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Smoking cessation care during pregnancy: A qualitative exploration of midwives’ challenging role

  • Author Footnotes
    1 Twitter handles of author: @AnnaKalamkarian.
    Anna Kalamkarian
    Footnotes
    1 Twitter handles of author: @AnnaKalamkarian.
    Affiliations
    School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia
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  • Elizabeth Hoon
    Affiliations
    School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia

    Discipline of General Practice, University of Adelaide, Adelaide, South Australia 5005, Australia
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  • Author Footnotes
    2 Twitter handles of author: @chittles74.
    Catherine R. Chittleborough
    Footnotes
    2 Twitter handles of author: @chittles74.
    Affiliations
    School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia

    Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia
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  • Gustaaf Dekker
    Affiliations
    Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia

    Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, Adelaide, South Australia 5005, Australia

    Adelaide Medical School, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
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  • John W. Lynch
    Affiliations
    School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia

    Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia

    Population Health Sciences, University of Bristol, Bristol, UK
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  • Author Footnotes
    3 Twitter handles of author: @Lisa_Smithers.
    Lisa G. Smithers
    Correspondence
    Corresponding author at: School of Health and Society, University of Wollongong, Wollongong, NSW 2500, Australia.
    Footnotes
    3 Twitter handles of author: @Lisa_Smithers.
    Affiliations
    School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia

    Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia

    School of Health and Society, University of Wollongong, Wollongong, NSW 2500, Australia
    Search for articles by this author
  • Author Footnotes
    1 Twitter handles of author: @AnnaKalamkarian.
    2 Twitter handles of author: @chittles74.
    3 Twitter handles of author: @Lisa_Smithers.

      Abstract

      Problem

      The majority of South Australian pregnant women who smoke do not quit during pregnancy. Additionally, the prevalence of smoking is higher among pregnant women living in socially disadvantaged areas.

      Background

      Understanding challenges in midwives’ provision of smoking cessation care can elucidate opportunities to facilitate women’s smoking cessation.

      Aim

      We aimed to understand midwives’ perspectives on current practices, perceived barriers and facilitators to delivery of smoking cessation care, and potential improvements to models of smoking cessation care.

      Methods

      An exploratory qualitative research methodology and thematic analysis was used to understand the perspectives of midwives in five focus groups.

      Findings

      Four themes were generated from the data on how midwives perceived their ability to provide smoking cessation care: Tensions between providing smoking cessation care and maternal care; Organisational barriers in the delivery of smoking cessation care; Scepticism and doubt in the provision of smoking cessation care; and Opportunities to enable midwives’ ability to provide smoking cessation care.

      Discussion

      A combination of interpersonal, organisational and individual barriers impeded on midwives’ capacities to approach, follow-up and prioritise smoking cessation care. Working with women living with disadvantage and high rates of smoking, the midwife’s role was challenging as it balanced delivering smoking cessation care without jeopardising antenatal care.

      Conclusion

      Providing midwives with resources and skills may alleviate the sense of futility that surrounds smoking cessation care. Provision of routine training and education could also improve understandings of the current practice guidelines.

      Keywords

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