Tobacco Use Before, During and After Pregnancy
Smoking Among Utah Women Before, During and After Pregnancy
In 2008, ten percent of pregnant women, or 5,783 women, in Utah said that they smoked in the last three months before they got pregnant. Also in 2008, five percent of Utah women smoked during the last three months they were pregnant. While fewer women smoked while pregnant, many women are placing their own health, as well as the health of their unborn children, at risk from the effects of tobacco. That same year, the percent of women who said they smoked within four months after giving birth increased from the five percent smoking in the last three months of pregnancy to seven percent after giving birth (1,2). These numbers may be higher since women may be less than truthful about their use of tobacco due to the stigma attached to smoking while pregnant.
What is the cost of tobacco use before, during and after pregnancy for the mother and her baby and what help is available for women wanting to quit smoking?
Smoking Before Pregnancy (3)
Smoking may decrease your chances of getting pregnant
- Studies about men and smoking have shown mixed results. Some show a decrease in the chances of fathering a child while others show no changes between men who smoke and those who do not. Studies have shown an increase in the length of time it takes a woman who smokes to become pregnant even if she has been pregnant before.
Smoking During Pregnancy (3)
While any woman can have a poor pregnancy outcome, smoking while pregnant raises the chances of a poor pregnancy outcome. The poor outcomes that are increased among tobacco users include:
- An increased risk of having premature rupture of the membranes
- Premature rupture of the membranes (PROM) is when a woman’s water breaks before 37 completed weeks of pregnancy (a normal pregnancy is 40 weeks long). PROM can cause the baby to be born too early and too small to be healthy. It can also increase the chance that the mother may develop an infection in her uterus (womb).
- An increased risk of having a placenta previa
- Placenta previa happens when the afterbirth grows near or over the opening of the uterus (womb). Before or during labor, the woman may have heavy bleeding placing her and her baby at risk. It may result in the woman needing a Cesarean Section (delivery through an incision in the woman’s abdomen) in order to deliver safely.
- An increase risk of placental abruption
- A placental abruption happens when all of or a part of the placenta (afterbirth) separates from the wall of the uterus before the birth of the baby. This can cause heavy bleeding that places the mother at risk. It also lowers the amount of oxygen that the unborn baby receives. An emergency Cesarean Section may be needed if too much of the placenta has become separated from the uterus.
- An increased risk of preterm delivery
- Preterm (premature) delivery is birth of a baby three or more weeks before a woman’s due date. Some women who smoke while pregnant have to be delivered before their due dates because of problems that may be the result of their smoking such as those described above: preterm rupture of the membranes, placenta previa or placental abruption. Even if women who smoke do not have any of those problems, they are still at greater risk of giving birth to a premature baby than are women who do not smoke. Preterm birth often results in a baby being born too small to be healthy. These babies may need long and costly hospital stays after their premature birth and may have life-long health problems. These problems will be costly to the baby and the whole family. Preterm babies are also at increased risk of dying during the first year of their lives.
- An increased risk of fetal growth restriction and low birth weight
- Fetal growth restriction is a decrease in the size of the unborn baby in the uterus. It has been thought that the smaller size of babies of women who smoke was because smokers ate less. Studies have shown that women who smoke take in just as many calories as women who do not smoke. The difference in the size of babies between smokers and non-smokers isn’t the amount of fat the baby has but is a decrease in the amount of lean muscle in babies of smokers. The nicotine in cigarettes narrows blood vessels in the mother’s uterus, in the placenta (afterbirth) and in the baby’s umbilical cord. This lessens the amount of oxygen and nutrients the baby receives and may result in poorer growth and low birth weight (weighing less than 5 pounds, 8 ounces at birth). The more the mother smokes during pregnancy, the greater the risk of her baby being born too small. Even being around second-hand smoke while pregnant can cause a decrease in birth weight. If the mother stops smoking before the last three months of her pregnancy, most of the decrease in growth and birth weight can be stopped. If all mothers were non-smokers while pregnant, the rate of low birth weight births could drop by 20 percent and fetal growth restriction could drop by 30 percent (3).
- A possible increase in the risk of ectopic pregnancy
- Ectopic pregnancy happens when the fertilized egg implants and begins to grow not in the woman’s uterus but in another place - often in her fallopian tube. This is also known as a tubal pregnancy. The fallopian tube is a hollow tube that connects the ovary, where the egg grows, to the uterus. Since the fallopian tube is very small, a pregnancy growing there stretches the tube until it ruptures. This causes the death of the unborn, a large amount of bleeding and, if not found in time, the possible death of the mother. While studies cannot prove without a doubt that smoking can cause tubal pregnancies, it is still felt that there is some link between the two.
- A possible increase in the risk of having a miscarriage
- As with tubal pregnancies, studies cannot prove without a doubt that smoking increases a woman’s risk of having a miscarriage. However, it is still possible that there is some link between the two.
Smoking After Pregnancy (4)
Second-hand smoke from the mother or other people living in the household can cause problems for the infant that include the following:
- Smoking raises the risk of Sudden Infant Death Syndrome
- Women who smoke during and after pregnancy increase the risk of their babies dying of Sudden Infant Death Syndrome – SIDS. Being around second-hand smoke after birth raises a baby’s risk of SIDS. When the baby is exposed to tobacco smoke both before birth and also after birth, the risk of SIDS is even greater.
- Smoking around a baby (second-hand smoke) increases the number of lower respiratory infections and ear infections the baby may have
- Many studies have shown that when parents or others in the home smoke around a baby, the number of lower respiratory infections (infections of the airways and lungs) and ear infections is increased.
- Smoking around older children causes breathing problems
- Second-hand smoke from smoking by the parents or others in the home increases coughing, wheezing, phlegm and being short of breath among children in the household. There is a decrease in lung function throughout childhood among those whose parents expose them to second-hand smoke. This effect is even worse if the child was also exposed to smoke before birth.
Help for Quitting Smoking – Utah Resources
In Utah, for help quitting tobacco use, call the Utah Tobacco Quit Line at:
For information in English
For information in Spanish
These phone lines are available Monday through Sunday
from 6:00 AM to 11:00 PM
Information is also available in more than 100 other languages
You may also get help for quitting tobacco use online.
For pregnant women who want to quit smoking, or who just quit smoking or for women who smoke and are planning to get pregnant, the Utah Department of Health’s Tobacco Prevention and Control Program has a program specifically for you called “First Step: A Pregnant Woman’s Guide to Quitting Tobacco Use”. For a place in your area that offers this program call the Tobacco Free Resources Line at: 1.877.220.3466.
If you live in Utah, are pregnant and on Medicaid or Primary Care Network (PCN) and want to quit smoking, you may be able to receive intensive quit counseling and nicotine replacement therapy. For more information, call 1.888.567.TRUTH.
Help for Quitting Tobacco Use – National Resources
There are several national resources for people needing help to quit tobacco use. They are:
The Department of Health and Human Services, Women’s Health.Gov. “How to Quit Smoking” (Accessed July 12, 2010). This site offers basic tips on how to quit smoking, medications available to help in your efforts to quit and other sources of support.
The National Cancer Institute and the Centers for Disease Control and Prevention. “Quit Smoking Today.” (Accessed July 12, 2010).
On this site you will find information and support for your quitting efforts whether you are thinking about quitting, preparing to quit, or needing help staying quit. There is a toll free number and a live counselor available to support you through real time texting.
The American Lung Association. (Accessed July 12, 2010).
The American Lung Association has several resources available including an online program called “Freedom from Smoking”.
The American Cancer Society (Accessed on July 12, 2010).
The website has information on quitting smoking under the “Stay Healthy” tab on the home page. Under “Stay Away from Tobacco” is an online guide to quitting smoking at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002971-pdf.pdf.
Tobacco use before, during or after pregnancy has harmful effects for both the mother and her baby. Even secondhand smoke can be harmful for the mother, her unborn child and other infants and children in the household. If you don’t use tobacco, don’t start. If you use tobacco and are planning on becoming pregnant, now is the time to quit. If you are already pregnant and smoke, you have two great reasons to quit: your health and your baby’s health. If you have already given birth to your baby, now is the time to quit for three great reasons – your health, your new baby’s health and for the health of future children. Check out the resources listed above to help you in your quitting efforts. Remember that it can take several quitting attempts before you succeed. Good luck – you won’t regret giving up tobacco use!
- Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health. Available online@: http://ibis.health.utah.gov. Retrieved 3 June 2010.
- Utah Department of Family Health and Preparedness (PRAMS). PRAMS Query Model. Available online at: http://ibis.health.utah.gov/query/selection/prams/PRAMSSelection.html. July 2010.
- U.S. Department. of Health and Human Services, Centers for Disease Control and Prevention and Health Promotion, Office on Smoking and Health. 2004 The Surgeon General’s Report on the Health Consequences of Smoking. “Chapter Five: Reproductive Effects.” 2004. Atlanta. pages 256-610. Available online at: http://www.cdc.gov/tobacco/data_statistics/sgr/2004/pdfs/chapter5.pdf.
- U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General, Chapter Six, “Respiratory Effects in Children from Exposure to Secondhand Smoke”. 2006. Atlanta, Ga. pages 261-420. Available online at: http://www.surgeongeneral.gov/library/secondhandsmoke/report/chapter5.pdf