Smoking and pregnancy

An estimated 20 percent or more of women smoke cigarettes while they're pregnant. In fact, smoking is thought to be the most common substance abuse problem for pregnant women. The habit is linked to more than 5,000 infant deaths in the United States each year.


General information
Inhaling tobacco smoke increases the amount of carbon monoxide in your blood. The carbon monoxide replaces oxygen.
When you smoke during pregnancy, the blood flowing through the umbilical cord to your baby contains less oxygen. The nicotine in tobacco constricts blood flow, which makes the situation worse. When you smoke, your baby gets less oxygen and nourishment. This stunts his or her growth and development.

Nicotine also increases your heart rate and blood pressure. In turn, nicotine increases your baby's heart rate. This increase places your baby under unnecessary stress.

Finally, various other harmful compounds in cigarette smoke reach your baby after they circulate through your system. Secondhand smoke in your home can affect you and your unborn baby in the same way.


Complications
If you smoke while you're pregnant, the degree of complications is directly proportional to the number of cigarettes you smoke. This is also true for secondhand smoke. The greater the exposure, the greater the risk of complications. Smoking during pregnancy has been associated with:
miscarriage
ectopic pregnancy (when the fertilized egg implants itself outside the uterus)
premature rupture of membranes (when your water breaks early)
premature labor and delivery
placenta previa (when the placenta -- a structure in the womb that develops during pregnancy to nourish the baby and help him or her discard waste -- covers the cervix)
abruptio placenta (early separation of the placenta from the uterus)
low birthweight and height, increasing the baby's risk of death and disease (Birthweight is decreased by an average of 7 to 10 ounces.)
fetal or newborn death
sudden infant death syndrome (SIDS)
cleft lip (a birth defect in which there is a division in the upper lip or upper jaw, or both) and cleft palate (a birth defect in which there is a division in the roof of the mouth)
attention-deficit hyperactivity disorder (ADHD), behavioral problems and learning difficulties

Treatment
It's important to quit smoking before conception and remain smoke-free after delivery. Smoking can damage the placenta in the first few months of pregnancy. If you quit early in pregnancy (preferably before the 16th week), your baby is less likely to develop problems. Remember, it's never too late to quit. Quitting at any time during your pregnancy will help reduce the harmful effects of smoking.
Here are some tips to help you quit:

Make a plan to quit. You can set a date to quit cold turkey, or you may want to taper off until you quit completely. To help, limit the areas where you allow yourself and others to smoke. Consider making your home and car smoke-free, for example.

Plan healthy ways to deal with situations that may cause a cigarette craving. For example, find an activity that takes your mind off smoking and helps the urge to pass.

Get moderate amounts of exercise, and drink plenty of water. Before beginning an exercise program, consult your doctor. If your doctor gives you the OK to exercise, remember to discuss any changes you may need to make in your routine as the pregnancy progresses.

Ask for support. Realize that most people attempt to quit several times before they're successful. For encouragement, join a support group for smoking cessation. Discuss smoking cessation with your doctor.

Encourage other smokers in your home to quit with you. Or, ask them to smoke outside the house -- away from you and the baby.
If you're considering using a form of nicotine replacement (such as the nicotine patch or nicotine gum) while you're pregnant, be sure your doctor gives the OK.