I am 24 weeks pregnant and I have been smoking through my whole pregnancy. I just can’t quit but I feel so guilty. I want to, but I don't know if I can. I just wanted to know if my baby is going to be okay and if he will be born healthy. I feel him kick often so it makes me feel a lot better, but I just can’t quit as I get stressed out.
Our midwife Melissa says:
It can be hard to give up smoking, but pregnancy gives you a huge incentive to stop. Around 20% pregnant women smoke, so you are not alone. We know that women who are able to stop smoking in the first trimester are likely to give birth to babies who are close to a normal size, so the earlier you can quit, the better for your baby.
There is no safe level of smoking, so all women are encouraged to quit rather than cutting down. Reducing the amount of cigarettes smoked still exposes the baby to the harmful substances contained in cigarettes, but of course smoking fewer cigarettes is better than smoking more cigarettes, so if you are unable to quit, you are better off smoking less.
Smoking affects your body and hence your baby by increasing your heart rate, reducing the amount of oxygen you deliver to your baby, increasing your blood pressure and depressing your nervous system. It can cause an increase in chest infections and blood clotting disorders. These can be harmful in pregnancy and around the time of birth.
Smoking during pregnancy also increases the risk of miscarriage, stillbirth, low birth weight babies, problems with the placenta (it doesn’t function so well), bleeding during pregnancy and preterm labour. On average, babies born to women who smoke during pregnancy are smaller than those born to women who don't smoke during pregnancy, and low birth weight is one of the main causes of illness in babies, and of stillbirth.
Smoking in pregnancy and around a new baby greatly increases the risk of cot death (SIDS). This risk is four times higher if you smoke between one and nine cigarettes a day during pregnancy, and is eight times higher if you smoke 20 cigarettes or more each day. Therefore, it is important that you not only quit, but also your partner and anyone who may be around the baby.
If you cannot give up completely, then certainly smoking fewer cigarettes will be helpful, but even one cigarette a day can be harmful to babies.
If you are finding it hard to quit, the Quitline (13 QUIT) can help. Quitting smoking can be hard because Nicotine is highly addictive, and the Quitline can discuss with you the options that are available to you. Some of the options include:
1. Going cold turkey: simply stopping. There’s no evidence that the stress of doing this harms the baby, and it is inexpensive. Support may be needed.
2. Nicotine replacement therapy: this can take the form of patches and can help to prevent withdrawal. The downside is that you are still using a drug, and we don’t know how much nicotine is needed to contribute to poor outcomes in babies. The upside is that if you successfully use nicotine replacement therapy, you will avoid all the other harmful chemicals that go into cigarettes. Gums and lozenges are also available.
3. Counselling: this can be with a counsellor, the Quitline, a midwife, psychologist, or GP.
4. Acupuncture, homeopathy and herbal medicine can be used to balance cravings.
5. Hypnotherapy: administered by a qualified hypnotherapist, this can be very successful.
What separates women who quit from women who do not quit? It is all about mindset and setting yourself up for successfully quitting. It is about gathering the resources and information that you need to quit. Anticipate that you will have cravings – and plan ahead for how you will handle these. Tell your friends you are quitting and ask for their help and support. Tell your midwife you are quitting and ask for her/his support. Seek advice from your GP. Remind yourself of why you are making a choice to quit (no-one is forcing you), and why it matters to you. Remember that in the coming weeks, your cravings will diminish and you will get there! Each day it gets easier.
This answer was written for Birth by midwife Melissa Maimann from Essential Birth Consulting.
Last revised: Wednesday, 16 January 2013
This article contains general information only and is not intended to replace advice from a qualified health professional.