10 Risks of Smoking Before and During Pregnancy

As of Dec. 20, 2019, the new legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S.

Cigarette smoke is a toxic mix of more than 7,000 chemical compounds, 250 of which are known to be poisonous and 70 that can cause cancer. Air tainted with secondhand smoke is dangerous to breathe, whether or not you're actively smoking.

If you're pregnant, the risks are even greater because the inhaled toxins are poisonous to an unborn child as well. Quitting smoking at any point during your pregnancy can start to improve your and your baby's health.


Fertility Challenges

Pregnant woman smoking and holding an ashtray

IAN HOOTON / Getty Images

Research has shown that it can be more difficult to get pregnant if you smoke, so if you're thinking about having children, it would be to your advantage to stop smoking before trying to get pregnant.

Sperm Count May Be Affected, Too

One study found that sperm count was reduced by 19% in men who smoked compared with men who didn't smoke.


Miscarriage, Stillbirth, and Ectopic Pregnancy

Smoking during pregnancy is associated with an increased risk of miscarriage, stillbirth, and ectopic pregnancy.

One study found that people who smoked while pregnant were 41% more likely to experience stillbirth when compared to people who didn't smoke while pregnant.

Research strongly suggests that the risk of stillbirth is also increased if you are regularly exposed to secondhand smoke during pregnancy.


Placenta Previa

If you smoke while pregnant, you may have an increased risk for placenta previa, a condition in which the placenta is attached to the uterine wall too close to the cervix. People with placenta previa often have to give birth by cesarean section.


Placental Abruption

Placental abruption occurs when the placenta detaches from the uterus prematurely. This can cause preterm delivery, stillbirth, and even early infant death. People who smoke during pregnancy are more likely to have this condition compared to their nonsmoking counterparts.


Preterm Premature Rupture of Membranes

Preterm premature rupture of membranes (PPROM) is a condition in which the amniotic sac breaks, leaving you and your baby more susceptible to infection and increasing the likelihood of premature delivery.

One study found that pregnant people who smoked heavily (more than 10 cigarettes per day) increased their risk of PPROM in the early gestational age.


Low Birth Weight

Scientists have found a cause-and-effect relationship between smoking or secondhand smoke exposure during pregnancy and low birth weight. Low birth weight is one of the leading causes of infant death in the United States.


Cleft Lip/Cleft Palate

Cleft lip and cleft palate are birth defects that occur when the lip and/or mouth don't form properly during early pregnancy. Research has shown that the risk of these defects is higher for babies of parents who had smoked during the early months of pregnancy.


Sudden Infant Death Syndrome (SIDS)

If you smoked during pregnancy, your baby may be at an increased risk for sudden infant death syndrome (SIDS). Babies who live in a home tainted with second- and thirdhand smoke also face an increased risk of SIDS.


Reduced Oxygen to the Fetus

Researchers suspect that nicotine in the bloodstream of someone who is pregnant may constrict blood vessels in the umbilical cord and uterus, reducing the amount of oxygen to the unborn child. Nicotine may also limit the amount of blood supplied to the fetal cardiovascular system.


Respiratory Problems

When a developing infant is exposed to cigarette smoke in-utero, their lungs may be affected. The lungs can experience permanent structural changes, and pulmonary function may be altered. As a result, the risks of respiratory illness and asthma increase.

Are E-Cigarettes a Safer Choice?

Electronic cigarettes, or e-cigarettes, are a delivery system for liquid nicotine, which turns into a vapor when heated.

While it's true that e-cigarette vapor contains fewer toxic chemicals than traditional cigarette smoke, it does deliver some potent poisons and cancer-causing chemicals to both the pregnant person and their child. 

Nicotine itself is a poison and unhealthy for the developing fetus. Additionally, researchers have found formaldehyde, acrolein, heavy metals, and tobacco-specific nitrosamines (TSNAs) present in e-cigarette vapor.

The chemicals in e-cigarette vapor may cause damage to an unborn child's brain and lungs. Additionally, some of the flavorings used in the nicotine liquid may be harmful to the developing child.

If you're pregnant and can't stop smoking, talk to your doctor about how to approach cessation. It's important not to self-medicate with electronic cigarettes thinking they're a healthy replacement for cigarettes.

Reducing Risk With Preventative Measures

In addition to quitting smoking while you're pregnant, there are other safety measures you can take. Even brief exposure to secondhand smoke can be dangerous, so it's best to exercise caution.

There is no safe level of exposure to cigarette smoke when you are pregnant. Becoming more aware of your level of exposure can help you minimize health risks to both you and your infant.

For instance, if your partner is smoking while you are pregnant and unable to quit, talk to them about how you can both minimize your contact with the smoke. Have them smoke outside and wear a coat or another garment they can remove and keep outside.

They should avoid wearing the same clothes they smoke in around the house, as thirdhand smoke can spread onto furniture and increase your likelihood of exposure to harmful substances.

Both you and your partner should wash your hands before touching your baby if you have smoked or been near someone who has smoked after your baby is born.

What the Research Says

Statistics gathered by the Centers for Disease Control and Prevention (CDC) tell us that:

  • Approximately 10% of women reported smoking during the final trimester. 
  • Of those who smoked three months before getting pregnant, 55% quit during their pregnancy, but the relapse rate within six months of delivery was 40%.

If you are planning to get pregnant or you're already pregnant and you smoke, take the important step towards quitting by finding the resources and support that works for you. It's worth every bit of work it takes to quit smoking, both to give your child the best possible start in life that you can and to live long and healthfully yourself.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

The potential risks that smoking can cause to you and your unborn child can be scary, but remember, you can help reduce these risks by quitting smoking and taking precautionary measures around people who do smoke.

While no amount of exposure to cigarette smoke is safe, prolonged exposure increases the health risks. Talk to your doctor about quitting smoking while pregnant.

19 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Terry Martin
Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction.