What to expect when you're expecting (32 page)

But the news isn’t all bad. Some studies show that women who quit smoking early in pregnancy—no later than the third month—can eliminate all of the associated risks. For some smoking women, quitting will never be easier than in early pregnancy when they might develop a sudden distaste for cigarettes—probably the warning of an intuitive body. Sooner is better, but quitting even in the last month can help preserve oxygen flow to the baby during delivery.

If you’re concerned that quitting will cause you to gain extra weight, keep in mind that although there is no evidence that smoking actually keeps weight down
(many smokers are overweight, after all), it is true that some smokers gain weight while in the process of quitting. Interestingly enough, those who gain some weight while trying to break the smoking habit are more likely to succeed—and they find it fairly easy to drop those few pounds later. Trying to diet while trying to quit usually leads to failure in both arenas. What’s more, dieting while growing a baby is never a good idea. So though you should definitely pack away the cigarettes for good, don’t worry if you start packing on a few more pounds than you otherwise would have. There’s never been a better reason for both.

Since nicotine is an addictive drug, most people experience withdrawal symptoms when they quit smoking, though the symptoms and their intensity vary from person to person. Besides the obvious craving for tobacco, some of the most common symptoms are irritability, anxiety, restlessness, tingling or numbness in the hands and feet, lightheadedness, fatigue, and sleep and gastrointestinal disturbances. Some people also find that both physical and mental performance are impaired at first. Most find that they initially cough more, rather than less, because their bodies are suddenly better able to bring up all the secretions that have accumulated in the lungs.

To try to slow the release of nicotine and the jitteriness that may result, avoid caffeine, which can add to the jitters. Get plenty of rest (to counter fatigue) and exercise (to replace the kick you used to get from nicotine). Avoid activities that require a lot of focus and concentration if you find you’re in something of a fog, but keep busy by doing mindless tasks. Hanging out wherever smoking is prohibited by your state laws may also help. If you experience serious depression as part of withdrawal, talk to your practitioner immediately.

The worst effects of withdrawal will last a few days to a few weeks. The benefits, however, will last a lifetime—for you and your baby. See box, previous page, for more tips on how to quit.

“I don’t smoke, but my husband does. Will this hurt our baby?”

Smoking doesn’t affect just the smoker. It affects everyone around him, including a developing fetus whose mother happens to be nearby. So if your spouse (or anyone else you spend time with) smokes, your baby’s body is going to pick up nearly as much contamination from tobacco smoke by-products as if you were lighting up.

If your spouse says he can’t quit smoking, ask him to at least do all his smoking out of the house, away from you and the baby (but remember that smoke and its by-products will stick to his clothes and skin, which means you’ll still get some exposure to them). Quitting, of course, would be better, not just for his own health, but also for the baby’s long-term well-being. Parental smoking—mother’s or father’s—increases the risk of SIDS in infancy, of respiratory problems at all ages, and of damage to the lungs even into adulthood. And it ups the chances that your children will become smokers one day.

You probably won’t be able to get friends and other relatives to kick the habit, but you may be able to get them to curb their smoking around you (otherwise, you’ll have to spend less time around them). Keeping smoking coworkers out of your breathing space will be easier to do if there are laws protecting nonsmokers in your workplace (many states have such laws). If the law isn’t on your side, try tactful persuasion—show them this section on the dangers of secondhand smoke to a fetus. If that fails, try to get a regulation passed where you work that limits smoking to certain areas, such as a lounge, and prohibits smoking in the vicinity of nonsmokers. If all else fails, try to move your work space for the duration of your pregnancy.

“I smoke pot occasionally—basically only socially—and have for years. Could this have caused harm to the baby I’m now carrying. And is smoking pot during pregnancy dangerous?”

You can safely put past pot behind you. While it’s usually recommended that couples trying to conceive pass on pot because it can interfere with conception, you’re already pregnant—so that won’t be a problem for you. And there’s no present evidence that the marijuana you’ve smoked before you conceived will harm your fetus.

But now that you’re pregnant, it’s time to get off the pot. All the research isn’t in yet, and the research that has been done so far isn’t the most helpful kind. That’s because it’s hard to study marijuana use—like many lifestyle choices—in a vacuum. Often those who smoke pot during pregnancy are also drinking alcohol, smoking cigarettes, or using other drugs, making the data inconclusive (is it the pot or the beer or the cigarettes that resulted in a poor fetal outcome?). Other times, pregnant women who smoke marijuana may have less than optimal prenatal care, so it’s hard to know whether a bad outcome came from the pot or the lack of prenatal care. What is known so far about marijuana use during pregnancy is that the drug passes through the placenta, which means that when you smoke pot, you’re sharing it with your unborn baby. Some studies show that marijuana use is associated with poor fetal growth and babies born small for gestational age; other studies show no such relationship. Still other studies have shown even more negative effects—from tremors and withdrawal-like crying during the newborn period to attention, learning, and behavioral problems later on in childhood.

With no sure proof that it’s safe to smoke pot during pregnancy—and some evidence that suggests it may be quite harmful—it’s wise to treat marijuana as you would any other drug during pregnancy: Just say no.

If you have already smoked early in your pregnancy, don’t worry. But if you’re tempted to continue using it, try some of the suggestions for quitting tobacco (and alcohol)—kicking one addiction is similar to kicking another. Focus especially on healthy forms of relaxation that’ll net you that natural high (yoga, meditation, massage, even endorphin-releasing exercise). If you can’t seem to stop smoking pot, speak to your practitioner or seek other professional help as soon as possible.

“I did some cocaine a week before I found out I was pregnant. Now I’m worried about what that could have done to my baby.”

Don’t worry about past cocaine use; just make sure it was your last. On the upside: A single use of cocaine before you found out you were pregnant isn’t likely to have had any effect. On the downside: Continuing to use it during pregnancy could be dangerous. How dangerous isn’t quite clear. Studies on cocaine use during pregnancy aren’t that easy to interpret, mostly because cocaine users are often also smokers—which means that it’s difficult to separate the probable negative effects of cocaine use from the documented negative effects of smoking. What numerous studies have shown is that cocaine not only crosses the placenta once it develops, but it can damage it, reducing blood flow to the fetus and restricting fetal growth, particularly that of the baby’s head. It is also believed to lead to birth defects, miscarriage, premature labor, low birthweight; jitteriness and withdrawal-like crying in the newborn; as well as numerous long-term problems for a child, including neurological and behavioral problems (such as difficulty with impulse
control, with paying attention, and with responding to others), motor development deficits, and possibly lower IQ scores later on in childhood. Certainly, the more often an expectant mother uses cocaine, the greater the risk to her baby.

Tell your practitioner about any cocaine use since you’ve conceived. As with every aspect of your medical history, the more your doctor or midwife knows, the better care you and your baby will receive. If you have any difficulty giving up cocaine entirely, seek professional help immediately.

Pregnant women who use drugs of any kind—other than those that have been prescribed by a physician who knows they are pregnant—are putting their babies at risk. Every known illicit drug (including heroin, meth, crack, Ecstasy, “ice,” LSD, and PCP) and many prescription drugs that are often abused (including narcotics, tranquilizers, sedatives, and diet pills) can, with continued use, cause serious harm to a developing fetus and/or to your pregnancy. Check with your practitioner or another knowledgeable doctor about any drugs you’ve used during pregnancy. Then, if you are still using drugs, get professional support (from a certified addiction counselor, an addictionologist, or a treatment center) to help you quit now. Enrolling in a drug-free-pregnancy program now can make a tremendous difference in the outcome of your pregnancy.

“I spend hours a day on my cell phone. Could this have any effect on my baby?”

Look who’s talking (on the cell phone): practically everyone. And luckily, there’s no need to put your cell out of service now that you’re talking for two. No pregnancy risks have ever been suggested from cell phone use. And there are plenty of good reasons to keep connected to your cell phone—it can allow you to be available for that call from the doctor or midwife you can’t wait for at home, to make consultation appointments with pediatricians while you’re waiting at the obstetrician’s, to alert a spouse at the first signs of labor when you’re nowhere near a landline. A cell phone may also allow you to be more flexible in your workday and in the amount of time spent chained to a desk (which might result in more time for needed rest and relaxation or baby preparations).

That said, cell phones aren’t completely risk free. Driving while talking on a handheld cell phone is unsafe—at any speed and under any circumstances (and illegal in some areas)—particularly when the hormone-induced fog of pregnancy leaves you more easily distracted than usual. Even a hands-free phone conversation can be risky if it takes your attention off the road. Play it smart and pull over to a safe area before placing your calls.

“I use my microwave practically every day to heat up food or even cook. Is microwave exposure safe during pregnancy?”

Amicrowave oven can be a mother-to-be’s best friend, helping to make healthy eating-on-the-run possible—with a minimum of effort and cooking odor. And happily, all the research indicates that microwaves are completely safe to use during pregnancy (and at all other times). Two sensible precautions: Use only cookware that is specifically manufactured for use in the microwave, and don’t let plastic wrap touch foods during microwaving.

“We have a hot tub. Is it safe for me to use it while I’m pregnant?”

You won’t have to switch to cold showers, but it’s probably a good idea to stay out of the hot tub. Anything that raises the body temperature over 102°F and keeps it there for a while—whether it’s a soak in a hot tub or an extremely hot bath, or an overzealous workout in hot weather—is potentially hazardous to the developing embryo or fetus, particularly in the early months. Some studies have shown that a hot tub doesn’t raise a woman’s temperature to dangerous levels immediately—it takes at least 10 minutes (longer if the shoulders and arms are not submerged or if the water is 102°F or less). But because individual responses and circumstances vary, play it safe by keeping your belly out of the hot tub. Feel free, however, to soak your feet.

If you’ve already had some brief dips in the hot tub, there is probably no cause for concern. Most women spontaneously get out of a hot tub before their body temperatures reach 102°F because they become uncomfortable. It’s likely you did, too. If you are concerned, however, speak to your practitioner about the possibility of having an ultrasound exam or other prenatal test to help put your mind at ease.

Lengthy stays in the sauna or steam room aren’t smart, either. A pregnant woman is at greater risk for dehydration, dizziness, and lower blood pressure in general, and these are all symptoms that may be exacerbated by such extreme heat. And as with a hot tub, pregnant women should avoid anything that might potentially raise their body temperatures.

For more information on the safety of other types of spa treatments (massage, aromatherapy, and so on), see
page 147
.

Is Hot Stuff Not So Hot?

Considering cuddling up with an electric blanket when the winter chill sets in? Or easing that achy-breaky back with a heating pad? Too much heat isn’t so hot when you’re pregnant, since it may raise your body temperature excessively. So cuddle up to your sweetie instead of that electric blanket (or if his tootsies are as icy as yours, invest in a down comforter, push up the thermostat, or heat the bed with an electric blanket and then turn it off before you turn in). Still feeling the chill. Keep in mind that as the months pass, you’ll probably be keeping yourself so warm—thanks to a pregnancy-boosted metabolism—that you’ll be kicking off all your covers anyway.

As for that heating pad, wrap it in a towel before you apply it to your back, belly, or shoulders to reduce the heat it passes along (an ankle or knee can take the heat), keep it at the lowest setting, limit applications to 15 minutes, and avoid sleeping with it. Already spent some time under that electric blanket or heating pad? Not to worry—there’s no proven risk.

“I have two cats at home. I’ve heard that cats carry a disease that can harm a fetus. Do I have to get rid of my pets?”