Smoking in Pregnancy

Common Questions and Risk Factors

Smoking cigarette

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You've probably heard by now that smoking isn't the best thing for you. Now that you are pregnant or are considering becoming pregnant, it's even worse.

Problems With Smoking During Pregnancy

There are many things that we know about smoking during pregnancy. We know that the woman who smokes during her pregnancy has a baby who gets less food and oxygen than her non-smoking pregnant counterparts. We know that certain risk factors are increased for these women. These risk factors include:

  • You are more likely to have a miscarriage.
  • Your baby is more likely to die before birth.
  • Smoking can cause placenta previa (a dangerous situation where the placenta covers the cervix).
  • It can cause a placental abruption (where the placenta separates from the wall of the uterus denying oxygen to your baby).
  • It increases your risk of a preterm birth. Babies born too early can suffer more breathing problems and have longer hospital stays.
  • It increases the chances of your baby learning difficulties as a child.
  • There is a higher incidence of Sudden Infant Death Syndrome (SIDS or crib death) in babies born to mothers who smoked or who are exposed to second-hand smoke after birth.
  • Smoking increases the chance of fetal growth restriction (IUGR).

Now we even know that babies who have been exposed to smoking in the womb, even second-hand smoke, have more genetic defects.

When pregnant women smoke, blood vessels—including those supplying the placenta—constrict. Blood flow is compromised and the fetus may be deprived of oxygen and nutrients. The risk of placental abruption, premature separation of the placenta from the uterine wall, is increased.

Because of this deprivation, the baby may show signs of growth retardation (IUGR). This can also lead to preterm labor or premature rupture of the membranes because the body feels that the baby can no longer be fed properly.

We also know that smoking is an addiction. Women need support and assistance to quit smoking.

There are special programs available to pregnant women and those thinking about conceiving. Talk to your doctor or midwife about using medical help like the patches, while these still have nicotine to help with cravings, you are not getting the other harmful substances associated with smoking.

Some Common Questions

  1. What if you're already well into your pregnancy, is it worth it? Yes. No matter point in pregnancy you stop there are always great benefits to the baby and you. When the baby is born don't start back up; remember that second-hand smoke can lead to increased risk of crib death, more frequent colds, and ear infections, to name a few complications.
  2. What if you quit and your partner doesn't? Encourage them to quit with you, be support for each other if possible. If your partner doesn't quit then request that they smoke outside or away from the baby or areas where the baby dwells.
  3. Don't you want a smaller baby, and won't smoking help you have a smaller baby? Smoking will result in a smaller baby but not in a good way. Growth-retarded babies have issues including they need to eat more, sleep less, and will require more frequent hospitalization.
  4. What about breastfeeding and smoking? Breastfeeding is so wonderful for your baby that it is generally recommended to continue breastfeeding even if you smoke. Although there are still risks to you and the baby from smoking. Quitting can be a wonderful gift for your baby. The patch is also approved for use during breastfeeding, talk to your doctor or midwife for more information.
  5. We just started planning for a baby. We are going to quit but how long should we wait? Quit as soon as possible.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.