I didn't know much about vaping until listening to the November episode of Sprogcast.
If you don't know what Sprogcast is, you can listen here. It's a brilliant podcast, midwives Mark Harris and Karen Hall talk about current research and midwifery issues and it's awesome for parents too. They don't shy away from the hard stuff (deficits in staffing and the independent midwife crisis spring to mind!) but they also don't scaremonger.
I always come away from Sprogcast feeling well informed yet reassured. That the magic of good midwives, right?! 🙂
This particular episode got me thinking about smoking in pregnancy in general and I thought I'd write you a post letting you know the most important points I came across. I also found a really good resource which I'll link you to at the end when I've explained what it is.
I hadn't remembered that 1/5 of women will smoke at least once in pregnancy.
These days it's hard not to know that cigarettes are bad for you so I found this surprising.
To round up some of the effects of cigarettes, they contain over 4000 different chemicals and we know that smoking is the single biggest cause of death worldwide, due to illness such as heart disease and cancer.
In terms of pregnancy, smoking can cause miscarriage, premature birth, stillbirth, low birth weight, intrauterine growth restriction, birth defects and sudden infant death syndrome, as well as other issues.
You'll already know this I'm sure.
The damage is caused in part by the effect of toxins on the placenta.
Smoking causes oedema of the capillaries, reduced bloodflow and other changes to the 'morphology' (structure) of the placenta.
One of the other reasons why cigarettes have potentially deadly effects is because of the carbon monoxide in the smoke.
Carbon monoxide latches on to the haemoglobin in red blood cells which is where oxygen should be carried.
This is one of the reasons why smoking has an effect on your ability to exercise. In pregnancy, it means the fetus is not supplied with oxygen as well as it should be.
The good news is that carbon monoxide levels start to fall as soon as a Mum stops smoking and can be back to almost non-smoking levels within 12 hours.
Back to my surprise at the rates of mothers who smoke.
We don't know for sure why some people have such a hard time with addiction.
Addiction is different from substance dependence. It means that you continue to use a drug or engage in a behaviour despite bad consequences. Substance dependence means you have physical symptoms of withdrawal once you stop using that drug.
But people who are addicted to a drug can go back to using it independent of withdrawal symptoms.
That's why many with addiction issues switch between damaging drugs or behaviours.
It may be that there is a genetic element in terms of the potential to become addicted to any substance.
All of this means it's sometimes not as simple as Mums switching to Nicotine Replacement Therapy (NRT) to give up smoking, though this can help.
There's a fascinating chapter from the free online World Health Organisation book Gender, Women and the Tobacco Epidemic which explores the concept that there are women who can give up smoking spontaneously when they find they are pregnant. These women tend to be from higher socioeconomic backgrounds. Mothers from backgrounds which predispose them to having greater challenges in life often find it more difficult to give up.
Whatever background a Mum is from, they're likely to experience guilt, shame and anxiety if they struggle to give up smoking.
So I wanted to point you to this brilliant 'Smoking In Pregnancy Challenge Group' resource on the use of e-cigarettes in pregnancy.
(Or, as Mark Harris points out maybe we should stick to the word 'vaping' as opposed to 'e-cigarettes' to avoid confusion, as tobacco products are so much more harmful?).
Mums have a far higher chance of giving up smoking if they use specialist services and NRT, but if they're really struggling and want to use vaping, this is far safer than smoking.
The downsides are as follows.
We don't yet know the longterm effects of vaping, in or out of pregnancy. We should bear in mind that vaping devices are sold by private companies and so we probably need to keep an eye on what kind of advertising they're doing, as nicotine is addictive after all.
We know that young people who try vaping are more likely to take up smoking and commercialisation like candy flavoured vaping isn't that sensible in my opinion if we're trying to limit the potential for abuse.
But, vaping is so much safer than smoking, with no exposure to the toxins or carbon monoxide that tobacco contains, that it seems a much, much better option than smoking.
I'll round off by saying that the Infant Feeding Survey (2010) found that 26% of Mums smoked in the 12 months before their pregnancy or during their pregnancy. This is down from 32% in 2005.
I think this is pretty amazing because conversations about smoking are so hard to have and yet midwives and other professionals continue to offer this support. More mothers will be healthy and alive to look after their children and more babies will have good outcomes. If you think about the deaths that have been prevented because of the hard work of midwives and others, it's incredible.
The butterfly effect of all those individuals who now have a chance at life because their parents were supported to give up smoking is an amazing thought.
Now I'd love to hear about your personal experience:
1) Is there any effective way of supporting Mums with giving up smoking you've come across? Anything you would or wouldn't say to them?
2) Have you or anyone you know had trouble giving up smoking? Can you comment giving us your insight so we can understand better?
You know I hold midwives and anyone interested in midwifery and helping Mums and babies in high regard. You're doing good things in the world. As always, it's a pleasure to write for you and thanks for reading.
Have a wonderful week,