Sunday 22 September 2019

'I’m getting a bit narky, but this gets up my nose' - Dr Ciara Kelly sparks debate on issue of breathalysing pregnant women for smoking

Geraldine Gittens

Geraldine Gittens

Dr Ciara Kelly sparked a debate yesterday when she admitted to getting "narky" over a recommendation by Irish doctors that pregnant women be breathalysed to check whether they are smoking.

According to a study published this month from the Coombe hospital and University College Dublin, women who hide their smoking habit miss out on vital monitoring of their pregnancy and end up having more problems as a result.

Researchers questioned 234 women presenting for antenatal care, 15pc of whom admitted they were smokers.

However, when they were given a breath carbon monoxide (BCO) test another 10pc, many well-educated, came clean on their persistent smoking, the 'European Journal of Obstetrics and Gynaecology and Reproductive Biology' reported.

The study's authors said this strengthened the case for breath carbon monoxide screening at the first antenatal visit.

Professor Michael Turner of the UCD Centre for Human Reproduction, who led the study, said that smokers were more likely than non-smokers to have a growth-restricted or malnourished baby - which increases the risk of an adverse pregnancy outcome such as stillbirth.

Read More: Educated pregnant 'secret smokers' put babies at risk

But yesterday on her Newstalk show Lunchtime Live, Dr Kelly said that while smoking in pregnancy is “really bad”, women don’t need “sneaky tests to find out if they’re lying”.

“To be very clear, smoking is really bad in pregnancy. Please don’t smoke in your pregnancies. Please, please don’t, but here’s the thing, we need to start talking to women rather than mistrusting them and doing kind of sneaky tests to find out if they’re lying. This constant mantra of the lying pregnant woman is infuriating.”

“All of us should stop smoking," she said. "Everyone should stop smoking. I think smoking is a scourge... but I think all you need to do is this: talk to the women – they say that these are middle class women who are hiding it because the stigma is big – say to them, look lads if you don’t disclose it, we monitor you differently and you have a worse outcome, so tell us if you smoke and we won’t judge you, we’ll support you, we’ll try and help you and we’ll monitor you the way you need to be monitored as a smoker.”

She added: “Say that to women, and see if that makes them disclose, and I suspect that nine out of ten cases, it will. And that’s all you need to do – a little bit of respect, a little bit of autonomy, a little bit of dignity given back to patients is far more in our line that immediately jumping to this paternalistic thing again I think.”

The authors of the report from the Coombe and UCD recommended that a high reading of BCO should result in referral of the woman to smoking cessation services and close monitoring of the baby.

But Dr Kelly told listeners yesterday that “mistrust and insult” seem to be the first port of call in Irish society.

“I’m sorry I know I’m getting a bit narky, but this gets up my nose, as perhaps is apparent,” she said.

“Women who are mothers are more devoted to their babies than [speaks to listeners who texted in saying they were in favour of the breathalysing] you will ever be you, you, busy bodies trying to police them. Women care about their children, stop treating them with this level of mistrust and insult that seems to be our first port of call in Irish society, to this day, and I’m very unhappy about it.”

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