Midwives’ interactions with women who smoke in pregnancy

Smoking is associated with ill health for a woman and her baby during pregnancy and throughout the remainder of the lives of both parties (McDermott, et al, 2002; Lux et al, 2000; Sondergaard et al, 2001). Continued smoking during pregnancy is compellingly linked with a woman’s socioeconomic status and level of education (Colman and Joyce, 2003; Lindqvist and Ãberg, 2001; Lu et al, 2001; Paterson et al, 2003). Employment status, relationships and socialization with other smokers and perceived lack of social support impact on smoking rates and efforts to quit during pregnancy (Lindqvist and Ãberg, 2001; Paterson et al, 2003; Siahpush et al, 2003; Siahpush, 2004). The focus of research around women who continue to smoke in pregnancy has mainly centred on health professional interventions designed to cause the woman to stop, usually by pointing out the negative impact of smoking on the developing fetus (Haug et al, 2000; Lumley et al, 2004; Secker-Walker and Vacek, 2003). Few smoking cessation programmes address the unique dynamics of cessation and relapse in the diverse sub-population of pregnant smokers (Devries and Greaves, 2004). This study examines the relationships between women and midwives so that the tensions between the midwives’ efforts to improve the women’s health through smoking cessation and the need to maintain a relationship throughout the childbearing experience can be considered.