Despite British media attempts to make it appear that all pregnant women will have to prove they do not smoke by taking a carbon monoxide test, the National Institute for Health and Care Excellence (NICE), which provides guidance to ensure quality and value for money in the National Health Service, UK, insists that the “NICE does not call for the test to be made compulsory and women can choose not to have it.”
Some reports claim that the new “draft guidance” from NICE is “ill judged” and will undermine midwives’ relationships with pregnant mothers. Today the Royal College of Midwives said they supported the guidelines.
Cathy Warwick, RCM chief executive, said:
“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.
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.”
What the guidance does not recommend, is to force all pregnant mothers to take a breath test, NICE stressed. It recommends that pregnant women be invited, perhaps encouraged to have their carbon monoxide levels tested to determine tobacco smoke exposure.
Regular active smokers as well as passive smokers (secondhand smokers) tend to have high levels of carbon monoxide in their blood and exhaled breath. By measuring levels, the mother will see a physical measure of her exposure, which if high may encourage her to give up smoking.
NICE added that the test helps make sure pregnant smokers are offered appropriate support to quit for the good of their unborn baby.
The guidelines say that women who smoke and have either recently given birth or are pregnant should be offered a range of options to help hem give up.
Director of Public Health at NICE, Professor Mike Kelly, explained:
“During pregnancy, smoking puts the health of the women and her unborn baby at great risk both in the short and long-term, and small children who are exposed to second-hand smoke are more likely to suffer from respiratory problems. One of our recommendations is for midwives to encourage all pregnant women to have their carbon monoxide levels tested and discuss the results with them.
This isn’t to penalize them if they have been smoking, but instead will be a useful way to show women that both smoking and passive smoking can lead to having high levels of carbon monoxide in their systems. It will also alert non-smokers with high carbon monoxide levels to possible CO poisoning, which can be caused by a faulty boiler or car emissions.”
NICE is currently developing “Smoking cessation- supporting people to stop smoking: draft quality standard” which was put out for consultation in March this year. Within this draft, there is a recommendation to offer pregnant mothers a carbon monoxide test.
If a woman smokes during her pregnancy her risk of miscarrying is considerably higher, compared to non-smoking pregnant mothers. The incidence of SIDS (sudden infant death syndrome), sometimes referred to as cot deaths in the UK, is also higher if the mother smoked regularly during her pregnancy.
Babies born to mothers who smoked regularly during pregnancy tend to weigh less at birth than other babies.
According to the Yale School of Medicine, a pregnant mother who smokes at least 20 cigarettes per day risks having a baby with a lower reading score later on.
Written by Christian Nordqvist