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Midwives concerned over smoking pregnancy test

WebMD UK Health News
Medically Reviewed by Dr Sheena Meredith
female businesswoman on smoke break

13th May 2013 - Midwives have expressed concern over plans to ask pregnant women to take a breath test to check whether they are smoking.

The Royal College of Midwives says it is likely to pile on the pressure during a busy first antenatal appointment. They say the test would only be a partial solution to cutting smoking as some women will refuse to be tested.

Mothers have complained about the test on a popular internet forum, saying it risks damaging the relationship between pregnant women and their midwives.

Breath test

The idea for testing women during pregnancy was floated by the National Institute for Health and Clinical Excellence (NICE) which is currently developing a quality standard on smoking cessation. One of the draft quality statements is that pregnant women should be offered carbon monoxide testing to assess exposure to tobacco smoke at their first antenatal appointment and throughout their pregnancy.

NICE says the breath test could make an important contribution as the health risks for babies and mothers who smoke are substantial. It says smoking can cause complications in pregnancy and labour, including ectopic pregnancy, bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes.

Some pregnant women find it difficult to say that they smoke because the pressure not to smoke during pregnancy is so intense. As a result, some women who decide to continue smoking during pregnancy miss out on advice and support about quitting.

According to NICE, a carbon monoxide test is an immediate and non-invasive way of assessing whether someone smokes or not.

Smoking cessation

Those who test positive for carbon monoxide would be referred to NHS stop smoking services.

The recommendation is only in draft form at the moment but could be officially adopted in August this year.

'Meddlesome nonsense'

A number of mothers have complained on the Mumsnet forum about the idea to test for smoking. One mother called it "utter meddlesome nonsense", while another said it "may deter people from seeking pre-natal care if they're going to be nagged to stop at every appointment".

The Royal College of Midwives believes introducing the test at the first antenatal appointment may be a step too far. Its chief executive Cathy Warwick says in a statement: "Midwives have a vital role to play in promoting public health, and reducing smoking in pregnancy is extremely important."

She continues: "Of course, not all women will want to take this test. Any test which becomes routine must be offered along with comprehensive information and women must be able to opt out. Tests can help midwives educate women in the hope that they reduce their baby’s exposure to cigarette smoke but not all women will accept the test and it is only a partial solution.

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