Smoking while Pregnant

Smoking tobacco is harmful for everyone – be it a man or a woman, old or young, the thousands of chemicals in tobacco leads to various health problems. But, smoking during pregnancy is even more harmful as it affects both the mother and the unborn child, increasing the risks of various irreversible complications and birth defects. Smoking tobacco in any form, cigarettes, cigars and even hookah, is equally bad for pregnant women.

How does smoking affect the baby during pregnancy?

During pregnancy, the developing fetus gets all the oxygen and nutrients it needs from the mother through the umbilical cord ^[1]. There are over 4,000 harmful chemicals in cigarettes, including extremely dangerous substances like lead, cyanide ^[2] and around 60 carcinogenic compounds. As you smoke, these toxic compounds enter your bloodstream, contaminating the only source of nutrients and oxygen for the fetus.

Among all the threatening substances, carbon monoxide and nicotine are the most harmful, accounting for most of the smoking related complications in pregnancy ^[3]. Nicotine narrows the blood vessels in your body, including those in the umbilical cord. This reduces the oxygen supply to the baby, requiring the under-developed heart to beat harder, the more the mother smokes ^[4]. Additionally, the red blood cells (RBCs) carrying oxygen begin picking up carbon monoxide molecules instead, lowering the oxygen supply even further ^[3]. The limited oxygen and nutrient supply hinder the development of various organs and body parts of your baby, leading to growth restriction and various birth defects.

Smoking should also be avoided by breastfeeding women to protect their babies from the same harmful substances ^[5].

What are the risks of smoking during the first trimester?

Smoking during any stage in pregnancy is harmful for the baby, but the dangers are somewhat higher during the first weeks of fetal development ^[6]. The embryo (your baby) undergoes the most crucial development during the initial months as the principal systems and organs (e.g. the neural tube, circulatory system, heart and digestive system) begin developing at this stage. So, a shortage of oxygen and nutrients at this stage may hamper the basic fetal development, leading to serious organ defects and developmental problems.

What are the potential side effects of smoking cigarettes while pregnant?

According to Robert Welch, the chairman of the Department of Obstetrics and Gynecology at Providence Hospital in Southfield, Michigan, smoking while pregnant is one of the principal causes leading to adverse outcomes in babies ^[3]. Studies show around 5% of the total infant deaths to occur due to smoking during pregnancy ^[7].

Dangers to the fetus

Decreased fetal movement (for around an hour after each cigarette) ^[8]
Impaired functioning and development of the placenta
Stillbirth
Lower than average birth weight (usually about 200 gm less than normal) ^[8]
Heart murmur and congenital heart defects (structural abnormalities)
Colic
Reduced lung capacity ^[8]
Asthma and other respiratory problems ^[9]
Ear infections ^[10]
Sudden infant death syndrome or SIDS (cot death)^[11]

Effects on the Baby

Lower than average birth weight (usually about 200 gm less than normal) ^[8]
Heart murmur and congenital heart defects (structural abnormalities)
Colic
Reduced lung capacity ^[8]
Asthma and other respiratory problems ^[9]
Ear infections ^[10]
Sudden infant death syndrome or SIDS (cot death)^[11]

Long Term Effects

Growth retardation
Childhood obesity
Increased risk of cleft lip and cleft palate ^[12]
Behavioral problems like attention deficit hyperactivity disorder (ADHD) with age ^[13]
Learning disorders due to restricted brain development
Genetic conditions like autism ^[14]
Brain damage and cerebral palsy ^[15]
Vision problems ^[16]

Babies born to mothers who smoked during pregnancy are more likely to smoke when they grow up ^[17]

Maternal Complications

Ectopic pregnancy ^[18]
Miscarriage ^[19]
Extreme vaginal bleeding
Placenta previa (the placenta growing in the lower uterus, partially or completely covering the cervix) ^[20]
Placental abruption ^[21]
Pre-term labor ^[22]
Premature rupture of the membranes (PROM) ^[8]

Women suffering from epilepsy should stay away from cigarettes when pregnant as it increases the risk of pre-mature labor and contractions ^[23].

What are the benefits of quitting smoking when pregnant

Some women try to cut down the number of cigarettes they smoke everyday while others think it is safer to switch to lighter brands. Although, the less you smoke the safer it is for the baby, giving up tobacco altogether is the only way of ensuring a healthy pregnancy and baby. The harmful substances in tobacco may have considerable ill effects on the fetus even if you smoke only one cigarette a day. Here are the principal benefits of giving up smoking during pregnancy:

Less severe symptoms of morning sickness
Increased strength and energy ^[21]
Better sense of taste and smell
Easier labor and delivery ^[4]
Considerably reduced chances of life threatening complications
Saves a considerable amount of money that can be spent on preparations for your baby ^[9]

How does secondhand smoking affect pregnancy?

Secondhand or passive smoke is the mixture of the smoke coming from the burning end of a cigarette and that exhaled by a smoker ^[24]. The smoke burning off the end of a cigar or cigarette contains more harmful substances than that inhaled while smoking ^[25]. Researches show that women exposed to passive smoke during pregnancy have 23 percent higher chances of delivering a stillborn baby while the risks of birth defects increase by 13 percent ^[26]. Regular exposure to secondhand smoke heightens the risks of the following problems both in the mother and child:

Heart diseases
Lung cancer ^[27]
Asthma
Emphysema (a lung condition characterized by reduced respiratory function)

Serious consequences of passive smoke may also include low birth weight, congenital defects, SIDS and stillbirth ^[28].

How to quit smoking while pregnant?

Quitting cold turkey is often considered the best way to give up smoking both for you and your baby ^[29]. Pick a certain date when you throw all your cigarettes, lighters and ashtrays away for good.
Take up a knitting project or needlework to keep your hands busy
Keep yourself occupied with light housework or activities like reading, going for a walk or watching TV to suppress the cravings ^[21] (The cravings do not last for longer than 2 to 5 minutes) ^[30]
Open a bottle of water to take a few sips each time you feel like opening a pack of cigarettes ^[30]. Avoid sitting still in a couch and wait for the cravings to pass, as this makes it more likely for you to give in to the cravings
Chew some sugar-free gum or have some healthy snacks to keep your mouth busy
Drink plenty of water to keep yourself hydrated ^[21]
Avoid the things and situations that usually make you want to smoke ^[9]
Ask your partner and family members to avoid smoking around you to help you refrain from tobacco and to keep your baby safe from passive smoke ^[31]
Avoid going to places like bars and clubs where people are more likely to smoke
Talk to your health care provider regarding whether it is safe to use the nicotine gum, patch, nasal spray and medications intended to assist in quitting smoking and fighting the cravings ^[21]

If you are unable to stop smoking completely at once, try to gradually cut back the number of cigarettes you smoke every day until you do not need to smoke again. However, it is advisable to try and complete this long-term stop-smoking plan within the 14 week of pregnancy ^[29].

Does smoking affect the chances of getting pregnant?

Scientific researches show smoking to have an adverse effect on female fertility ^[32] with studies showing infertility to be more common in women who smoke. Additionally, smokers are likely to face more difficulty in conceiving compared to non-smokers. So, it is recommended to give up tobacco as soon as you start planning to have a baby. Smoking is also known to increase the chances of having an ectopic pregnancy ^[9]

Is smoking while pregnant illegal?

Smoking in pregnancy is not illegal in the United States. However, there is a significant amount of debate regarding whether or not it should be made illegal as it can be considered a form of child abuse.

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