Maori women are not getting the support they need to stop smoking while pregnant, the author of an international study says.
New research has found Maori women are at a social disadvantage when it comes to education, healthcare and employment – driving high rates of smoking and undermining attempts to quit.
It found a third of Maori women report smoking when they first see their lead maternity carer, compared to 14 per cent of Pakeha women.
Massey University’s School of Public Health associate professor Marewa Glover is a co-author of the study Smoking In Pregnancy Among Indigenous Women in High-income Countries.
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She said smoking in pregnancy was the highest preventable risk factor for pregnant Maori women. Risks include increased risks of miscarriage, stillbirth, sudden infant death syndrome, respiratory illnesses, glue ear, and other ongoing health issues.
“When women are pregnant people just expect them to give up a whole lot of behaviours – drinking, smoking – yet where is the support for them to do that? Many women don’t seek help because they don’t want to be judged, and research shows that stigmatisation stops women from getting medical care,” Glover said.
“If women are smoking on the street, people will come up and abuse them. They don’t understand the context of women’s lives and what is driving them to smoke. A whole lot of women can’t just stop, and we can’t just keep slamming them.”
Barriers to giving up included the stress of daily life, poverty, unemployment, and the normalisation of smoking in social circles.
Glover has been studying Maori smoking in pregnancy since the early 2000s, but said seeking funding has been difficult. “Funders seem to think it just effects a few people, so it’s not important. I do not think that Maori pregnant women, and stopping smoking, is seen as a priority issue.
“This is extremely important, helping women through their pregnancies and babies to get the best start in life. It’s a historical issue arising from the colonisation process, and not enough has been done to address that disparity.”
Research needed to be done as to why it was so difficult for social services to reach pregnant women in the community, whether other Maori-led programmes could help and if electronic cigarettes could be an option. A small study where pregnant women had home visits from support people found 33 per cent had given up and half had cut down smoking before birth.
The research, published in journal Nicotine & Tobacco Research, involved researchers from Canada, the United States, Australia and New Zealand.
Rates were worst in Canada, where 83 per cent of Inuit women smoked through pregnancy, compared to 18 per cent of non-indigenous Canadians. In Australia, around half of pregnant Aboriginal women smoke, compared to 13 per cent of that country’s general population.