Smoking and pregnancy: Understand the risks

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Smoking and pregnancy: Understand the risks

Smoking and pregnancy don't mix well — but you can take steps to boost your odds of quitting for good. Start by getting answers to the most common questions about smoking during pregnancy.

Does smoking affect fertility?

You probably know the general risks of smoking — from smelly clothes and wrinkles to heart disease and lung cancer. If you smoke and you're pregnant or planning to become pregnant, however, you have even more incentive to quit. Smoking can make it harder for you to get pregnant. Smoking also increases the risk of ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube.

How does smoking during pregnancy affect a baby?

Smoking during pregnancy exposes a baby to carbon monoxide, which limits the baby's supply of oxygen and the delivery of nutrients. Exposure to nicotine also increases a baby's heart rate and reduces fetal breathing movements.

Smoking during pregnancy has been linked with other problems as well, including:

  • Vaginal bleeding
  • Problems with the placenta, such as when the placenta partially or totally covers the cervix (placenta previa) or when the placenta separates from the inner wall of the uterus before delivery (placental abruption)
  • Low birth weight
  • Preterm premature rupture of the membranes — when the fluid-filled membrane that surrounds and cushions the baby during pregnancy (amniotic sac) leaks or breaks before labor begins and before week 37 of pregnancy
  • Preterm labor
  • Premature birth
  • Birth defects involving the heart, limbs, skull, muscles and other areas
  • Pregnancy loss

Smoking during pregnancy can also affect a baby after he or she is born, increasing the risk of:

  • Sudden infant death syndrome (SIDS)
  • Colic
  • Asthma
  • Respiratory infections
  • Childhood obesity

Some research also suggests that smoking during pregnancy might affect a child's emotional development, behavior and ability to learn. Smoking during pregnancy might even impair a child's own fertility.

How does exposure to secondhand smoke affect pregnancy?

Breathing secondhand smoke during pregnancy can also affect your baby's health. Women who don't smoke but are exposed to secondhand smoke are at increased risk of pregnancy loss or having a baby who has birth defects or a low birth weight.

Can quitting smoking during pregnancy reduce a baby's health risks?

Absolutely. If you smoke, quitting smoking during pregnancy is the best way to give your baby a healthy start. If you quit in the first four months of pregnancy, you might lower your risk of having a low birth weight baby to that of a nonsmoking woman. Quitting smoking during pregnancy can also reduce the risk of premature birth, pregnancy loss, infant death and other complications.

Reducing the amount you smoke during pregnancy is a step in the right direction, but quitting smoking will have the most impact on your health and your baby's health.

What's the safest way to quit smoking during pregnancy?

The safest way to quit smoking during pregnancy is without the aid of medication. Start by consulting your health care provider for advice or seeking counseling. Then consider these practical tips:

  • List the reasons you want to quit, such as protecting your baby's health.
  • Get rid of any smoking materials — in the house, at work, in your bags and in the car.
  • Avoid situations that make you want to smoke.
  • Spend time with people who don't smoke, and visit places where smoking isn't allowed.
  • Wait out cravings by running an errand or eating a healthy snack.
  • With your care provider's OK, use physical activity to manage withdrawal symptoms.
  • Make sure you have someone you can talk to when you need support.
  • Consider setting a goal and creating a reward for meeting it. For instance, if you quit for a certain length of time, use what you would have spent on cigarettes to buy something for yourself or the baby — or put the money into a savings account for your baby.

Is it safe to use stop-smoking products during pregnancy?

If you're still having trouble quitting smoking, ask your health care provider about nicotine replacement products — such as a nicotine patch or inhaler, or nicotine gum, lozenges or nasal spray. Using any of these products to stop smoking will spare your baby exposure to many of the harmful chemicals found in cigarettes.

Many nicotine replacement products are available over-the-counter. If you choose to use the nicotine patch, minimize your baby's exposure to nicotine by removing the patch while you sleep. As your cravings and withdrawal symptoms fade, work with your health care provider to gradually reduce how often you use the patch or any other nicotine replacement product.

If you'd rather use a non-nicotine medication to stop smoking during pregnancy, the antidepressant bupropion (Zyban) might be an option. Work with your health care provider to weigh the risks and benefits in your case.

Is postpartum relapse common?

Adjusting to life with a newborn can be stressful. As a result, many women who quit smoking during pregnancy relapse shortly after giving birth. Women who relapse are more likely to have friends and loved ones who smoke and tend to have less social support. If you quit smoking during pregnancy, recognize the risk of relapse after your baby is born and consult your health care provider for advice on how to avoid starting smoking again.

Remember that breathing secondhand smoke poses health risks for a newborn, including an increased risk of asthma and SIDS. If you breast-feed your baby, he or she will be exposed to many harmful chemicals through your breast milk. Cigarette smoking will also decrease your milk production and might impair your ability to breast-feed for as long as you'd like. If you smoke after giving birth, don't smoke near your baby or while you breast-feed. Most important, make plans to quit again.

Stopping smoking is rarely easy. It might take more than one try to quit for good. Remember, however, it can be done — and your entire family will reap the benefits.

Last Updated: 2012-03-15
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