Smoking During Pregnancy: How Harmful Is it?

Even with all the information on how to quit, 26 percent of American women of childbearing age smoke. About 11 percent of these women smoke during pregnancy. If you are pregnant (or thinking about having a baby), the best time to quit is now. Your doctor can give you advice and answer your questions.

Your doctor can help you by:

• Using a "5-step" approach
  • Doctors are trained to use a counseling approach called "the 5 A's." Your doctor should:
    • Ask you about your smoking habit
    • Advise you to quit
    • Assess your willingness to quit
    • Provide resources to assist you
    • Help you to arrange support at home

  Your doctor should also advise you to avoid second-hand smoke, which can harm your baby.

• Helping you to remain tobacco-free while you are breastfeeding
  • Your baby is exposed to harmful chemicals if anyone is smoking nearby while you breastfeed.
  • Nicotine reaches your baby in breast milk hours after you smoke your last cigarette. When nicotine passes into the milk, it can give your baby nausea, abdominal cramps diarrhea and can cause vomiting.

• Answering your questions, such as:
  • What complications are caused by smoking during pregnancy?
    • Placental problems: Your unborn baby gets nutrients from you through the placenta. Smoking doubles the risk that the placenta can become damaged, causing bleeding and even your baby's death.
    • Increased risk of premature rupture of the membranes: When the sac holding your baby breaks, you go into labor. If this happens before 37 weeks, your baby is born prematurely and may have to have some kind of life-support.
  • How does smoking affect your developing baby?
    • Smoking doubles the risk for low birth weight and premature birth.
    • It increases the risk for serious health problems like cerebral palsy, mental retardation and learning problems.
    • Babies of smokers are often jittery and hard to soothe, perhaps because of nicotine withdrawal.
    • Babies of women who smoked during pregnancy are up to three times more likely to die of sudden infant death syndrome (SIDS).
  • Can't I just "cut down" on my smoking?
    • You can protect your baby by quitting. Even one puff reduces your baby's oxygen supply and exposes your child to dangerous chemicals. Switching to low-tar cigarettes doesn't help. It causes you to inhale more deeply, taking in the same level of nicotine.
  • I'm already in my third trimester. Isn't it too late to quit?
    • No. It's never too late to quit. Even if you give up smoking in the third trimester, you are allowing more oxygen to get to the baby during pregnancy and delivery. You are also helping your baby to grow.
  • Is it safe to use "the patch" during pregnancy?
    • The safety of nicotine replacement therapy (NRT) during pregnancy is uncertain. Generally, NRT is reserved for heavy smokers. Some doctors recommend nicotine gum or nasal spray, because there is less exposure to your developing baby than with the patch. Talk to your doctor about which choice is best for you.

Related Articles Smoking and Other Pregnancy Don'ts The Buzz On Caffeine: Are You Getting More Than You Bargained For?

External Sources American Lung Association Hébert, R. What's new in nicotine & tobacco research? Nicotine & Tobacco Research.2004; 6: S95-S100 March of Dimes National Partnership to Help Pregnant Smokers Quit

This article was reviewed and updated June 2007.

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