33. Substance Abuse
Every action you take during pregnancy
may potentially affect the baby growing inside you. Substance abuse is
never healthy for you; when you’re pregnant, it can also harm your baby.
Many substances you normally use without
adverse effects may adversely affect a developing fetus. Some
substances readily cross the placenta and enter your baby’s
bloodstream, where they can cause problems. Cigarette smoke, alcohol
and drugs are dangerous for the fetus.
Cigarette smoking can have serious
effects on you and your growing baby. Over 10% of all pregnant women
smoke; some experts put the number at 20%. Smoking is higher among
pregnant women under 20 years old and those over 35. Stop smoking
before or during pregnancy; fetal and infant mortality rates increase
by more than 50% in first-time pregnant women who smoke more than a
pack of cigarettes a day.
Tobacco smoke contains harmful
substances; when you smoke, so does your baby! When you inhale
cigarette smoke, it crosses the placenta to your baby and may harm the
fetus. In addition, nicotine in a pregnant woman’s bloodstream
interferes with the normal development of the major neurotransmitter
systems in a baby’s brain.
Nicoderm Patch/Gum, Zyban and Chantix
You may be wondering if you can use an
aid, such as a patch, gum or a pill, to help you stop smoking during
pregnancy. The specific effects on fetal development of these devices
Nicotrol, available as an inhaler, nasal spray or patch, is sold under the brand names Nicoderm and Nicorette; it’s also sold generically. All three Nicotrol preparations contain nicotine and are not recommended for use during pregnancy.
Nicotine-replacement therapy may be
suggested if a woman can’t stop smoking on her own. Studies show the
benefits of these products may outweigh the risks during pregnancy, but
some experts disagree. They state nicotine addiction cannot be stopped
by using nicotine, which is contained in patches and gums. Discuss the
situation with your healthcare provider if you have questions.
Zyban (bupropion hydrochloride) is an
oral medication that is a nonnicotine aid to help with smoking
cessation. This medication is also marketed as the antidepressant
Wellbutrin or Wellbutrin SR. Zyban is not recommended for use by
Chantix (varenicline tartrate) is a
prescription medication available to help someone stop smoking. It
doesn’t contain nicotine, but it is not recommended for pregnant women.
Studies show it may reduce a fetus’s bone mass and also cause low
The problem is so serious that warnings for pregnant women appear on every cigarette package:
SURGEON GENERAL’S WARNING: Smoking by pregnant women may result in fetal injury, premature birth and low birthweight.
Some people mistakenly believe it’s OK to
use smokeless tobacco during pregnancy. It’s not! Use of any smokeless
tobacco product contributes to nicotine in the bloodstream.
In addition, if baby’s dad smoked
before conception and during pregnancy, the child has an increased risk
of developing problems during childhood. If both parents smoke while a
child is growing up, the child may have an increased risk of developing
Effects on the Fetus
A pregnant woman who smokes reduces her
fetus’s oxygen supply by as much as 50% because carbon monoxide in
cigarette smoke displaces oxygen in the mother’s bloodstream. Toxins in
cigarette smoke narrow blood vessels. Smoking can damage the placenta
and hamper baby’s growth.
Smoking during pregnancy can increase the
risk of many problems in a baby. Studies also show if you smoke during
pregnancy, your child may have a much greater chance of being a smoker
as an adult. The belief is that babies born to moms who smoke during
pregnancy may be more susceptible to nicotine addiction.
Infants born to mothers who smoke weigh
less than other babies, which can cause problems. When a woman smokes
during pregnancy, the substances she inhales interfere with her body’s
absorption of vitamins B and C and folic acid, and increase her risk of
Effects on the Pregnant Woman
Serious pregnancy complications are
more common among women who smoke. The risk of developing placental
abruption increases by 25% in moderate smokers and 65% in heavy
smokers. Your smoking may affect future pregnancies. Studies show you
double your risk of placental abruption in a second pregnancy if you
smoke during your first pregnancy.
Placenta previa occurs 25% more often in
moderate smokers and 90% more often in heavy smokers. Cigarette smoking
also increases the risk of miscarriage, premature rupture of membranes
and fetal death or death of a baby soon after birth. Risk is directly
related to the number of cigarettes a woman smokes each day. Risk can
be even greater if you smoke more than a pack of cigarettes a day.
The best thing to do is quit smoking
completely before and during pregnancy. If you can’t quit totally,
reduce the number of cigarettes you smoke to help reduce your risks.
Effects of Second-Hand and Third-Hand Smoke
Exposure to second-hand and third-hand
smoke can be harmful for a mom-to-be and her baby. Second-hand smoke is
smoke you breathe in when others around you are smoking. Third-hand
smoke occurs when tobacco toxins stick to fabric, hair, skin and other
surfaces, such as walls, carpets and floors, even after smoke has
disappeared. It can be just as harmful as second-hand smoke. A clue to
the presence of third-hand smoke is smell—if you can smell it, it’s
either type of smoke increases a nonsmoker’s risk of giving birth to a
low-birthweight baby. Ask your partner, family members, friends and
co-workers not to smoke around you while you’re pregnant. Avoid
situations that expose you to second-hand or third-hand smoke!