Author:

Keywords:

Smoking, pregnancy, qualitative, midwives

Abstract:

Knowledge, attitudes and practice of Flemish gynecologists and midwives on smoking and smoking cessation during pregnancy. Background Smoking during pregnancy is associated with health risks for mother and child, such as stillbirth, low birth weight, intrauterine growth restriction (IUGR), preterm delivery, placenta pathology and sudden infant death syndrome (SIDS). In 2011, smoking prevalence during pregnancy in Flanders as 12.3%. The preconceptional and prenatal period are best suited to provide counseling and to encourage smoking cessation. Gynecologists and midwives should be well placed to provide counseling on smoking cessation. Aim To examine the knowledge, attitudes and practice of gynecologists and midwives regarding smoking and smoking cessation during pregnancy. Method A qualitative research design using semi-structured interviews with 8 gynecologists and 9 midwives. Key findings Knowledge: While both gynecologists and midwives recognize low birth weight, IUGR and SIDS as important neonatal issues due to smoking; gynecologists stressed women’s health problems more than midwives. Knowledge regarding the use of nicotine replacement therapy during pregnancy was lacking. Attitudes: Smoking during pregnancy is perceived as problematic. Respondents tend to have a stereotype view on ‘the smoking pregnant woman’, namely a low educated younger single mother. Practice: Most midwives and gynecologists provide smoking cessation advice without assessing the women’s readiness to quit, which may cause resistance in smoking clients. Lack of time, lack of communication techniques and disillusionment, because very few clients actually quit smoking, are barriers to engage in giving advice. Implication for practice We recommend to use the A-A-R – method: - Ask permission to talk about smoking behavior - Assess the readiness to quit - Refer to specialists in smoking cessation techniques and counseling. Distinction between obstetric care and smoking cessation counseling may increase the efficiency of cessation due to the specific expertise involved in both areas.