smokingThe Royal College of Midwives has given its backing to NICE proposals on smoking cessation and supporting pregnant women to stop smoking, saying carbon monoxide tests at antenatal appointments could be "extremely helpful".

An estimated one in five women smoke while expecting and, in often to reduce resulting low birthweights, NICE has suggested that women should be tested for carbon monoxide found in cigarettes during antenatal appointments and given help to quit if levels are too high.

Vital role in promoting public health
Commenting on the proposals, RCM chief executive Cathy Warwick said: "Midwives have a vital role to play in promoting public health, and reducing smoking in pregnancy is extremely important.

"Of course, not all women will want to take this test. 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. The real solution here in cutting the prevalence of smoking in pregnancy is more midwives and more continuity of care from the same midwife.

"NICE is a listening organisation. They have asked for our views, and we have given them. 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."

Substantial health risks
In its draft guidance for helping people to stop smoking, NICE called for all pregnant women to be tested and referred to 'smoking cessation services' if needed.

Estimates suggest that 21 per cent of women smoke while pregnant and the NICE guidance said "the health risks for babies of mothers who smoke are substantial."

"Smoking can cause complications in pregnancy and labour, including ectopic pregnancy, bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes," said the Nice draft guidance."