As an Obstetrician, I found it amazing that people would actually smoke while they are pregnant. However, I don't think people actually pick up the cigarette thinking, "I am going to hurt my baby now!" In fact, when I thought about it, what is the real difference between smoking in a closed up car or feeding the kids so much junk food? There's really not much difference at all. It comes down to education. Many of the mothers-to-be have grown up around cigarette smoke and just take it as a part of life. I think it really needs to be explained as to why it makes such a huge difference. When marketers are able to convince our young mothers that a Pop Tart is a healthy choice because it is baked, there is something wrong with our educational system. We have got to do a better job of getting the message out there. It is difficult. I have really poured my heart out in the Daily Dose. I am desperate for people to get this message. Please pass this information on to one, two, or your entire list of contacts. Invite them to join.

What is the effect on a pregnancy that is bathed in cigarette smoke? Is it really such a big deal after all? According to the American Lung Association, smoking during pregnancy accounts for an estimated 20 to 30 percent of low birth-weight babies. This is directly responsible for up to 14% of all premature births and about 10% of all infant deaths. Given these statistics, why is it not illegal to smoke when pregnant? I think it does come down to simple education. We, as a society, know the numbers but we don't really believe them. I can remember when I was practicing Obstetrics that it was never really discussed that the premature birth or the preterm labor was the cause of smoking. That was too obvious. We had to look for other explanations: teenage mother, drugs, working too much, stress or just about any other cause. All the while the 800 pound gorilla (cigarette) was in the room.

What really happens when a mother smokes with a fetus in her womb?  First of all, 10% of pregnant women smoke. This is not to be laid at the feet of the women. The men also have a role in this huge epidemic. If these women are exposed to second hand smoke, they are at an overwhelmingly increased risk for themselves and their babies. Nationally, 18% of all women smoke. In developing countries only 8% of women smoke. 

According to the U.S. Public Health Service, if all pregnant women quit smoking, there would be an estimated 11% decrease in the number of stillbirths and a 5% reduction in the number of newborn deaths. Given these numbers, why would a person ever pick up another cigarette around kids or during pregnancy?

In 2004, 11.9% of babies born to smokers in the United States were of low birthweight, compared to non-smokers low birth rate of 7.2%. This can result from poor growth before birth to premature birth. It is well documented that smoking will delay fetal growth.  Low birthweight babies will face an increased risk of serious health problems during the newborn period and also lifelong risk of disabilities, cerebral palsy, learning disabilities, mental retardation, and even death. The more that a woman smokes the higher the chance of a low birthweight baby. The good news is that if she stops smoking by the end of her 27th week, or at the end of the 2nd trimester, she will no more likely have a small baby than a non-smoker. When can get this message out there. All we have to do is share and to educate. 

However, if a woman smokes for a month before pregnancy and up until the end of her first trimester, she is significantly more likely to have a baby with a congenital heart disease. This risk is increased with the number of cigarettes that she smokes in a day. So again, it is a dose related event. Education is key. No one would intentionally hurt their baby or their family.

Not only can it cause problems with the baby, it can also cause some significant problems with the pregnancy. There are conditions in pregnancy that can threaten the life of the mother as well as the baby. Placental previa, where the placenta is in front of the baby in the birth canal, and placental abruption, where the placenta sheers off the uterine wall before delivery, can be life-threatening to the mother. Premature rupture of the membranes can also lead to premature birth and low birthweight babies. This is a huge problem.

There are alternatives to smoking. There are ways to quit smoking. I am going to talk about all the options that you have to quit smoking. Pass this Daily Dose onto all your teenage friends and families, newlyweds, single moms and to everyone that you love. Remember, it is much easier to maintain your health than to obtain your health. Start now!

To your Health,

Dr. Michelle Haendiges.