Pre-and Post Natal Smoking Issues

Table of Contents

• Introduction
• First Trimester
  • Making a choice
  • Benefits for mother
  • Benefits for fetus
• Second Trimester
  • Social factors
  • Managing stress
  • Keeping motivated
• Third Trimester
  • Secondhand smoke
  • Partner interactions
  • Preparing for birth
• Post-Partum
  • Relapse
  • Quit for yourself
  • Resources
• References

Introduction

Many women who quit smoking during pregnancy do so "for the baby" rather than for themselves. Quitting smoking has considerable health impacts for both women and fetus during pregnancy and long thereafter. There are several concerns and issues that you may experience when attempting to quit or stay quit during different points of your pregnancy.

First Trimester

Making a choice

Pregnant woman 1: I just found out that I'm pregnant. I'm worried because I smoke. I care about my baby so much and know it's time for me to stop. But I don't know where to begin.

Pregnant woman 2: For me, quitting immediately worked. But it's not always so easy.

Statement: 50% of women who smoke spontaneously quit or reduce their tobacco use during pregnancy.^{Footnote 1}

Benefits for mother

Pregnant woman 1: Does quitting smoking provide benefits for me too?

Pregnant woman 2: For me, since I've quit... I've had so much more energy. My senses of taste and smell have improved, and my skin and hair look and feel healthier. I've also saved a lot of money and reduced my chance of heath complications.

Statement: Women who quit smoking reduce their risk of miscarriage, pregnancy complications, and premature birth during pregnancy.^{Footnote 2}

Benefits for fetus

Pregnant woman 2: Your fetus will get the nutrients and oxygen it needs for growth inside you. And as your child grows, he or she will be in much better health.

Pregnant woman 1: That is really motivating. I only want the best for my baby, but I also really want to be a healthy mom.

Statement: Women who quit smoking prevent nicotine, carbon monoxide, and other chemicals in tobacco smoke from passing on to the fetus through the placenta.^{Footnote 3,Footnote 4,Footnote 5}

Second Trimester

Social factors

Pregnant woman 1: I feel overwhelmed with all of the changes I'm facing. I'm single and worried about having enough food and money to provide for myself and my baby when it's born. But I still want to try my hardest to quit or reduce the amount I smoke.

Pregnant woman 2: I know it's a lot of pressure. I am facing some of the same stresses.

Statement: Younger mothers under 20 years of age are up to five times more likely to report smoking in pregnancy than women over 35,^{Footnote 6} and low income and single mothers are also highly susceptible to smoking in pregnancy.^{Footnote 7,Footnote 8,Footnote 9,Footnote 10}

Managing stress

Pregnant woman 1: Sometimes I smoke to relieve stress.

Pregnant woman 2 : I know it's hard sometimes... For me, I would take deep breaths and try to cope in other ways. When I was quitting, I chewed gum to take my mind off it. But you know you can always call me...I do know what you are going through.

Statement: Women who quit early in pregnancy report lower levels of stress and depressive symptoms compared to women who report smoking during pregnancy.^{Footnote 11}

Keeping motivated

Pregnant woman 1: I slipped up and had a smoke the other day. This complete stranger gave me a horrible look. I felt so ashamed.

Pregnant woman 2: There is nothing to feel ashamed about. You have made so much progress. Just keep trying.

Statement: Women who are visibly pregnant and smoking, and mothers of infants and small children who smoke, may experience negative judgment from others.^{Footnote 12}

Third Trimester

Secondhand smoke

Pregnant woman 1: Congratulations...I'm so excited for you and your little one.

Pregnant woman 2: Thank you...I'm happy too...but I wish people wouldn't smoke around my baby, I know it's not good for her.

Statement: Pregnant women who do not smoke but are exposed to second-hand smoke are more likely to deliver low-birth weight babies.^{Footnote 13} Children exposed to second-hand smoke are more likely to suffer from asthma and other respiratory infections.^{Footnote 14}

Partner interactions

Pregnant woman 2: It's been really hard...I've quit smoking but my partner still smokes. I'm worried about the effect it is having on me and my baby.

Pregnant woman 1: That's too bad, because you need all the support you can get when you quit smoking.

Statement: Interactions between partners can affect women's attempts to quit and stay quit. ^[15] Also, women who live with a partner who smokes are more susceptible to relapse than those who do not. ^{Footnote 16,Footnote 17}

Preparing for birth

Pregnant woman 1: I'm going to have my baby soon. I'm so anxious that I've been craving cigarettes a lot these days.

Pregnant woman 2: Keep trying! You should talk to your doctor to get some help to ensure you don't start smoking again.

Statement: For those who have trouble quitting altogether, consult your health care provider about different smoking cessation and relapse prevention options. ^{Footnote 18}

Post-Partum

Relapse

Pregnant woman 2: I have to be honest with you.... I was doing so well during the pregnancy but recently I slowly began to smoke again.

Pregnant woman 1: I've been tempted too. I have so much stress with my new baby and I feel like when I smoke that's the only two minutes I have for myself.

Statement: While many women quit smoking during pregnancy , this is often temporary. Relapse rates vary, but are approximately 50% within six months after giving birth, ^{Footnote 19} and 70%-90% within a year. ^{Footnote 1}

Quit for yourself

Pregnant woman 2: I felt during the pregnancy I was only worried about the health of my baby. Now I'm realizing that I need to think about my own health as well.

Pregnant woman 1: You're right...if we are going to stay quit....and live a long time for our children, we need to figure out how to value ourselves and look after our own health too.

Statement: Many women who quit smoking during pregnancy do so "for the baby" rather than themselves. ^{Footnote 20,Footnote 21} The stresses associated with caring for a new baby lead many women to resume smoking. ^{Footnote 21}

Resources

Pregnant woman 1: Hey...I've found some great stuff here that has helped me with this process.

Pregnant woman 2: Great...thank you.

References:

Act Now BC: Questions and Answers on Alcohol and Drug Use in Pregnancy - (2007). A question and answer worksheet for pregnant women addressing factors associated with drinking and smoking during pregnancy.
http://www.actnowbc.ca/EN/pregnant_women/smoking_during_pregnancy/

TRIPS Booklet - An tobacco reduction resource for pregnant and postpartum women, entitled "Couples and Smoking: What You Need to Know When You are Pregnant". It is targeted to women who are pregnant and interested in reducing or quitting smoking and it explores the ways that couple interactions influence cessation efforts. The booklet includes a combination of information, self-assessments, and questions and answers. More information is available at: http://heretohelp.bc.ca/publications/visions/tobacco/alt/3

Pregnets - Website contains information for pregnant/postpartum women on: second-hand smoke, information on how to talk to a doctor, common questions and answers, statistics, and an online forum for discussion.

Quitnow.ca - A website with resources and information to help women quit smoking (not specific to pregnant women).