Midwife Attitudes and Advice to Pregnant Smokers

Abstract

Midwives (N = 138, response rate = 51%) from two regions (SW England and London/SE England) responded to a questionnaire designed to assess (a) their attitudes to giving anti-smoking advice to pregnant smokers, and whether they perceived this as part of their professional role; and (b) the types of advice they gave to pregnant smokers as part of their routine practice. Midwives' own smoking status was also recorded. Attitudes towards giving anti-smoking advice were generally positive, and almost all reported routinely explaining the health dangers of smoking to pregnant smokers. Midwives who had never smoked (63%) reported attitudes and behaviour which did not differ significantly on average from those of the remainder of the sample. Overall, those who gave more anti-smoking advice also perceived this to be a more important part of their professional role. The form of this relationship depended somewhat on midwives' own smoking status. Among midwives who had never smoked, those who held role attitudes that were more favourable towards anti-smoking intervention reported providing relatively more advice based on warnings of health consequences and an emphasis on abstinence. Among the remainder of the sample, more favourable attitudes predicted greater use of behaviourally-oriented advice to facilitate cessation or smoking reduction, but were unrelated to the use of health warnings and emphasis on abstinence. These findings underline the need for professional training of midwives in the use of strategies for behavioural change.