Category: Health and Wellness
All pregnant women should be tested for smoking so that they can be given quitting advice if necessary, a health watchdog says.
The National Institute for Health and Clinical Excellence said carbon monoxide tests should be carried out on every expectant mother.
If implemented, every woman would have the breath test at her first ante-natal appointment.
Midwives criticised the test, saying it could make the women feel "guilty".
NICE said the guidelines were not aimed at penalising smokers but were designed to help women and their families give up smoking during and after pregnancy.
"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," Professor Mike Kelly, Nice director of the centre of public health excellence,
said.
"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.
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Use of the monitor has the potential to make women feel guilty and not engaged.
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Sue MacdonaldRoyal College of Midwives
"This isn't to penalise 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."
The guidelines were welcomed by the Royal College of Midwives, but it urged "non-judgemental" support for women smokers.
RCM education and research manager Sue Macdonald said: "There appears to an emphasis on pregnant women, which is appropriate given the evidence. However,
the key issue here for NICE is their emphasis on the 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 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."
The cost of the monitors also raised concerns for the RCM, as well as safety, infection control, and "whether this is the best use of funds to address smoking
cessation," she said.
Good! Pregnant women already have to be screened for hepatitis, syphillis, blood grouping (RH negative blood types form antibodies to RH positive blood type babies), chicken pox antibodies, you get the picture. I also wonder if they shouldn't have to be drug screened.
I'm sick sick sick of the whole "equality" movement that makes people and situations equal even when they inherently are not. Pregnant women are NOT the same as their non pregnant counterparts. They have another life to consider, that of a baby that cannot fend for themselves. Maybe it's time to do like they do on the tribal reservations...where one is NOT governed by the U S Constitution but by the laws of the Navajo, Chippewa, whatever tribe, considered a sovereign nation...and lock up women who have more than one pregnancy where they continue to consume alcoholic beverages, or force 'em to be sterilized after one fetal alcohol child. Smoke test 'em, drug test 'em, hey those are painless urine tests usually.
Where I draw the line is the idea in the U S that mothers over 35 should be forced to undergo amniocentesis to see if the child has Downs' Syndrome, than forced to abort if they do have a 3rd chromosome on the 21st pair. 1) The vast majority of babies who actually are born with that problem have mothers with no risk factors. I actually know a woman with a retarded boy, and his younger sister doesn't have any level of mental retardation, and obviously she would have been two years older when she had this little one, and supposedly the risk goes up with every year of age. 2) Amniocentesis in and of itself is supposed to be an extremely painful test with a risk of miscarriage, possibly of a perfectly healthy infant. Maybe 2% of women who go for this test have it come back positive for a chromosomal defect. If a baby has a severe enough defect often it is naturally miscarried as unable to survive. Smoking and drug use are choices, and it's one thing if men or nonpregnant women take advantage, another altogether for those who are pregnant.
Oddly enough, and obviously I'm no expert, but one would think that if a woman smokes, she's quite aware of it. As far as I know, sleep smoking or somking while in a medatative state in which all memory is lost, is not a common occurrence. So what exactly is this test going to show? Is the doctor going to walk in and go, "Hey miss smith, you smoke, bet you didn't know that one beforehand."
That, to me, is about the same as asking a pregnant woman if she's sexually active. It seems pretty damn pointless.
Should woman stop smoking during pregnancy, some say yes, but then woman have been smoking during pregnancy for about the last five hundred years or so, and still doctors cannot say it will cause damage, only that it can. Then again, being startled can actually cause damage to the baby, as can any number of other activities that are common to life as we know it.
the fact of the matter is that, yes, you have to be a bit more careful when your pregnant, and guys even have to be a bit more careful if they're trying to get a girl pregnant. does that mean you should totally shut down your life? No, I, and many respected doctors not published in popular media today, don't think so.
I think the women should be encouraged, but not required by law, to stop smoking during pregnancy. After all, it'll be her child, health problems and all, but one thing that really bothers me is the babies that are born with drug addictions, FASD, and other drug and alcohol related birth defects, so I do agree that precautions should be taken to stop this, but I also agree that the point here shouldn't be to make the woman feel guilty.
Nicotine level tests don't make a pregnant woman aware of what she's doing, they measure nicotine levels. And they also provide a liability waiver for a physician should a baby be born w specific problems. They have the test, its results, and counseling on file should the * decide to sue once her child is born. Honestly the laws in neighboring New Hampshire are so ridiculous they allow women to sue an obstetrician 20 years after her child was born if they feel he/she is responsible for that child's plight. That law has driven a lot of obstetricians into gynecology only or out of medicine. An ob/gyn I met from New York state has a friend who sold his practice and bought a bagel shop. Some factors, like age, can't be controlled. Some women aren't in stable partnerships until they're older, or maybe they divorce & remarry & want a child by the second husband, but behavior is controllable, and pregnant women should be made to feel guilty about bad behavior.
When SATURDAY EVENING POST was still published, they ran an article about a research study involving children (adult) of mothers who smoked. It showed that such adults not only were kind of short in stature but had incompletely formed kidneys, so a tendency towards high blood pressure. My ex boyfriend's mom smoked in the '50's while pregnant w him, before people really knew of its dangers. He had 140/90 blood pressure, considered at that time borderline hypertension, now considered a problem, and he wasn't obese, diabetic, a smoker, or any other risk factor for this problem. Totally shut down one's life? No, but they should be more careful about what they take into their systems.
Oh yes, they should be responsible, of course, and they should have to live with the consequences if they're not, but the point should be to educate, not dictate.
But who are you, or anyone else, to say what is bad behavior or not? Perhaps you like to collect crushed velvet elvis posters, and I think it looks tacky, should I ridicule you for your choice? No, because its your life, your taste, your choice, and your crushed velvet elvis posters, not mine.
I'm one of the few blind people I know that adores guns, and plans to get a concealed weapons license. Is this bad behavior? I don't think so, but other people do. but its not their life to dictate.
It makes me angry when other people think they should be able to dictate other people's lives. Just because some study says the behavior might have consequences.
and lets be honest here people, it is still might. there has never, I repeat, never, been a study that says it is. I know several people who smoke, and who smoked while they were pregnant, and whose parents smoked while they were pregnant with them, and they're all fine.
President izinhower smoked more than two packs of unfiltered cigarettes a day, and lived to be nearly ninety years old.
So I say this, stay out of other people's lives. I can garrantee you that your life has some problem you can fix. So until everything in your life is absolutely perfect in every possible imaginable way, and their is no way you can improve on it, stay out of other people's business. It doesn't concern you, leave it alone.
The reason this is being proposed is to protect and create jobs in the NHS. Somebody will have to make sure there are enough testing kits. People will need to be employed to do the tests. People will need to be employed to help the pregnant smokers quite smoking. Once employed, these people will join a union, making it stronger, more powerful and more influencial, (unity and strength and all that). If this is too costly and jobs have to go, Labour will then be able to accuse the current government of making more people unemployed.
When will people realize that jobs can't just be manufactured? If you want to create jobs, give up. If you want more jobs to be available, how about we make it easier for new businesses to be created. More new businesses, mean more new jobs. Plus, lower the minimum wage, and get rid of affirmative action. That will create a lot of jobs.
thank you, SilverLightning; very well said!! my aunt smokes, has done so for years...even when she was pregnant. both her and my cousin turned out fine; who the hell are others to criticize how she lives her life?
Well testing is good and incurragement to stop things that might or might not harm the child, but it's sort of pointless because maybe she doesn't smoke now, but picks up the habit mid way? Test for things that can be cared for other things it's pointless.
More of the ol' equal choices stay out of other peoples' lives blither blather...fine you try dealing with spinal fluids for syphillis on 3 day old infants, or eye swabs for various sexually transmitted diseases on 'em, or gonococcal swabs on young kids when the mothers date, try shipping narcotics confirmations on newborns, then tell me you still feel the same. Sure my life is imperfect, but the topic wasn't Spongebob's life, or velvet Elvis posters, or even concealed weapons permits that don't affect anyone until the weapon is drawn, it was smoking and pregnant women. They are being asked to breath into a machine & advised to quit, whoopee!
Nice is a quango which is at risk of being scrapped by the government.
No wonder so many babies and young children get asthma and other related conditions because so many mothers insist on smoking around them. Agree with post 2 because it could cause harm to those around them as well as the mother and the child.
still, it's personal choice...
I'm a very strong smoker's rights advocate and believe that people should have the right to smoke if they choose to do so without being controlled by others. That said, I agree that pregnant women are different. Even though there's evidence that second-hand smoke is a myth, this has nothing to do with babies who rely on their mother's blood and body to grow and to survive. While I, as a person standing near you, may not be affected by smoking, I'm sure that a fetus will absorb nicotine etc. and this is totally unhealthy for it. I agree with you, spongebob, that there should also be drug tests etc. and that those women who insist on having children without stopping alcohol etc. should be sterrilised. However, unlike you, I'm fully in favour of aborting fetuses with the potential for Downs Syndrome in it's serious form as well as other such debilitating diseases that would render the child unable to fend for him/herself when at an appropriate age to do so. That said, I think better tests need to be created that don't pose the risk of killing the fetus, incase it really is healthy. SilverLightning, you made an excellent point about the pointlessness of this in the sense that one would hope women who smoke are aware that they do so, unless they have multiple personalities or something. However, this may be used to assess the risks involved with light, moderate and heavy smoking. For example, they may not be as concerned with someone like me, who smokes one or two cigarettes a day, as they would with someone who smokes one or two packs a day. Also, what you do with your life is one thing. Hurting the innocent is another. So if you, for example, get a gun and use it for target practice or whatever, that's fine. If you go and shoot an innocent person, that's not, especially when the person is unarmed. This fetus, that will one day be a child, cannot defend itself and is forced to rely on it's mother biologically for everything until it's born. So if harming others is wrong, what is wrong with trying to prevent mothers from doing drugs etc? I was born prematurely, addicted to heroin and then went through over 20 days of withdrawl, because my biological mother couldn't care less. I went blind at two-months-old due to rop. Now I didn't do anything to deserve it. So she had the right to take her drugs but why do I have to continue suffering for her mistakes, even 26 years after the fact? I hardly think this was a personal choice of mine.
But then, if they are alloweed to give all these tests, what is to stop them from testing other things? What if one day they decide they want to test the guy who gets the woman pregnant. That can effect the babies health even more than the mother's actions in some cases. What if they decide that they want to test both the genes of the parents to see if the baby will have some deformity or disease from genetics? What if they decide that they want to create a formula for a perect baby, and only those that fit it are allowed to go through full pregnancy and be delivered?
If they can test this, what is to stop them from testing the next thing, and the next thing, and so on? What point do you say, enough is enough?
I think all of these ideas, minus the perfect baby, are very good ones. If men affect the outcome of the pregnancy that much, then by all means, test them!
Should that be a choice though? Should I, if I want to father a child, have the choice to be tested or not? What gives someone else the right to tell me that I need to be tested for this disorder or that gene? What gives someone that power?
You can test, but changing peoples habits is like changing the weather. Take care of the things you can take care of like STD's and such things on the babies, but until smoking becomes illegal you can only advise, and women should get all advice on the proper care of babies as a rule, but testing them except for drugs and such things you can help with is silly, because in the end you are still only able to advise.
There isn't any point in testing people unless there are consequences for causing harm to children while they're in the woomb. This initiative is just about securing more contracts, getting more public sector employees recruited, strengthening existing unions, etc.
You're right about consequences. Those who hurt fetuses in the womb, with the exception of those who choose to abort, must be punished.
Oh, (and I'm going to get flamed), but you can choose; (with the baby having no choice) to take a baby's right to life away, but you can't choose to do something that has not been proven to be with out a doubt harmful? Controlling things that are not proven harmful; (most drugs are acceptions since it is proven that drugs like heroine, crack, ETC, and, alcohol are very harmful to unborn fetuses) are only one more way to make the "perfect" borg human. While we are taking the right for a woman to smoke away why don't we just go and steralyze; (complain about the spelling if you want, but I'm simply to pissed to care), every blind, deaf, paralyzed, ETC, human just because they might (might) pass it on to the kid or harm the kid in some way...Might???
I say sterrilise only when it's certain that the child will inherit said disease, and again, only when the disease is serious enough to warrant it. I think full rights to smoke should be restored once the mother has had the child. The only problem then becomes the infant getting second hand smoke. I'm not sure at what age it ceases to matter when a person is around smoke but I'm sure they need to develop a little. That said, I'm sure the mother could find time to do it when the child is in a safe environment, such as a crib or play pen, where she could go into another room or outside but still be able to watch the child via camera, window or close proximity, or when the child is with another trusted adult, such as the mother's partner or a grandparent.
Also, she could use electronic cigarettes when around the child. But I don't think these should be laws, in this case, just suggestions.
Oh, I'm not saying that I agree with smoking during pregnancy, but I don't want the government telling me what I can do with my child when they can't prove it will hurt him/her, and while others are being allowed to continue in much more harmful activities...Drinking while pregnant or a parent; (even the father drinking can harm said unforn or born child), ETC.
Agreed. If smoking is to be monitored, it's imperative that these much more harmful things be monitored as well.
I don't know about where this law was made, but at least where I am going to the midwife I can sign a waver if i don't want testing done. For example I chose not to have the first trimester screnings. They are in general to find out whether or not the child has downs or spinabiffata, and are generally there to find out if the mother has a child like that if they want to terminate the pregnancy. Since I had quite a bit of phollic acid at the beginning of my pregnancy and am younger than 35 and with nobody in the family with downs I said skip it.
I can choose to do this with most tests I don't for most, but in most cases the woman has a choice.
I smoke sometimes when I am not pregnant, but I have not touched a clove or cigaret since about a month before I got pregnant. When I say sometimes I mean even less than Aleni. My husband had enough problems with asma, and i have a couple adverse affects from my father's smoking when Mom was pregnant and afterword. If I can avoid passing things like that on to my child by all means I will avoid it.
One thing I didn't see come up as one of the risks that they have found links for with smoking parents and children is SIDS.
If women are pregnant they should be responcible enough to know what is healthy and not, and oveusly not all women either know or care. If they feel a little guilty for smoking during pregnancy so what. Yes it is their choice, but feeling a bit of guilt at least means they've thought about the possible conciquences, and later they can't be surprised if little Jonny sufficated in his crib, or ends up with such bad assma that every attack sends him to the ER.
Yes it's the parent's choice, but if they're a parent I'd hope they make a smart and informed choice.
Damia I'm glad you live somewhere you get a waiver if you opt to skip testing. I had a gyn I liked from NY, and I told her of my unpleasant experience with ob care here in MA, and she told me, having done her schooling & residence in Buffalo, that NY obs aren't required to give as much info as they are in MA. I don't know where this idea that being over 35 raises the risk of Downs from 0 to almost certainly, but the tables I've seen show risk increases for every year a potential mother gets older. One lady in a PARENTS magazine opted out of Downs testing at 30, and had a Downs child, yet her 2nd child 3 years later didn't have that problem.
I opted out at 37, but obs are much more forceful up here to the point they are thoroughly unpleasant to deal with, which is part of why I don't want another child. I have worked in the medical field since the Clinton administration, I should know the blood test they are very forceful about is not that reliable, especially if certain patient data is entered incorrectly. One tried to give me a brochure to line a 2nd trash can. I'm not quite sure what part of "No" they don't understand. Mimi is not a Downs syndrome child.
Age can't be changed, or chromosomes, but behavior can. I did see some years ago, don't remember the source, that there is a link between smoking parents and crib death.
My first job out of college was with a counselling center for battered women. The womens' counselor was married, with a family, yet hung up a sign that said, "A woman needs a man like a fish needs a bicycle." Huh?! This inconsiderate woman had an asthmatic daughter, yet even smoked cigarrettes in the family car. As someone who has asthma I can tell you it is no picnic having an attack. Best case scenario you feel as if your lungs are an elevator that needs to ascend 5 floors, yet can only go 3, so you have to either work very hard or go on the nebulizer to get the other 2, and that's best case. Worst case scenario is panic. I feel for these children whose parents think only of themselves, and who hasn't known the dangers of smoking since the '60's? Good luck with your pregnancy and your child.