9 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 cause cancer. Air tainted with secondhand smoke is dangerous to breathe, whether you're an active smoker or a passive smoker (a non-smoker breathing in cigarette smoke).

For pregnant women, the risks are even greater because the inhaled toxins are poisonous to their unborn child as well, setting the stage for numerous health problems as they get their start in life.

Let's take a look at how cigarette smoking affects both mom and the developing child she is carrying.


It's Harder to Get Pregnant

Pregnant woman smoking and holding an ashtray

IAN HOOTON / Getty Images

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

Dads-to-Be Are Affected, Too

Dads-to-be who smoke should seriously consider quitting along with moms-to-be. Research has shown that smoking damages DNA in sperm and can lead to fertility problems, miscarriage, and birth defects.


Increased Risk of Miscarriage, Stillbirth, and Ectopic Pregnancy

Smoking during pregnancy increases the risk of miscarriage, stillbirth, and ectopic pregnancy. And, although it has not yet been proven, research strongly suggests that the same risks are present for women who have quit or never smoked and are exposed to secondhand smoke before or during pregnancy.


Placenta Previa Risk

Pregnant smokers have an increased risk for placenta previa, a condition in which the placenta is attached to the uterine wall too close to the cervix. Women with placenta previa often have to give birth by cesarean section.


Placenta Abruption Risk

Placenta abruption occurs when the placenta detaches from the uterus prematurely. This can cause preterm delivery, stillbirth, and even early infant death. Pregnant smokers are 1.4 to 2.4 times more likely to have this condition develop as compared to their nonsmoking counterparts.


Premature Rupture of Amniotic Membranes

Women who smoke during pregnancy are more likely to experience premature rupturing of the amniotic sac, making it more difficult for them to carry to full gestational term.


Smaller Babies

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.


Increased Cleft Lip/Cleft Palate Risk

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 whose mothers smoked during the early months of pregnancy.


Increased SIDS Risk

Babies born to mothers who smoked during pregnancy are at an increased risk for Sudden Infant Death Syndrome (SIDS). Babies who live in a home tainted with secondhand smoke also face an increased risk of SIDS.


Reduced Oxygen to the Fetus

Researchers suspect that nicotine in the mother's bloodstream 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.

Are E-Cigarettes a Safer Choice for Pregnant Moms Who Can't Quit?

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

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 mother and child. 

As mentioned above, nicotine itself is a poison and unhealthy for the developing fetus. Additionally, researchers have found formaldehyde, acrolein, heavy metals, and TSNAs, all of which are present in e-cigarette vapor.

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

The latest policies by the U.S. Food and Drug Administration (FDA) now require that e-cigarette companies end the manufacture and sale of flavored vaping products (excluding menthol and tobacco) by the end of January 2020.

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

What the Research Says

Statistics gathered by the 2011 Pregnancy Risk Assessment and Monitoring System from 24 states in the U.S. tell us that:

  • Approximately 10% of women reported smoking during the final trimester. 
  • Of those who smoked 3 months before getting pregnant, 55% quit during their pregnancy, but the relapse rate within 6 months of delivering was 40%.

If you are planning to get pregnant, or you're pregnant and smoking, use the quitting smoking resources to get started with smoking cessation.

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.

Was this page helpful?
Article 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.
  1. Centers for Disease Control and Prevention. Smoking & Tobacco Use. Chemicals in Tobacco Smoke. Updated March 2011.  

  2. Sarokhani M, Veisani Y, Mohamadi A, Delpisheh A, Sayehmiri K, Direkvand-Moghadam A, Aryanpur M. Association between cigarette smoking behavior and infertility in women: a case-control studyBiomed Res Ther. 107;4(10):1705-1715. doi:10.15419/bmrat.v4i10.376

  3. Marufu TC, Ahankari A, Coleman T, Lewis S. Maternal smoking and the risk of still birth: systematic review and meta-analysisBMC Public Health. 2015;15:239. doi:10.1186/s12889-015-1552-5

  4. Reece S, Morgan C, Parascandola M, Siddiqi K. Secondhand smoke exposure during pregnancy: a cross-sectional analysis of data from Demographic and Health Survey from 30 low-income and middle-income countriesTob Control. 2019;28(4):420–426. doi:10.1136/tobaccocontrol-2018-054288

  5. Shobeiri F, Jenabi E. Smoking and placenta previa: a meta-analysisJ Matern Fetal Neonatal Med. 2017;30(24):2985–2990. doi:10.1080/14767058.2016.1271405

  6. Kaminsky LM, Ananth CV, Prasad V, Nath C, Vintzileos AM; New Jersey Placental Abruption Study Investigators. The influence of maternal cigarette smoking on placental pathology in pregnancies complicated by abruptionAm J Obstet Gynecol. 2007;197(3):275.e1–275.e2755. doi:10.1016/j.ajog.2007.06.026

  7. Vitoratos N, Botsis D, Grigoriou O, Bettas P, Papoulias I, Zourlas PA. Smoking and preterm laborClin Exp Obstet Gynecol. 1997;24(4):220–222.

  8. Pereira PP, Da Mata FA, Figueiredo AC, de Andrade KR, Pereira MG. Maternal Active Smoking During Pregnancy and Low Birth Weight in the Americas: A Systematic Review and Meta-analysisNicotine Tob Res. 2017;19(5):497–505. doi:10.1093/ntr/ntw228

  9. Centers for Disease Control and Prevention. Reproductive Health. Infant Mortality. Updated March 2019.

  10. Martelli DR, Coletta RD, Oliveira EA, et al. Association between maternal smoking, gender, and cleft lip and palateBraz J Otorhinolaryngol. 2015;81(5):514–519. doi:10.1016/j.bjorl.2015.07.011

  11. Anderson TM, Lavista Ferres JM, Ren SY, et al. Maternal smoking before and during pregnancy and the risk of Sudden Unexpected Infant DeathPediatrics. 2019;143(4):e20183325. doi:10.1542/peds.2018-3325

  12. El-Ardat MA, Izetbegovic S, El-Ardat KA. Effect of cigarette smoking in pregnancy on infants anthropometric characteristicsMater Sociomed. 2014;26(3):186–187. doi:10.5455/msm.2014.26.186-187

  13. National Academies of Sciences, Engineering, and Medicine. Toxicology of E-Cigarette Constituents. In: Eaton DL, Kwan LY, Stratton K, eds., Public Health Consequences of E-Cigarettes. Washington (DC): National Academies Press (US); 2018.

  14. Whittington JR, Simmons PM, Phillips AM, et al. The use of electronic cigarettes in pregnancy: A review of the literatureObstet Gynecol Surv. 2018;73(9):544–549. doi:10.1097/OGX.0000000000000595

  15. Centers for Disease Control and Prevention. Reproductive Health. What are the health effects of tobacco use on pregnancy?. Updated July 2016.

Additional Reading