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!

What a waste of money and time!

i did have it THIS year redtoothbrush

iclaudius it is ironic that you have taken great offence to my implying you may be stupid (note I said "if you", not "you are") yet when a midwife or other health care professional suggests a woman may be stupid, ignorant or a liar that is fine.

Perhaps think about how you felt when you reacted to my post. That is how women are being made to feel. Only it's worse because they are hormonal and in unfamiliar surroundings dealing with unfamiliar rules. Not nice is it?

I had a carbon monoxide test at my booking in appointment in October - I wasn't told it was anything to do with whether I smoked.

Feel a bit insulted now, was my midwife just checking I was telling the truth about not smoking, or was she really checking for carbon monoxide in general (e.g. faulty boiler, passive smoking)?

k8 i've never ever felt like the midwife implied i was stupid and i've seen a lot of different midwives

The funny thing is, I am a smoker but always give up when pregnant (unfortunately I relapse in between) I was asked to take the test (and told they were testing all mums to be) after already telling her I was a smoker and asked if I could see the "smoking midwife" (saw her with my previous pregnancy and felt her support had really helped in staying smoke free) and was told oh we don't do that if you want to quit you'll need to see a doctor or go to Boots, but just think of the baby and don't do it! Now, whilst I except that is a fair point, a. Why get women to do the test but offer no back up support, and b. If it was that easy to 'think of the baby and not do it', surely there wouldn't be a problem! I managed it but its not easy and I was lucky to have other support around me. Smokers arn't warped evil parents that don't love their children enough, smoking is aaddictive! I doubt that are many smoking mums that aren't desperate to quit when pregnant, if they lie about it its probably because they're ashamed and don't want the usual assumptions to be made about it. But trying to catch them out with an initial test, what help will that do?! Proper support is whats needed.

You might not have done but the point is other women have. The other point is that the outcome does not make any difference to the action. Whether they test or not makes no difference.

iclaudius, this test you had, did you already have a child/ren when it was carried out or was it done during your first pregnancy?

No my most recent pg only

It makes no difference if they just best you at booking in and that's it... sure this is actually about mother/baby welfare rather then research/stats?

How intelligent do you have to be glad to be told that your gas fire doesn't leak as a result of a midwife testing you and you alone, when it's a well known fact that a leak will affect your children (and pets and the elderly) first if it does?

A CO2 monitor in the home gets my vote too.

• That should read, 'How intelligent do you have to be in order to be told that your gas fire' etc etc.

You can imagine the training 'women are under reporting smoking, so we are going to screen them' 'what if they don't want to be screened for smoking, if they are adamant they don't smoke.' 'tell them the test will also identify other sources of CO2, leaking boiler, pollution'

They hold us in such contempt.

If MWs really are fudging the reasons for the test with guff about gas appliances that is worrying for three reasons:

1. They are not getting informed consent
2. They are not being honest and therefore undermine the trust in the relationship
3. Some people will think their gas appliances are safe because they've been tested (I wouldn't have believed it but I read it here) thus putting themselves and their family at risk because they are less likely to see the need for a home co monitor and alarm. Because what is a safe gas appliance on one day does not necessarily remain a safe gas appliance in the future.

Obviously if MWs feel they have to fudge reasons that is indicative that the official reason is poorly evidenced or downright spurious.

You are making the NHS sound like big brother- some Orwellian infrastructure trying to trap us somehow

I didn't really want HIV testing or a load of other stuff they asked me - I requested not to answer the odd question on the form and was told 'that's fine'

People are happy to have bloods GTT and ultrasound - why not this? I only know one person turn down an ultrasound.

Because it's much harder to give someone an ultrasound against their will and because an ultrasound isn't testing for something a woman can know and tell you.

A woman knows for certain if she's a smoker. She has no way of knowing if her baby has spina bifida or another abnormality without a scan. Besides, the lead up to ultrasounds is much longer, the process for obtaining informed consent is much more robust (booklets, forms, separate appointments, explanations, seeing a sonographer instead of a midwife).

Just to prove it to you, I will find out if the next poster is a smoker or not without using a gadget. Please bear in mind that the outcome of this test remains the same regardless of the answer.

Ready?

Next poster, please would you tell me if you are a smoker? if you are I can provide you with details of NHS services to help you quit because the dangers to your health are well documented.

Not in my experience Kate I have had ultrasounds sprung on me as we'll as other tests
I'm pleased with the NHS maternity care and trust that they are doing the best for me and moreover ( and I do feel more importantly) my baby

This really gets my goat. In some areas, women don't get two ante-natal scans yet there is money to spend on this???

This is just a ludicrous waste of time and money!

I'm not a smoker k8, but thanks for the offer :)

Thank you sunny :)

See, no test, risks highlighted a bit, could have done a better job but it's sooooo late, offer of support made. And if sunny was lying? Never on the interweb! Well making her take a test wasn't going to make her access cessation services if she didn't want to, was it?

Lying on the interweb! Never!

I think its ridiculous. No one should be forced to have a test when a simple yes or no suffices. It's providing a job for someone though- creating a few stats to share on a lovely fact finding mission in the US maybe?

Perhaps the smoking cessation program isn't going so well after having all this money spent on it. It's a way of getting the numbers up and justifying continuing. My df wanted to give up and went along for a meeting but he said he couldn't sign up with all the fixed meetings ( work commitments ) and hoops he had to jump through, and it was easier just to go to boots and get some nicotine tablets. He said it was really hard to get the women to stop calling him and nagging to get back on the program. He called her a stalker(!)

People already know smoking is bad for you. They don't need a test or to be brow beaten by a Mw. The only reason I was asked, right before my emcs, was because I would have been more at risk with anesthetic.

I don't see the problem with it - if you smoke it may help you make an informed decision. Maybe it's a bit of a shock tactic. I'd imagine it would help the MW access things - smoking increases risks so if the level is higher, I'd presume it would result in heightened risk.
Smoking isn't recommended in pregnancy because it isn't good for baby - just like alcohol.
Alot of people would stop drinking but keep smoking.