Midwives' perceptions of providing stop-smoking advice and pregnant smokers' perceptions of stop-smoking services within the same deprived area of London.

INTRODUCTION: To identify and juxtapose midwives' perceptions of providing stop-smoking advice and pregnant smokers' perceptions of stop-smoking services.

METHODS: A qualitative design was used in an attempt to expose and compare in-depth perceptions of midwives and pregnant smokers. Three focus groups lasting approximately 1 hour and involving 15 midwives were carried out, and 10 pregnant smokers participated in semistructured interviews. The qualitative data were analyzed by using the full version of grounded theory.

RESULTS: The perceptions of midwives regarding provision of advice were related to outcome of advice, the relationship with patients, personal experiences, attributes, perception of role, the impact of external factors, and aspects related to pregnant smokers and pregnancy. Pregnant smokers' perceived barriers and facilitators to approaching stop-smoking services were categorized into areas of smoking behavior, advice from health professionals, stop-smoking services, and negative perceptions of pregnant women who smoke.

DISCUSSION: In theory, many of the perceived barriers to providing advice could be overcome by implementing effective mandatory training for midwives. However, real issues, such as lack of time, have a major impact on the provision of advice. Pregnant smokers expect and appreciate receiving stop-smoking advice from midwives. Yet, they tend to have negative expectations of stop-smoking services, although the experiences of those who have attended these services are positive. Raising awareness of stop-smoking support for pregnant women is crucial in empowering women to make informed choices about their health and the health of their children.