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Mothers must be able to 'opt out' of smoking test, say midwives

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The Royal College of Midwives has insisted that pregnant women must have the choice of opting out of a breath test for smoking, which is being recommended in new draft clinical standards for antenatal care.

Expectant mothers should be asked to take breath tests to prove if they are smoking during their pregnancy, under a draft quality standard drawn up by the National Institute for Health and Care Excellence.

An estimated 20% of women smoke while expecting, which is believed to lead to a low birth weight for their babies and cause complications in pregnancy and labour.

In a bid to lower the lower the numbers, women should be tested for carbon monoxide found in cigarettes during antenatal appointments and given help to quit if levels are too high, according to the draft version of the NICE quality standard. It is based on existing clinical guidance from the institute.

On Sunday the Royal College of Midwives released a statement on the draft standard, which is currently out for consultation.

RCM chief executive Cathy Warwick said: “Midwives have a vital role to play in promoting public health, and reducing smoking in pregnancy is extremely important.

“I visited a maternity unit this week, and heard from fellow midwives just how helpful these tests can be in showing to women the potential damage that smoking can have on their baby.

“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.”

She added that the NHS has too few midwives. “The real solution here in cutting the prevalence of smoking in pregnancy is more midwives and more continuity of care from the same midwife,” Professor Warwick said.

“NICE is a listening organisation. They have asked for our views, and we have given them. We would like them to make clear in any advice to women that midwives should offer the test but that ultimately the final decision must lie with the woman.”

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Readers' comments (1)

  • "Mothers must be able to 'opt out' of smoking test, say midwives"

    Pregnant women do have the right to opt out of CO testing! In some health boards in Scotland, it is normal part of routine care that Carbon Monoxide levels are tested. What is the problem here? Would we consider not carrying out normal observations, blood tests, scans, etc? In my health board there is a dedicated (if small) team of stop smoking advisors specifically for pregnant smokers. We test the women and refer them if they are smoking, and give their consent, to the service. This has led to higher levels of quit attempts and rates, and research into the overall picture and other measures to aid quit attempts is ongoing. Continuing to do as little as has been done to deal with the numbers of pregnant smokers is inexcusable.

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