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Smokefree Pregnancies Are Child Health Priority


Education for Change

Friday 14 October 2005
Smokefree Pregnancies Are Child Health Priority

Pregnancy and child health leaders have called for smoking in pregnancy risks to be brought out of hiding and taken seriously. Leaders from fertility, midwifery, obstetrics, neonatology, paediatrics, general practice and public health services met yesterday to consider ways of highlighting the harm caused by the in utero exposure of babies to tobacco smoke.

Forum participants agreed that achieving smokefree pregnancies would be a key driver of tobacco control and maternity care policies in the future. Priorities for action were increased professional and public awareness of the dangers, and assistance for parents to become smokefree.

Smoking in pregnancy is the single biggest preventable cause of pregnancy complications, including miscarriage, preterm birth and stillbirth. Each year around 18,000 unborn babies are exposed to poisonous tobacco chemicals in the womb.

Stephanie Cowan, Director of forum-organisers Education for Change, said it was critical that babies had the chance to grow and develop normally during the nine months of pregnancy.

“The chemicals in tobacco smoke cross the placenta, damaging it in the process. Tobacco-exposed placentas do not work as well as they should, meaning that the baby’s supply of food and oxygen is restricted. As a result the pregnancy may end in miscarriage or stillbirth or the baby may be born early and struggle to survive.”

She said that despite being the main preventable cause of adverse outcomes for pregnancy and child health, smoking in pregnancy was treated more as a social issue than a health one, by parents and health professionals alike.

“Smoking in pregnancy causes a whole raft of problems – infertility, placental problems, pregnancy complications, intra-uterine growth restriction, preterm births, stillbirths, sudden infant death syndrome, bronchioloitis, asthma, glue ear, hospital admission, learning and behavioural difficulties and more.”

She said that Education for Change and health groups would now focus on raising awareness of smoking in pregnancy risks and supporting parents to be smokefree.

“The forum was only the first step. We want to see smoking in pregnancy having a profile to match its place as the number one way to protect the life and health of children, with associated increased resourcing. ”

Education for Change

The smokefree pregnancy forum was organised by Education for Change, which provides health-funded education services to health professionals to prevent sudden death in infancy, address smoking in pregnancy and infancy, and support systems level smokefree change in hospitals and health care services. Education for Change also provides services to support families achieve a smokefree start to life for their children.

For more information about Education for Change, please visit, or e-mail Director Stephanie Cowan can be contacted at, or phone 03 379 9947 mobile 027 6499 428.

Purpose of the forum

This was the first smokefree pregnancy forum ever to be held in New Zealand. Its purpose was to raise professional awareness of the frequency, severity and varied effects of tobacco-induced fetal damage and its enormous contribution to death and disease among babies and young children. The multidisciplinary group attending the forum included leaders from fertility, midwifery, obstetrics, neonatology, paediatrics, general practice and public health services.


How does exposure to tobacco smoke in utero cause SIDS?

Smoke damages unborn babies in all sorts of ways. For example, babies used to smoke also get used to low levels of oxygen. They are born with blunted arousal (wake-up) responses. Arousal is an important defence against danger if there are breathing problems during sleep. Babies with normal arousal responses are safer from SIDS.

How many babies are affected by smoking in pregnancy?

Each year 18 000 pregnancies and more than 90 000 preschool children are exposed to tobacco smoke.

Is second-hand smoke breathed in during pregnancy also harmful to the baby?

Yes. There is a dose effect of increased harm from increased exposure to smoke.

What is in tobacco smoke?

Tobacco smoke contains over 4000 chemicals. These include:

- Nicotine used in insecticides
- Carbon monoxide found in exhaust fumes
- Ammonia found in floor cleaner
- Arsenic found in rat poison.

Carbon monoxide is the most dangerous toxin for an unborn baby.

How can we reduce the pre-birth exposure of babies to tobacco smoke?

A smokefree pregnancy is the only way to protect an unborn baby. We must work with parents, not against them, being mindful of the demanding influence of nicotine addiction and the desire of parents to do the best for their children.

When parents understand how smoking restricts the food and oxygen available to their baby in pregnancy, when they understand how smoking damages the young child’s airways making breathing more difficult, then it is easier for them to see smoking as their enemy, not friend. Parents wanting support to become smokefree are encouraged to talk with their midwife, doctor or nurse.

What actions would you like to see taken to reduce the number of tobacco-exposed pregnancies?

That every person in New Zealand knows about the effects on babies of smoking in pregnancy, and every pregnant woman and partner be supported to become and/or stay smokefree by their families and health care professionals.


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