The UK's health watchdog believes that all pregnant women should be given breath tests to see whether or not they smoke.
Every expectant mother should be encouraged to take a carbon monoxide test so that those who smoke can be given appropriate advice for quitting, according to the National Institute for Health and Clinical Excellence (NICE).
However, midwives are critical of the plan, claiming that medical practitioners should encourage women to quit smoking rather than making them feel guilty.
The watchdog said the new guidelines are aimed at helping women and their families give up smoking during and after pregnancy rather than penalising smokers.
Nice director of the centre of public health excellence Professor Mike Kelly said: "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."
However, Royal College of Midwives (RCM) education and research manager Sue Macdonald warned that the breath test may make women feel "guilty".
Ms Macdonald said: "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."
Copyright © Press Association 2010
Your comments (terms and conditions apply):
"I believe that as health professionals we have a responsibility to convey to our pregnant clients and their families that smoking does have some very serious and damaging effects on them and the unborn baby. It should not be an option to speak about this, rather our duty. The help available through the NHS is good and does help people quit. The message is that it is possible to stop smoking and using the CO monitor can assist this process. Midwives take routine blood samples from pregnant women for a myriad of conditions, this is another similar test and should be seen as such. Perhaps we should be thinking what message we are conveying to these women if we are tentative about speaking of the risks of smoking in pregnancy" - Esther New, NHS Wiltshire
"I agree with Sue Macdonald that women should not be forced to do the test or be made to feel guilty but perhaps it could be offered to mothers if they WANT to know their carbon monoxide levels, as a form of brief intervention. If they do choose to take the test they are probably more motivated to quit. In this case smoking cessation advice and support could then be offered as follow-up. I think that rather than forcing women to quit we need to look at the other issues in their lives that make them choose to smoke (some women think they will have smaller babies if they smoke, but may not realise the harm they are causing to the foetus) and partner smoking behaviour is an influencing factor too. Would NICE make it compulsory for fathers as well? A national health promotion campaign linking in with National Smoking Week offering pregnant women the test and explaining the damage smoking can cause to a foetus might be better as well as education in schools" - Samantha Lewis, Manchester
"As a smoking cessation counsellor as well as a practice nurse, I think this is a brilliant idea - the reason being a reading above 1 shows visibly that there is carbon monoxide in the blood. People often need 'proof' before they do something positive. It won't make any difference to most of the mums, especially in the low income bracket but for some, it will be well worth it. When I show the model of inflamed airways to asthma patients they can 'see' what I am talking about. I am always simple and down-to-earth with my patient and this idea is very quick, easy and visual" - Pauline Filby, Chlemsford
"I don't feel pregnant women should be forced to take the test. However, I do think smoking during pregnancy is a form of abuse to the unborn child and should been seen as abuse. Encouraging pregnant women who smoke to see what their carbon monoxide level is may give them food for thought. It
should not be seen as a test to make them feel guilty but open their eyes to what they are doing to their unborn child. CO2 is a poisonous gas and I don't think smokers are always aware of that!" - Anne St Pier, Essex
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