Contemporary Midwifery Perspective on Smoking During Pregnancy

Running head: LETTER
Letter to the Editor
Name of the Student
Name of the University
Author Note

LETTER1
Dated: 30 April, 2019.
The Editor,
XXXXX,
XXXXXXXXXX.
Subject: Contemporary midwifery perspective on smoking during pregnancy.
Sir/Madam,
Smoking tobacco at the time of pregnancy has been identified to create significant
negative impacts on the reproduction and health of the women, in addition to the general
effects that are exerted by tobacco. Ideally, women are not advised to smoke at, during, or
after their gestation period. In addition, active smokers are also encouraged to reduce their
daily cigarette consumption, with the aim of minimising the risks that are caused to the
children and their mothers. This letter is being written to you in order to draw attention to the
impacts of smoking during pregnancy. In addition, the letter will also elaborate on the
principles of midwifery practice, followed by elaboration on one standard of practice, in
relation to a case scenario.
There is mounting evidence for the fact that the profession of midwifery has the
principle objective of being ‘with women’, and also places an explicit focus on maximising
the outcomes related to reproductive health of the patients. Time and again it has been found
that oppression and gender inequality are persistent features of human societies and cultures,
and exist all across the world. In addition, these aspects also get reflected in the reproductive
health amid women, with unsatisfactorily increased rates of maternal mortality in low- and
middle-income countries (Pairman & McAra-Couper, 2015). This is in clear contrast to the
high rates of interventions in high-income countries. The midwifery profession deals with
childbirth, pregnancy, and post-partum period, together with caring for the new born infants.
In other words, there lies a clear difference between the medical profession of midwifery and
allied medical specialities. It has been established that most females should be provided the
provision of accessing midwifery-led models of care (ICM, 2014). In addition, women must
also be encouraged in order to seek help from the care models, while placing due caution on
application of the advice, in relation to considerable obstetric or medical complications
(Moloney & Gair, 2015). The basic principle of midwifery is based on the fact that the
process of childbearing is a profound experience and it carries noteworthy meaning to the

LETTER2
pregnant women, the community, and their family members. Furthermore, according to
Yanti, Claramita, Emilia and Hakimi (2015) the philosophy also considers birth as a normal
physiological procedure and regards midwives as most suitable and competent care providers
who have necessary skills and expertise of attending and proving care to women who are at
low risk, during their pregnancy, labour period, delivery, and postnatal period. It is a well-
known fact that midwifery profession has the capability of empowering women in order to
undertake responsibility for own health, and that of their family members. The profession
most often involves fostering partnership with females and encompasses a continuous,
personalized, and non-authoritarian care approach (Tierney, Sweet, Houston & Ebert, 2017).
It has often been found that healthcare professionals who implement an authoritarian care
regimen, increase fear among the patients, and subsequently result in non-compliance to the
proposed treatment plan. In contrast, the midwifery profession comprises of delivery of care
in a manner that is holistic in nature, and is based on an understanding of the physical,
emotional, psychological, spiritual, social, and cultural experiences of females. The
philosophy of midwifery is also based upon utilisation of best available evidences. The
profession of midwifery is in practice for several centuries, and has characteristics and
features that have progressed contrarily, according to regional, cultural, social, and local
knowledge and traditions (ICM, 2014). In addition, it has also been found that continuity care
models that are led by midwives, are often associated with decrease in the usage of epidural
anaesthesia, lesser number of episiotomies, reduction in instrumental births, and an increase
in breastfeeding and the rates of spontaneous vaginal births (Sandall, Soltani, Gates, Shennan
& Devane, 2016). Females also display a reduced likelihood of experiencing preterm birth on
being subjected to appropriate midwifery care practices.
The Nursing and Midwifery Board of Australia (NMBA) has accurately defined
midwives as competent, educated, and authorised individuals for providing effective and safe
delivery of quality care services that directly promotes the health and wellbeing during birth,
pregnancy, postnatal time, and parenting transition. The board has formulated seven
standards of practice that are namely, (i) promotes wellbeing and health through
implementation of evidence-based midwifery practice, (ii) fostering engagement in
professional relations and respectful partnerships, (iii) demonstrating the competence and
answerability for midwifery practice, (iv) undertaking thorough and comprehensive health
assessments, (v) formulating plans for midwifery practice, (vi) delivering quality and safety
in midwifery practice, and (vii) evaluating the outcomes for improving midwifery practice