Midwives are being called on to assess carbon monoxide levels of pregnant women to see whether they have been smoking.
Posted 23 June by Maura O'Malley
Midwives are being called on to assess carbon monoxide
levels of pregnant women to see whether they have been smoking.
Midwives would encourage women at the first antenatal
appointment and subsequent appointments to have a breath test that measures levels of the gas.
The recommendation is made in revised NICEguidelines
on smoking in pregnancy. It is hoped that this move will ensure that pregnant
smokers receive appropriate support to quit for the good of their unborn baby.
High carbon monoxide levels can be seen among active and
passive smokers, so by testing the levels of all pregnant women, those who
smoke or who are regularly exposed to second-hand smoke, will see a physical
measure of their exposure.
The guidance also recommends that women who smoke and are
either pregnant or have recently given birth, are offered a range of options to
help them quit, including automatic referral to smoking cessation services and
sensitive and non-judgemental support by professionals.
It is thought to cost the NHS between £20m and £87.5m each
year to treat mothers and small infants under 12 months old with problems
caused by smoking in pregnancy.
However, the RCM's education and research manager Sue Macdonald said: 'There appears to be an emphasis on pregnant women, which is appropriate given the
evidence. However the key issue here for NICE is their emphasis on the CO2 monitor.
It is crucial that health practitioners, including midwives, focus
on being supportive rather than making women feeling guilty, or as though they
may not be truthful. Use of the CO2 monitor has the potential to make women
feel guilty and not engaged. We need to look at a range of individualised
interventions for women that meet their needs and aspirations.
'There is also the cost implication of all midwives carrying monitors, and
issues such as safety and infection control, and whether this is the best use
of funds to address smoking cessation.'