The objectives of our study were 1) to explore knowledge, beliefs and practice among midwives and gynaecologists concerning a smoking cessation policy for pregnant women and their partners and 2) to examine if midwives and gynaecologists do have a role in smoking cessation in pregnant women.
We performed a qualitative study using semi-structured interviews with nine midwives and eight gynaecologists. Data were analysed using deductive content analysis, based on the 5 A's framework (Ask – Advise – Assess – Assist – Arrange).
The national smoking cessation policy seemed to be insufficiently known. ‘Ask’ and ‘Advise’ were part of a standard prenatal consultation, the next three steps were rarely implemented. Participants had a negative image of ‘the smoking pregnant woman’: a low educated woman with a smoking partner and ‘bad examples’ in their history. Reported barriers were fear of provoking resistance and lack of time and communication skills regarding smoking cessation.
These findings suggest that training in communication skills and dealing with resistance should be offered, i.e. by using motivational interviewing. It could be considered that a trained midwife or tobaccologist is part of an obstetrical team or that the AAR-method (Ask – Advise – Refer) is used instead of the 5 A's framework.