxide test to assure your gas fire isn't leaking carbon monoxide then it is unreasonable of me to expect you to comprehend almost all women are capable of making informed decisions when given the facts.

Can I suggest that rather then relying on a CO test from a midwife you buy a carbon monoxide detector for your home. They cost les than a tenner and will keep testing the atmosphere in your home protecting you and your family. You do of course have to change the batteries every so often but I think even a young woman could manage that Hmm

iclaudius · 12/05/2013 23:49

i was asked for my consent for the test which was in a 15 minute booking

i was told it was optional

i at no time felt bullied

maybe my experience was different to the majority

i see very little of my mw, as i said and do not feel a great need for a trusting relationship as i know she will not deliver me but again thats just my personal experience.

Monty27 · 12/05/2013 23:50

Yes, spend the money on carbon monixide tests for houses, money well spent.

Good post K8

Fgs when are we ever going to get some privacy and freedom???

iclaudius · 12/05/2013 23:52

K8 'stupid' ? Very nice? I think I'll nip off now you are getting abusive

Please re read the thread when i told you were jumping to wrong conclusions

chipmonkey · 12/05/2013 23:53

No, this infantilises women.

Freddie upthread you said this was going toward the Irish position? I was never asked to do this test in 5 pregnancies in Ireland and was never asked to partake in any test without my former knowledge or consent? Or is this something new?

rambososcar · 12/05/2013 23:53

Can you explain exactly how it's helpful to spend a considerable amount of the already overstretched, overworked and underfunded NHS's - no, taxpayer's - money on an initiative which will be used to patronise and bully women, treat them like idiots and liars, alienate them and, as our experiences of the "you have to" and "you have to or else" contingent prove, in some cases cause a breach in UK laws regarding medical consent?

And then can you explain quite what you mean by "the greater good" in this instance, please?

iclaudius - those were the questions I asked you. You responded with "ramboscar - why do YOU suggest these tests are being introduced then?".

Now, apart from the fact that it doesn't matter why I suggest the tests are being introduced and that they shouldn't be is far more the case, apart from the fact that in truth I have no fucking idea why such a ridiculous, insulting, money-wasting, patronising, manpower-wasting concept was ever dreamt up, I'd have thought it would have been a little more usual and helpful to respond to the questions with either an answer, a refusal to answer or the reply that you haven't a Scooby, not to respond with another question.

iclaudius · 12/05/2013 23:55

chipmonkey it's new - i didn't have it last year

rambososcar · 12/05/2013 23:55

"Let me be clear here. There IS emerging evidence out there that bullying patients on smoking, obesity during routine check ups for other things, instead of having the desired effect can have a negative effect on patient relationships, and can make patients less likely to seek medical attention for other things, which is highly concerning. "

Hell yes! It was the bullying, patronising and ignoring of patient consent from a midwife which caused me to say screw this, I'm having nothing to do with these people. Once was enough, you don't get a second chance to be an ass to me.

RedToothBrush · 12/05/2013 23:57

Lucky you then iclaudius.

Not everything is getting that though, and its pretty widespread.

Especially at a time where HCPs have to meet targets on all manner of things and are under pressure to get their required numbers, in order to get funding.

There's a great book out there called "The Patient Paradox" by Margaret McCartney, a practising GP, which discusses at some length this problem and the ethics behind it. Highly recommend.