Please God, allow her to see the way home. Awaken her to the realization that by filling the beautiful, beautiful brain you gave her with knowledge and understanding, that she can easily become vastly wiser than her dependency is strong.
Are you feeling a "fierce urgency of now" because of a developing life within? Do you fear that your chemical dependency will harm or destroy it? For nicotine addicts, especially smokers, news of pregnancy is often an emotional train wreck.
Why "Quitting for the Baby" Fails
Upon learning she's pregnant - often within minutes - the mother-to-be makes the biggest mistake of her pregnancy and life. Instead of accelerating her personal long-held dream of someday breaking free, she decides to "stop for the baby."
But how can something that sounds so right be so destructively wrong?
Only about half of women "claim" they were successful in ending nicotine use during their pregnancy.[1] Sadly, the real figure is probably closer to a third.
Researchers conducting third-trimester blood tests on women who claimed to have stopped smoking found that 25 percent lied.[2] But why do so few succeed?
Stopping for others, including the unborn, is a formula for relapse.[3]
It means spending an entire pregnancy either feeling deprived of smoked, vaped or chewed nicotine, or gradually growing numb to the fears of harm that the fetal teratogen and developmental neurotoxin nicotine will inflict, and eventually surrendering to it.
What logic is there in making this "the baby's" recovery instead of its mother's? Stop for the baby?
Is it the baby who needs help or a mom-to-be who for years has been destroying her insides and committing slow suicide by many times daily inhaling smoke's hundreds of tissue-damaging toxins?
If only she had to wear on the outside the damage already done within.
Why feel deprived and denied when you can reclaim, award, and bestow? Why invite reluctance and dread to defeat confidence, freedom, and wonderful?
And it's true. Being home again is vastly more incredible than an addict's endless dopamine wanting/use cycle allows them to remember or sense. A hallmark of addiction, it's a cycle that long ago buried all memory of the tranquility of life as you.
The choices? Choice "F"? Envision every waking hour of your pregnancy either battling or surrendering to urges and wanting for smoked, vaped, or chewed nicotine.
Choice "A"? Visualize a temporary journey of re-adjustment which leads to Easy Street; to the beginning of entire days where a calm and quiet mind never once thinks about wanting to use.
"Quitting for the Baby" Stories
Assume for a moment that you were able to stop "for the baby." No longer in harm's way, will the precious seconds surrounding childbirth be soured by fixation upon relapse?
Instead of savoring life's richest moments, will you be plotting the toxic act that will substantially shorten both your life and motherhood?
During delivery, will you get hammered hard by the use-cycle delusion that smoking is a stressbuster? Will each contraction and push birth thoughts that you've sacrificed long enough, that the danger of harming the baby is about to end?
Can you see how months of feeling pushed, robbed, deprived, forced, or compelled to stop "for the baby" makes pregnancy cessation vastly harder and far more unlikely?
The harsh truth? Doing it "for the baby" may as well be an open declaration that, "Hey, this child is going to have an actively feeding drug addict for a mom!"
These are quotes from e-mails I received. Most show where a "quitting for the baby" mindset leads:
- "I am 33 years old. I started smoking at age 13 and of course, never thought I would still be a smoker 20 years later, and a pack to a pack and a half each day. I stopped for nine months while I was pregnant and could not wait for the entire pregnancy for just one cigarette. The minute I was home from the hospital I started again."
- "I stopped smoking each time I found out I was pregnant, but right after they were born I was back to a pack a day."
- "I'm 38 years old with three children and have smoked since I was 17, stopping when pregnant only to re-light within hours of giving birth."
- "I started smoking at 13 (well I couldn't draw back like all the other girls) but by the time I was 14, I was smoking at every opportunity. The only time I stopped smoking is whilst I was pregnant and breastfeeding. Then, as soon as my babies weaned, I started again."
- "When I was pregnant with my first child I gave up smoking as soon as I found out, the same for the second pregnancy. My mistake is I started back up. I'm stopping smoking today even though I'm about to wean my daughter."
- "My daughter is 5 months pregnant and still smokes occasionally. Actually I don't know how much she smokes. For someone who is trying to be so protective of her unborn child, she isn't. She is an intelligent person but putting her baby at risk."
- "I am concerned about my neighbor's smoking. She is pregnant again but still smokes. She was smoking while pregnant with her 1st son who is 4 years old now and deaf."
Approximately half of women who stop smoking during pregnancy relapse within six months of giving birth.[4] Adding it all up, it means that, unbelievably, only about 1 in 5 women who smoked at conception will experience the joys of smoke-free motherhood.
It means that 4 out of 5 babies are forced to bond to the thousands of smoke chemicals deposited upon mom's hair, skin, and clothing.
Imagine your baby feeling extremely comfortable in the arms of a smoker off the street, especially one who smokes your brand. Imagine your newborn never knowing its mother's natural scent and fragrance.
As these email quotes suggest, the reasons given in trying to justify relapse after childbirth vary greatly:
- "I am an attractive, 39-year-old professional yuppie turned new mom who has been hiding it and in the closet for many years. I stopped successfully when I found out I was 2 weeks pregnant and then started during a brief bout of postpartum depression when my baby was 6 weeks old and I had stopped nursing. I was back to smoking a half a pack to a pack a day."
- "I am addicted to nicotine gum. I stopped smoking and started chewing the gum. Then I got pregnant with my daughter and stopped chewing the gum. My mother died right after my daughter was born, so I started smoking again. Three months later, I stopped using cigarettes and started with the gum again. I finally ended gum use in January of 2003. I was totally nicotine-free for about 18 months when my sister-in-law gave me a cigarette. I figured I could handle just one" "I bought a pack the next day. Now, I'm stuck on the gum again...no pun intended."
Driven by significant and very real risks, these women were able to temporarily suspend nicotine use. Then, postpartum depression and a mother's death were used as relapse justifications. Although not mentioned, it's highly unlikely that relapse and active drug addition improved either situation.
Nicotine-Free Motherhood
Pregnancy is a golden opportunity. It's a period during which a mind, body, and life can be clean, healed, and reclaimed in order to prepare for the blessings of nicotine-free motherhood.
Instead, roughly 4 of 5 pregnant smokers spend their pregnancy somewhere between the grips of penetrating guilt over the harms use continues to inflict, and a growing sense of self-deprivation, which they'll satisfy shortly after giving birth.
Let's be clear, it's normal and natural to want to stop for the baby. The risks of harm are tremendous. It isn't a matter of whether or not nicotine will damage the fetus but how bad and noticeable the damage will be.
In fact, the risks are so huge that the fears flowing from them consume reason, logic, and common sense.
Before learning they were pregnant, most women had their own dream of someday stopping smoking, at a time, place, and manner of their choice. But now, gripped by worry of harm to the developing life inside, it's a dream instantly forgotten.
Instead of seeing here and now as the perfect time to live that dream, it's abandoned in favor of self-sacrifice for the innocent preciousness within.
Their dream obliterated by fear, some are able to temporarily suspend use for the benefit of the fetus while others do not. Those that don't are forced to invent new nicotine use rationalizations in order to suppress the harms being inflicted. Here are two e-mail examples.
- "My daughter just found out that she is pregnant and she smokes. She was going to just stop but then a midwife told her that if she did, her fetus would go into shock and that she should just taper off."
- "I did attempt to stop when I found out I was pregnant the first time, but after thinking about all the people I knew who smoked while pregnant and had normal kids, I kept right on smoking." "I kept my mouth shut, as I had lied to the doctor and the hospital about smoking."
There's also the rationalization that "stopping for the baby is just too hard." And this one is true. Whether attempting to quit for the father, your doctor, a parent, or best friend, the challenge is vastly greater when trying to quit for others.
Think about the day-to-day agony and anxiety endured by these women. Imagine the disapproving stares and verbal abuse by those who notice them smoking. Society's disdain only heightens focus upon quitting for others, including the baby.
- "I am 8 weeks pregnant and have been struggling with stopping for some time. Even before my pregnancy, I was trying to stop. The scariest part for me is the anxiety it creates. Is it dangerous to go through withdrawal cold turkey?"
- "I am 26 years old. I'm 9 weeks pregnant. I've smoked a pack a day for 11 years. I've tried to stop 3 times now in 4 weeks and blown it every time. I am down to about 3-5 cigarettes a day. I am worried about my baby and I have smoked through the whole thing. I am trying to stop again. It has been about 12 hours without a smoke."
- "I am a 22-year-old female who is currently 32 weeks along in my pregnancy. I feel that the reason why I haven't stopped is just that! I am deathly afraid of the feeling of withdrawal."
As suggested by the first two women, one can only live in fear for so long before growing numb to it. If this isn't "your" recovery but instead a temporary pause for the baby, how long before that deprived feeling overwhelms diminishing fears? And how much anxiety and guilt will relapse bring?
As for the third woman, her fear of withdrawal is normal and natural. Years of being able to satisfy an urge or crave within seconds of smoking conditioned her to fear holding out longer.
What thousands of old urge satisfaction memories (dependency's bars) prevent her from seeing is that the only path to permanently ending wanting for more is in mustering the courage and commitment to say "no" to it.
Recovery
What's difficult to appreciate is that recovery is good and wonderful not bad. While true that increased estrogen is causing nicotine to be eliminated from the bloodstream faster than normal, thus increasing the need and desire to replenish,[5] within 3 days of ending use withdrawal will peak in intensity and then begin to gradually decline.
The period of greatest challenge will have passed.
Within 2 to 3 weeks, the brain will have substantially completed restoring neurotransmitter sensitivities and counts. Although the tease of thousands of old nicotine replenishment memories will continue to be felt, those memories were created by and belonged to an actively feeding drug addict whose blood-serum nicotine reserves were always on the decline.
Truth is, after that, the balance of recovery is nearly all psychological, as there is nothing missing and nothing in need of replacement.
By then, relapse would not match expectations. There will not be an underlying "aaah" wanting relief sensation as the brain had fully adjusted and nothing was missing.
But lapse would immediately re-fire dependency's engines. Nicotine drenched dopamine pathways would re-assign using again, the same priority as that circuitry assigns to eating food.
While most who attempt cheating when quitting walk away feeling like they've gotten away with it, brain scans show that just one puff and up to 50% of dopamine pathway receptors become occupied by nicotine. And it won't be long before the cheater finds their brain wanting, plotting to get, or even begging for more.
Additionally, the circumstances of lapse will be documented in high-definition memory, breathing life into thousands of old use memories that will, in the short-term (the time needed for recovery) make lapse nearly impossible to forget.
The expected "aaah" missing at the moment of lapse, her focus will instead turn to the sensations felt when scores of smoke toxins strike healing tissues, and carbon monoxide invades what was an oxygen-rich mind.
The toxic assault will likely compel her dizzy and disrupted mind to turn its focus to her now failed goal of "stopping for the baby." She'll wonder whether the burning sensations generated by carbon monoxide, hydrogen cyanide, arsenic, sulfur, ammonia, and formaldehyde are also burning her unborn.
But it's too late. Once nicotine is inside, relapse is all but assured, with more assaults and guilt to follow.
- "Unfortunately, I have given in and I had my first cigarette in 10 months yesterday. I had another today and now I'm feeling absolutely horrible about it. I am breastfeeding and I would like to continue breastfeeding without harming my child."
- "I am 41 years-old and smoked a pack a day since I was 15 years old, with the exception of 9 months when I pregnant (started right up again the day after she was born). I hated myself for failing. I hated the way I smelled. I hated "sneaking" a smoke to get through the day. I hated the disgusted looks of people walking by me as I huddled outside my office building sucking on that disgusting thing, rain or shine, cold or hot. I hated myself for hurting my daughter - thinking for sure, unless I could find the strength and courage to stop that my daughter would lose her mother."
Valid Nicotine Harm Concerns
Let's not kid ourselves. The draw of quitting for the baby instead of you is huge. In fact, once pregnant it's impossible to avoid hearing how damaging smoking and nicotine are. So let's get it out-of-the-way now. Let's acknowledge fetal risks in order to drive home the point that fetal toxin harms will continue unless healthy motherhood dreams are put first.
As you read, reflect on a simple truth. Unless coming home and staying clean and free are embraced, the baby's quality time with its new mom will be constantly interrupted by an addict's never-ending need to replenish missing nicotine.
The late Dr. Heinz Ginzel was my friend, a physician, and a retired University of Arkansas pharmacology and toxicology professor. He devoted decades to the study of nicotine.
In researcher speak/talk, Dr. Ginzel was deeply concerned over "fetotoxicity and neuroteratogenicity that can cause cognitive, affective and behavioral disorders in children born to mothers exposed to nicotine during pregnancy."[6] This is his message to expectant mothers:
"To set the stage, one has to recognize that nicotine interacts with the very basic functions of the peripheral and central nervous system, i.e., the nerves supplying organs and tissues of the body and the vital command stations in the brain. When these systems are formed during fetal life, the nicotine the mother is exposed to from smoking, secondhand smoke or NRT will impair their normal development."
"Such impairment can manifest itself in a variety of symptoms depending on the site, time and intensity of nicotine action. Here are a few examples: The notorious "Sudden Infant Death Syndrome" or SIDS has been traced to prenatal and/or postnatal nicotine exposure. Nicotine exposure is responsible for cognitive and learning deficits in children as well as affective and behavioral problems such as 'Attention Deficit Hyperactivity Disorder' (ADHD), with displays of unruliness and aggression."
"Neonatal nicotine exposure impairs so-called auditory learning, a very specific lifelong handicap. Prenatal nicotine also primes the developing brain for depression and for nicotine addiction in adolescence. Wrongly believing or being told that NRT is risk-free, pregnant smokers who would have stopped during pregnancy may begin using NRT throughout pregnancy."
"As a consequence, intelligence expressed by I.Q. standards may decline in their offspring, but as larger segments of the population are affected, this decline may not be readily discernible."[7]
Are you realizing the importance of making your #1 recovery priority "you," and allowing your baby to inherit the fruits of mom's wisdom? Still, given Dr. Ginzel's fetal nicotine risks review, it's easy to see why such a massive percentage of women make the mistake of "stopping for the baby."
Duke Medical University Professor Theodore Slotkin is probably the world's current leading nicotine toxicology researcher. He's deeply concerned that nicotine, including replacement nicotine, may cause as much or more harm to the developing fetus than crack cocaine.[8]
According to Professor Slotkin, "NRT, especially by transdermal patch, delivers more nicotine to the fetus than smoking does." "Studies have found that the brains of fetal mice wound up with 2.5 times higher nicotine concentrations than found in the mother's blood when on a slow continuous nicotine feed, as would be the case with the nicotine patch."[9]
The patch's continuous delivery of nicotine is believed to somehow overwhelm and saturate the ability of the placenta to perform limited nicotine filtering.
In 2008, Professor Slotkin wrote that "nicotine by itself is able to reproduce the net outcome from tobacco smoke exposure; that is not to say that the other components are not injurious, but rather, the replacement of tobacco with NRT is likely to produce less improvement than might otherwise be thought, and as shown above, may actually worsen some of the critical outcomes."[10]
What does Slotkin think about nicotine altering normal fetal brain development, as discussed by Dr. Ginzel? A 2013 article quotes Professor Slotkin as saying, "It would be the equivalent of trying to play this piano piece and some clown comes along with a chunk of two-by-four and slams a bunch of keys down and holds them down."[11]
Vaping E-cigarettes
Research suggests that vaped nicotine is destructive too. Quoting from a 2019 journal article in Tobacco Induced Diseases: "[T]here is a growing body of experimental studies in animals that suggest that nicotine in electronic nicotine delivery systems alters DNA methylation, induces birth defects, reduces the birth weight, and affects the development of the heart and lungs of their offspring."[12]
Lifetime Regret
Ponder the collective regret of the countless mothers whose intense focus on protecting the baby actually resulted in harming them.
- "I learned first-hand the results of smoking during pregnancy. I had taken lightly my responsibility to him and I will always regret it."
- "My son was born at a comparatively low birth rate, and notably, his umbilical cord, instead of a healthy red color, was a sickly, puss-like shade of yellow. It was not thick and healthy, but tapered and became thinner toward where it was attached to him."
- "So, now my second son is two-and-a-half with developmental delays, and my four-year-old has Attention Hyperactivity Disorder, with extreme emphasis on the hyperactivity part. I know in my heart that I probably caused these problems but I keep finding other excuses."
- "I smoked very little during my first pregnancy. My child has allergies and catches bronchitis very easily. With my second child I stopped smoking during pregnancy. My husband began smoking again and so did I. When I began breastfeeding after the birth it became another concern for me. I tell myself that it's not hurting the baby, but in my mind it bothers me."
And what will the child say?
- "I hate, hate, hate cigarette smoking, secondhand smoke and smokeless tobacco! My mother smoked while she was pregnant (both times) and smoked until I was 17 years old. I was born with a head tumor which continues to give me trouble after two surgeries and more than 35 years of life."
- "My mother smoked, even when pregnant with me. So I guess, being born that way, I've always been addicted to nicotine." "At age 22, my mother died of a sudden and massive stroke caused by hypertension, elevated by smoking. That's exactly what was put on the coroner's report. Even then, I kept smoking."
Liberty's Blessings
Are you sensing the importance of embracing recovery as your own loving gift of "you" to "you"?
Can you see that all fears of fetal harm are best and well served by celebrating pregnancy as a golden opportunity to reclaim your mind, priorities, hands, time, mouth, coins, lungs, emotions, health, freedom and life?
Now, together with these mothers, picture your new baby basking in liberty's blessings.
- "I am very happy to say that I have been nicotine-free for six months now! My kids have not missed any days of school this year. I have started to workout three times a week. I feel better. Most people tell me I look a lot better. My house and car are cleaner. I am so glad I stopped."
- "Now, although I still know I am an addict, I concentrate on keeping my recovery alive by celebrating my freedom. One thought I find very heartening is that I am doing "easy time." Compared with the first days, it is so easy for me not to smoke today. Most of the costs have gone, but I still get the benefits. Smoking is expensive in the UK, and so far I have saved £14,000 (that's U.S. $27,500)! I save so much I can easily justify a weekend away on my annual stopping anniversary. Best of all, I have a 10 week-old son who has a smoke-free mom."
- "I had stopped with my previous pregnancies (three older daughters), but I picked it right back up again with ferocity. After each failure I increased my nicotine intake more and more. At 2 to 2 1/2 packs a day, I saw not much hope for an end. But this pregnancy scared me. Now, I was much older and this baby was counting on me to not just stop during my pregnancy, like with the sisters, but for the rest of my life. I visited WhyQuit and read, and read, and read. I finally learned WHY every time I had picked them back up again in my postpartum periods. I was still in post acute withdrawal. Riddled with anxiety, I did not approach stopping with a recovery mind-set but with a 'suspended sentence' on smoking. For our fifteenth anniversary, I gave my husband another daughter ... and a nicotine-free wife."
Regarding postpartum depression, ready yourself for the possibility. Findings from studies analyzing how often it occurs vary greatly depending on where the women studied lived, the study's definition of depression, and whether or not the results included women who were experiencing depression before giving birth.
Among studies reporting new cases of depression arising after childbirth, 6.9% of 280 new moms in Israel reported postpartum depression at 6 weeks,[13] 12.5% among 1,584 Swedish women at 8 weeks, which declined to 8.3% by 12 weeks,[14] 5.8% among 465 Wisconsin women between months 1 and 4,[15] and 3.7% of 403 Minnesota woman during the first year following childbirth.[16]
If depressed following childbirth be sure and let your doctor know. Postpartum depression is not some character flaw or weakness but as real as the nose on our face.
It's believed to be associated with a large increase in progesterone-derived neuro-steroids during pregnancy, and its sharp decline following childbirth, which may have significant effects on GABA receptors.[17]
Emerging research suggests that these receptors could be a path to effective treatment.[18] Clearly, what no physician on earth will suggest as a treatment course is relapse to the highly addictive, fetal teratogen nicotine.
As for replacement nicotine, even its most vocal advocates are forced to admit that, "there is no evidence that NRT is actually effective for smoking cessation in pregnancy."[19]
It's my hope that this article has helped alert you to the importance of knowledge and understanding as extremely effective recovery tools. The highest known pregnancy cessation rates continue to be associated with "counseling and behavioral interventions."[20] It's what I refer to as "smart turkey."
It's my dream that you'll continue reading and discovering, that you'll allow the magic unfold as your nicotine-free body heals, mends and repairs, while at the exact same time growing a healthy new life within.
Baby steps, just here and now, these next few minutes, yes you can! And there's only one rule ... no nicotine just one hour, challenge and day at a time!
References:
2. George L, et al, Self-reported nicotine exposure and plasma levels of cotinine in early and late pregnancy, Acta Obstetricia Gynecologica Scandinavica, 2006, Volume 85(11), Pages 1331-1337.
3. Spitzer, J, Quitting for Others, WhyQuit.com, Joel's Library, 1984.
4. Colman GJ, et al, Trends in smoking before, during, and after pregnancy in ten states, American Journal of Preventive Medicine, January 2003, Volume 24(1), Pages 29-35; Kaneko A, et al, Smoking trends before, during, and after pregnancy among women and their spouses, Pediatrics International, June 2008, Volume 50(3), Pages 367-375.
5. Ebert L1, van der Riet P, Fahy K, What do midwives need to understand/know about smoking in pregnancy? Women and Birth, March 2009, Volume 22(1), Pages35-40.
6. Ginzel KH, et al, Critical review: nicotine for the fetus, the infant and the adolescent? Journal of Health Psychology, March 2007, Volume 12(2), Pages 215-224.
7. Ginzel, KH, Why do you smoke? WhyQuit.com, February 6, 2007.
8. Slotkin TA, Fetal nicotine or cocaine exposure: which one is worse? The Journal of Pharmacology and Experimental Therapeutics, June 1998, Volume 285(3), Pages 931-945.
9. Slotkin, TA, e-mail from Professor Slotkin to John R. Polito, January 8, 2006.
10. Slotkin, TA, Slotkin, If nicotine is a developmental neurotoxicant in animal studies, dare we recommend nicotine replacement therapy in pregnant women and adolescents? Neurotoxicology and Teratology, Jan-Feb 2008, Volume 30(1), Pages 1-19.
11. Morning Edition by Hamilton, Jon, In pregnancy, what's worse? Cigarettes or the nicotine patch? NPR (National Public Radio) Health News, November 25, 2013
12. Cardenas VM et al, The use of electronic nicotine delivery systems during pregnancy and the reproductive outcomes: A systematic review of the literature, Tobacco Induced Diseases, July 2019, 17:52. doi: 10.18332/tid/104724.
13. Glasser S et al, Prospective study of postpartum depression in an Israeli cohort: prevalence, incidence and demographic risk factors, J Psychosom Obstet Gynaecology, Sept 1998, Volume 19(3), Pages 155-164. doi: 10.3109/01674829809025693.
14. Wickberg B and Hwang CP, Screening for postnatal depression in a population-based Swedish sample, Acta Psychiatrica Scandinavica, Jan. 1997, Vol. 95(1), Pages 62-66. doi: 10.1111/j.1600-0447.1997.tb00375.x.
15. Chaudron LH et al, Predictors, prodromes and incidence of postpartum depression, Journal of Psychosomatic Obstetrics and Gynaecology, June 2001, Volume 22(2), Pages 103-112. doi: 10.3109/01674820109049960.
16.Bryan TL et al, Incidence of postpartum depression in Olmsted County, Minnesota. A population-based, retrospective study, The Journal of Reproductive Medicine, April 1999, Volume 44(4), Pages 351-358.
17. Maguire J, et al, GABA(A)R plasticity during pregnancy: relevance to postpartum depression, Neuron, July 31, 2008, Volume 59(2), Pages 207-713.
18. Nemeroff CB, Understanding the pathophysiology of postpartum depression: implications for the development of novel treatments, Neuron, July 31, 2008, Volume 59(2), Pages 185-186.
19. Coleman T, Recommendations for the use of pharmacological smoking cessation strategies in pregnant women, CNS Drugs, 2007, Volume 21(12), Pages 983-993.
20. Crawford JT, et al, Smoking cessation in pregnancy: why, how, and what next..., Clinical Obstetrics and Gynecology, June 2008, Volume 51(2), Pages 419-435.
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