Reducing Pregnant Women to Fibbing Children; Why The Smoking Tests at Antenatal Appointments are a Really Bad Idea

It’s been a while now since I had a baby. My youngest is now 13 months old, but I remember all the antenatal appointments during the times that I was pregnant. I had 3 booking in appointments in my time due to the fact that I miscarried at between children. All three appointments were brilliant: relaxed, informative, friendly. I really felt like I connected with my midwife even though it was a different one each time. Trust was established. I felt that I could call any of these women whenever I felt like I needed some support or had any queries. I left the appointments buoyed up with glee and only some of that was pregnancy bloating.

Were I to get pregnant this year and go to a booking in appointment, I have learned, I would be expected to perform a breath test designed to monitor carbon monoxide levels. I would refuse and I’m not the only one.

I am not a smoker, never have been and never intend to be. I was asked at each appointment whether I smoked and explained, as I just have, that I don’t. Tick. Done. Apparently it turns out that pregnant women can’t be trusted. The purported aim of this test is to offer advice and help for the expectant mother to quit smoking, but if the woman wants to quit smoking she will ask for these things. In truth this is designed to root out the liars and badger them until they quit. This quote from NICE explains their reasoning:

“Some pregnant women find it difficult to say that they smoke because the pressure not to smoke during pregnancy is so intense,” 

What’s that now? Some pregnant women find it hard to admit that they smoke because of societal pressures against smoking while pregnant? Well then I’m sure an ordered breath test will make them feel nice and relaxed and ready to talk about quitting.

Look, its not good to smoke during pregnancy. There are a multitude of reasons why smoking is bad for you regardless, and during pregnancy its especially not good for the foetus. If you are pregnant not only is it better if you quit, but surrounding folks ought to as well. I’m looking at you, fathers-to-be. But ultimately it comes down to your body, your choice. If you are a pregnant woman your rights as a human come first. I respect your choice because I’m a decent human being.

The point of the booking in appointment is to fill out the start of the blue folder (in my Trust the folder is blue) and to get onto the system as a being with child. The appointment usually lasts an hour and you can ask questions, find out valuable information and get to know the department who you will know over the next months. I’ve said it before: its about trust. You can’t have trust if you listen to a woman tell you that no she doesn’t smoke and then you insist upon a breath test to make sure she’s not lying. You just can’t. And that’s a bad thing. For women like me, the baby in your uterus will be much wanted. You’ll be happy and excited and want to feel validated for that feeling. Millions of women get pregnant every day, but (especially for your first) you want to feel the most special. You also want to establish that trust thing I keep harping on about.

For women like me in my 3rd pregnancy you have one child, have miscarried once and you’re pregnant again. You are scared. Due to the midwife being sick you are having your booking in appointment at 11 weeks instead of 8. You’ve already had some spotting in this pregnancy and spent some time in A&E thanks to that. You’re scared. Your much wanted second child might not ever become a child. You want to get the booking done so that you can go to the scan booked that afternoon, where it turns out the foetus did not make it past 8 weeks. Once again you answer no to the smoking question. Just imagine if at that moment your midwife insists on a breath test. You’re fragile and vulnerable and suddenly the person claiming to be there for you is treating you like a sneaky liar. Fuck that shit.

For some women, if we want to look at the possible worst case scenario, they are not there because they are having a much wanted baby with a man they love. Let’s imagine the case for hundreds of women in the country. She is pregnant by a man who scares her. She is isolated from her family and her friends have been steadily eroded from her life. She literally feels trapped and being permitted to go to a booking in appointment is about it in terms of freedom. The midwife is a friendly face who is there for advice and support in pregnancy, but she brings up domestic abuse, too. The pregnant woman suddenly has a little spark of hope. Maybe she doesn’t bring it up then, but as the relationship between mother-to-be and midwife grows so does the trust and one day she speaks out. Except that when the pregnant woman says she doesn’t smoke, the midwife brandishes a Breathalyzer  The mother-to-be is snubbed; she is not believed when she says she’s a non-smoker so why the hell would she be believed if she said “my husband hurts me”? Trust is broken right at the start and it’s impossible to build up again.

I can’t see a way in which this test is OK.  Perhaps the end result might be that the mother-to-be quits smoking, but if she truly wanted to quit she would bring it up at the relevent time, right? And if the mother-to-be quits but the father-to-be or anyone else living at the family home does not, then was it worth it? Second hand smoke in a persons home is almost as bad at direct smoke. But wait a second…no-one is suggesting breath testing the father, are they? Nope, this is just for the mother-to-be. I wonder why that could be…perhaps it has something to do with the fact that women are often considered to be nothing other than incubators once they become pregnant (warning on this link due to the possibility of graphic images, although that page is pretty safe).

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Only if you in turn trust us

 

(I must just point out that this has come from NICE guidelines, rather than directly from midwives, who I think do a terrific job under difficult circumstances and I’ve never met a bad one! I’m concerned, however, that their job will be compromised by this legislation, as well as the effect it will have on mothers-to-be.)

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