Is it normal for a midwife to reject a patient because of smoking?

Question

My midwife's back-up midwife found out that I'm a smoker (occasionally, don't lecture me) & she is unwilling to work with me. Even my midwife is a bit skeptical about working with me now. I don't see what the big deal is?? Please don't be rude or mean.

I should also mention that I did NOT hide the fact that I was a smoker from her, she just didn't realize or ask.

Answer 1

I have a midwife for my pregnancy. The reason she won't accept you as a patient is not because they're prejudiced or because they're afraid of the risks. Midwives are NOT doctors. Midwives are not able to care for any pregnant woman that could have or has complications with her pregnancy. I.E. if the mother needs a C-section, the doctor has to do it. If the baby is preemie, a doctor takes care of this also. Because of your smoking, your pregnancy is considered high-risk, so they should refer you to a doctor to handle the situation. Because midwives don't have the same qualifications as a doctor, they ONLY handle pregnancies that are normal, with no complications. If a complication comes up, like the placenta blocking the birth canal, or a number of other things, they should refer you to an OB/GYN.

Because you smoke, that's considered a complication, and in that instance, you need an OB/GYN anyway.

(Ignore the people lecturing you - they don't understand how difficult it is to quit.)

Answer 2

Okay, you are taking a bigger risk by being a smoker and it also has an effect on your child. Midwives can reject a woman as a patient - just like a doctor - if you don't want to follow their orders or their recommendations - they can refuse to treat you. If you have some major complications brought about your smoking, your baby is born with trouble breathing, they could risk having their insurance revoked. So do not be surprised if your primary midwife soon refuses to care for you any longer and refers you to a doctor where you will have to have your baby in a hospital setting, which may end up being all for the best, especially for the baby.

Answer 3

Your midwife doesn't want to work with you because God forbid your baby is born with complications due to your being a smoker, she may not be equipped or trained to deal with it. Midwives prefer to work with low risk, uncomplicated pregnancies/deliveries. She would probably rather not take the fall if something terrible happens to your baby during delivery because you have been smoking while pregnant.

Answer 4

There are many risk associated with babies of smoking mothers. Low birth weight, and under developed lungs are most common. I know a girl who smoked during both of her pregnancies. One baby was born blue, and had to be resuscitated and was in the neonatal ICU for 2 weeks. Both of her sons are also Autistic. Whether smoking had anything to do with their Autism, is unclear but it could be a risk factor. A midwife might not have the abilities to handle high risk pregnancies.

Answer 5

Smoking isn't all that healthy, which of course you know. I don't know if you were looking for a hospital birth, a birth center birth or a homebirth. If you were hoping to birth outside of the hospital, maybe the added health risks of being a smoker make your midwives uncomfortable with working with you?

Smoking cigarettes appears to double a woman’s risk of developing placental problems. These include placenta previa (low-lying placenta that covers part or all of the opening of the uterus) and placental abruption (in which the placenta peels away, partially or almost completely, from the uterine wall before delivery). Both can result in heavy bleeding during delivery that can endanger mother and baby, although a cesarean delivery can prevent most deaths. Placental problems contribute to the slightly increased risk of stillbirth that is associated with smoking.

Smoking in pregnancy also appears to increase a woman’s risk of premature rupture of the membranes (PROM) (when the sac inside the uterus that holds the baby breaks before labor begins). A woman with PROM may experience a trickle or gush of fluid from her vagina when her water breaks. Usually, she will go into labor within a few hours. When PROM occurs before 37 weeks of pregnancy it is called preterm PROM, and it often results in the birth of a premature baby.

Maybe these potential risks make the midwives uncomfortable? This is a highly litigous (sp?) society. Midwives have to be careful so they can keep their insurance. Taking a mom who is CHOOSING to accept potential risks to herself and her child in order to keep smoking may not seem like a safe risk to the midwives.

Have you had any other conditions that have pointed towards you potentially having a complicated pregnancy?

Answer 6

I'm not lecturing, but I would suspect the reason she rejected you is because of potential liability.

If you have smoked during pregnancy then the risks of birth defects or delivery problems will be greater. The midwife might fear that if something did go wrong you would blame her for the problems.

Answer 7

I don't know if it is normal or not, but I'm telling you right now, I smoked when I was pregnant. Like 10 ciggarettes a day, which was a cut back for me and I have a beautiful baby boy now. He's a year old. Nothing was wrong with him when he was born. He weighed 8lbs 12oz. My O.B. lectured me about this only one time and after that when I told her I was still smoking she told me that that was my decision knowing what the risks were and it ended there. She never again lectured me about it. Techniqly they are required to caution you to quit smoking once and after that, they can't say anything. I'd say find someone else.

Answer 8

Okay, well seeing as we know smoking is bad for a developing baby, they may see it as your a disregard for you childs health. I am not lecturing you by the way. cause what good would that do. I am just a concerned reader. I myself am not fond of cigarette smoke. and i grew up around it. i can smell it from amazing distances. as well as i am not comfortable around drinkers or drunks. so i will disassociate myself from these people. this may be the kind of action your midwife is taking. she feels this is against what she believes in and is so disassociating herself from the situation. And i know you know, but i have to say it, even occasionaly smoking is bad for a baby. so please be careful and try to stop, for you baby's sake and yours, so you can be around to raise your child. good luck to you. maybe you can talk it out with your midwife.

Answer 9

Please stop. There is no such thing as an "occasional smoker" you either are an addict or aren't. Obviously you are a smoker that can't stop or (for some crazy terrible reason) won't stop for the health of your fetus and yourself.

I have been giving out this site hand over fist. Seriously, it saved my life and I have stayed quit since my first pregnancy because of it. Please try to quit for yourself... read some articles on this site.

As far as your midwife not wanting to take you as a patient, my midwife won't take women who have had abortions. It is preference, and risk factors.

Good luck.

www.whyquit.com
http://whyquit.com/whyquit/LinksBirth.html

Answer 10

There are more risk with women that smoke for something to go wrong during pregnancy. Midwives usually are not trained to deal with those situations so most midwives wont work with a high risk pregnancy.