I tweeted something earlier this year about smoking when pregnant. The tweet both garnered support and ruffled some tobacco-stained feathers. It was inflammatory and accusing, as you’d expect, but it kicked off a debate and that’s always a good thing. It opened my mind, to an extent, but I don’t think my opinion has changed on the matter.

Smoking when pregnant

This is the tweet in question:

Moments before writing this out and sending it into the digital battlefield that is the internet, I’d walked past a heavily pregnant woman in Liverpool City Centre. She was smoking and wearing pyjamas.

TRIGGERED!

It was 16:05. I was disgusted by it, I’ve always been of the mindset “Do what you want to your own body, but the baby has no choice”. I think that’s fair, right? Smoking is a shit choice, but it’s an adult’s choice to make. Babies, though, I guarantee they don’t enjoy it. They don’t deserve the risks, either. And there are plenty of risks.

Part of me wanted to shout “DO YOU NOT KNOW WHAT YOU’RE DOING TO THAT BABY?”, but she does know. Of course she knows. There isn’t anyone out there smoking that doesn’t know the risks (I’m excluding far off tribes and undiscovered Amazonians here).

Motives of smoking when pregnant

Motive is the crux of it. It’s what it all boils down to and determines whether I was right to instantly judge that mum-to-be. It’s also what I never considered at the time.

There are two types of pregnant women that smoke:

  1. Those that do it because they don’t care, or they put their own needs before that of the unborn baby’s. Before this tweet, these were the only type as far as I was concerned. I didn’t imagine a situation where it would be better for the baby should the woman continue smoking when pregnant.
  2. Those that do it because they have no choice. They know it’s wrong, and perhaps they feel a tremendous guilt because of it. But maybe, just maybe, it’s the one thing stopping them from tipping over the edge with another mental condition.

My tweet invited a lot of criticism, and it was obvious that those defending it smoked when pregnant and wanted to appear to be from the second category. Do I think they were? No, not all of them, but it’s an easy excuse isn’t it? It’s a powerful excuse, one that you can’t really attack “just in case” it happens to be true.

I once saw a pregnant woman stood outside a local bar – glass of wine in one hand and a cigarette in the other. She was there every single day. I think she’s in category 1 and I genuinely don’t think that child has the best start in life. Mentioning this woman on Twitter was met with “you don’t know what’s going on inside of her though”. I do mate – there’s a baby craving a pack of pork scratchings and already thinking of excuses of why he can’t pay maintenance to his third ex-wife.

Is smoking when pregnant EVER acceptable?

A friend tweeted me back later that evening with his wife’s experience with this. She smoked through her pregnancy. I respect this guy, he’s someone I’ve looked up to in the blogging world since I started. I offered the point of view that perhaps she should have sought other nicotine sources. Here is his reply (in two parts):

https://twitter.com/Life_of_Tont/status/850031640978108418

https://twitter.com/Life_of_Tont/status/850031829042286592

So there’s that. Can I relate to that? No – but that doesn’t meant it’s not valid. I’m not entirely sold on the smoking being an action to make someone feel they’re in control, there are probably better avenues to go down. But that’s all I can say…”probably”, because I don’t know enough, and I’ve not been through this. For those of us without those issues, we just can’t put ourselves in that position.

There were other responses, for example:

This is a pretty extreme example, I understand the logic but I don’t think this translates to the real world in terms of frequency.

I knew a girl who was pregnant – this is going back about 15 or so years now. She was in the bar I worked at (before I was sacked for getting drunk, that’s another story). She was drinking and smoking – we were acquaintances so I asked her why she smoked during pregnancy. Her response was “the stress of trying to quit is worse for the baby”. She was bothered that I’d asked, and she reeled off a stock response and shrugged it off.

She was drunk, though, so perhaps not in the best position to give a sensible answer.

Official stance

The NHS claims the following:

It can be difficult to stop smoking, but it’s never too late to quit. Every cigarette you smoke contains over 4,000 chemicals, so smoking when pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart has to beat harder every time you smoke.

Geek out: Most people know that haemoglobin is what carries oxygen around the body. Oxygen sticks to it (we say haemoglobin has a high affinity for it). Haemoglobin has a higher affinity to carbon monoxide (CO) than oxygen. That’s why CO is so dangerous, it suffocates us. A baby’s haemoglobin has a higher affinity to oxygen than the mother, so it can take oxygen from her blood. So if there’s CO in the mother’s blood, the baby is in trouble. This is also why pregnant women may survive CO poisoning – the baby acts as a magnet for it, sadly.

The NHS advice sounds conclusive to me.

So should you be smoking when pregnant?

No. You shouldn’t. But then you knew that – and you’re not going to take my advice to stop because I’m sure you’ve heard it off other people closer to you. People will judge you for it, whether they’re right in doing so or not. If you’re doing it because you’re a category 2, then as controversial as it sounds, I wouldn’t do it walking through a city centre while wearing pyjamas. Perhaps it’s something you should do in private.

Let me know what you think in the comments below.