Talking about smoking cessation with pregnant women: Exploring midwives' accounts
The aim of the current study was to use interviews to explore midwives' experiences of talking to pregnant women about smoking cessation. Eight midwives based in one UK hospital took part in face-to-face semi-structured interviews. Thematic analysis revealed that midwives were aware of health risks associated with smoking, saw providing smoking cessation advice as part of their role, would value more support from GPs, and were clear that support and a woman-centred approach were key. Failure to refer women for support was related to cumbersome or misunderstood referral procedures rather than reluctance to refer.
It is estimated that 11% of women in the UK smoke during pregnancy (Office for National Statistics, 2014). Smoking is recognised as a significant predictor for adverse outcomes in pregnancy, increased risk of intrauterine growth restriction and premature birth (Royal College of Physicians, 2010; Centers for Disease Control and Prevention, 2014).
In the UK, National Institute for Health and Care Excellence (NICE) guidelines recommend that all pregnant women are advised to stop smoking and referred for stop-smoking support (NICE, 2008; 2010; 2013). However, midwives vary in their level of adherence to clinical guidelines for helping pregnant smokers to quit (Abatemarco et al, 2007) and may be unwilling to address smoking cessation with women in antenatal visits, possibly believing that their relationship with a woman could suffer if they did so (Randall, 2009).
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