Taboo subject....smoking :-(

March 8, 2004

Ok....I have been avoiding this question for a while because I feel

SOOOO gulity and so ashamed...But, I need HELP! When I found out I

was pregnant with my first child (over 4 yrs ago) I quit smoking

immediatly. It wasnt even an issue. Unfortunatly, I started smoking

again after she was born. I had my weight loss surgery in July 02,

and the smoking seemed to increase after that. I guess I replaced

alot of my food demons with smoking demons! Anyway, I am now 12 weeks

pregnant and when I first found out, I pretty much quit smoking again

(cut WAY down) but now I find myself letting more cigarettes creep

back in each day. It is unconceivable to me as to why I am letting

this continue. I fight with myself every minute of every day, but

still continue to do it! I feel such an intense feeling of guilt, but

for some reason it isnt enough to make me stop. I told myself that as

of today, I was just not going to buy anymore cigs. Please pass on

any helpful info...I have read about all of the horrible stories

related to smoking while pregnant. God knows I would never be able to

live with myself if something terrible happens because of my

selfishness and lack of self control. My doc said to use the patch,

but to me, that is just as bad for my baby. Help!!!

Thank you, Lori D.

March 8, 2004

Lori,

I commend you for being open and honest with us. I could tell you

all of the horror stories being a L&D/NICU RN, but it wouldn't mean

anything to you because it wasn't YOUR baby I was talking about

taking care of; it is other smoker's babies I have delivered.

All of the information you read about smoking while pregnant is true.

Smokers tend to have smaller babies and many of them have great

difficulty after arriving; many premature. The prematurity leads to

other possible health problmes. I am not going to try to tell you

that smoking is bad. You already know it or your wouldn't feel

guilty, right? Some smokers can have a healthy baby and they

think " hey, I smoked and my baby is fine " but if they could just take

a look inside to see the difference. As an old badge I used to wear

has a baby inside the womb, rubbing both eyes with little tiny fists,

it says at the top of the badge, " Babies Don't Thrive In Smoke Filled

Wombs " . They don't thrive. They *may* make it into the world safely,

but imagine what they endured to get here? I don't even want to start

telling you the health problems that can cause infants and children

of Moms who smoke around them, let alone smoke while pregnant. The

saying is true, " You are what you eat, smell, smoke and drink while

pregnant. " No one would give their 3 year old a cigarette right?

The patch can help you quit and your thinking that it is as bad

for the baby is not correct. You may start off with a high level of

nicotine in the first step patches (still not exactly as much as

cigs) then as you taper your patches, the amount of nicotine also

decreases in the patches. Your baby gets less and less nicotine,

until you are patch and smoke-free.

I can tell you with complete honesty that if you placed 50 fresh

placentas in a room and asked me to pick out which 25 of the Mom's

were smokers, I could do it without any problem because smokers

placentas are very VERY *icky*

They have a darker deep purplish/burgundy color rather than the

normal non-smoking oxygen-rich red color. The placenta's themselves

are much smaller than non-smokers. A normal functioning umbilical

cord is plump (approx diameter of a quarter), wiggly, spongy and just

much more pliable (I hope I am explaining this in terms you can

understand) than a smoker's placenta. Smoker's have smaller

placenta's (as small as a pencil!!!), the umbilical cord is usually

much flatter (not plump), more narrow and breaks apart easily. The

placenta is a very tough, strong and sturdy organ. I have literally

seen a somker's placenta fall and break apart just like a wet piece

of toilet paper during examination after a smoker's delivery. If it

happens to break away before delivery, your baby is deprived of

oxygen and may die before anything could be done to help him/her.

I did a delivery around Halloween with a Dr. who's patient was a

smoker. As the baby was coming out of the vagina, the cord was

wrapped around it's neck, when the baby's head came out and he was

attempting to deliver the shoulders, the umbilical cord around the

babies neck *broke in two*. Keep in mind that the cord hadn't been

clamped yet. Blood was everywhere, the Mom had to go to surgery to

remove a partially retained placenta because it *sheared* off and

left some of it inside here. She bled and bled and ended up having to

have an emergency hysterectomy. It was sad because she was just 20

and wanted more babies. Would any of that have happened is she hadn't

been a smoker? maybe maybe not. The elasticity, sponginess and recoil

of a healthy umbilical cord would have withstood the baby's head and

shoulders being delivered without a doubt in my mind. The Mother was

freaking out hysterically asking if it was her fault because she

smoked (of course, she had been lectured and told to stop, so she did

feel guilty). The Dr just said that he had only seen 5 or 6

deliveries in 25 years that the same thing happened, and they were in

smokers who admitted to smoking 2-3 (and one with 4) packs of

cigarettes a day.

I just wish I could show you the difference in a healthy placenta

and umbilical cord and then show you the smokers placenta and cord.

This is your baby's lifeline to you until he/she can start living and

breathing on it's own. I know then you would make the choice not to

smoke to possibly save your babies life.

Just my own personal opinion and experience. I have never smoked,

but I have had addictions that I have had to overcome in my life, so

I do understand how difficult it can be. If you can't stop smoking

for your own health and wellbeing, at least think of your baby and

other children.

Thank you again for asking for help and advice. That is an excellent

first step in getting the help you need.

------------------------------------------------------------

Smoking

What you need to know:

Smoking harms your baby. When you smoke, your baby gets less oxygen.

Lack of oxygen can cause your baby to grow more slowly and gain less

weight in the womb. Smoking during pregnancy has also been linked to

miscarriage and preterm labor.

What you can do:

Quit or cut back as much as you can. We know it's hard, but remember,

you're doing this for your baby. Here are some resources that can

help:

Your health care provider

Great Start program of the American Legacy Foundation. Their quit

line is just for pregnant women. Call .

American Cancer Society Quit Line:

Cancer Information Service, National Cancer Institute:

Pregnant women who don't smoke should avoid other people's smoke.

Studies suggest that regular exposure to secondhand smoke may harm

the baby.

Smoking: Tips to Quit

Write down your reasons for quitting. Look at the list when you are

tempted to smoke.

Choose a " quit day. " On that day, throw away all your cigarettes,

lighters and ashtrays.

Stay away from places, activities or people that make you feel like

smoking.

Ask your partner or a friend to help you quit, and call that person

when you feel like smoking.

Ask your health care provider about quitting aids such as patches,

gum, nasal spray and medications. Don't start using these without

your health care provider's okay especially if you are pregnant.

Don't get discouraged if you don't quit completely right away. Keep

trying. If you can't quit, cut back as much as you can.

Learn about smoking cessation programs in your community. You can get

more information from you health care provider, hospital or health

department. The organizations listed below can also help:

Great Start program of the American Legacy Foundation. Their quit

line is just for pregnant women. Call .

American Cancer Society Quit Line: .

Cancer Information Service, National Cancer Institute: (800) 422-

6237.

Smoke-Free Families: .

QuitNet.com

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Please see the next message about smoking as well.

March 8, 2004

Lori,

Oh sweetie, I sooooo feel your pain!!! Though this is my first child, I too,

like you, cut way down when I found out I was pregnant and then stopped, but man

o man I crave them bad every single moment of the day. What I have discovered

for myself that I think it has been harder to quit this time for me is because I

didn't want to quit, I quit because I was pregnant. I have slipped a few times

and have felt the guilt you are describing. If the doc gave you the permission

to use the patch, use it!!! It is way better for you and your baby than the

smoking. I never had the courage to even ask my OB if I could use one of the

quit smoking aids so I have been suffering, but don't suffer if you don't have

too. I admire you for having the courage to address this issue!!!

Axelrod