Dirty little secret; a ? for HB'ers and MW's

[Sighhh]

I'm 36 weeks pregnant, and I just quit smoking 2 weeks ago.

I have been a closet smoker for a long time. I only smoke when I am away on short business trips 2 or 3 times a month, but I often binge smoke during those times. I am also planning a homebirth, but the reality of what I have been doing is really starting to hit home. I'm wondering if HB is a stupid choice for me. If I have ruined it for myself and my baby.

Please hold off on the judgement...I can promise you that there is nothing that you can say that I haven't said to myself. I feel like a horrible mother to my baby, horrible partner to by DH, and horrible client to my MW. I'm posting here because I have created this dilemma for myself and need some clarity on what I should do.

My pregnancy has been great and uneventful. Placenta and cord looked great at the 20 week ultrasound, blood pressure is very good, iron levels lowish but within normal limits (and I have been supplementing since it was last checked), my weight gain is normal (up about 40 pounds) and fundal height has been right on target at every visit. I have kept active and fit, and my baby seems to be just as active in the belly as its older brother was. Stupidly, I smoked at the same pace throughout that pregnancy as well, which resulted in a fantastic natural birth (birth center) and perfectly healthy kid (apgars were 8 and 9, just shy of 8lbs). The only complication was a moderate pp hemorrhage that was managed with IV pitocin and methergen. He was born at exactly 42 weeks, and yes his placenta did look old and calcified.

I understand that smoking is a risk factor for postpartum hemorrhage, and this is what I am most concerned about. My midwife (DEM) will have herbs and IM pitocin available, and does all the other usual things such as putting babe to breast, uterine massage, etc. Homebirth midwives are not legally able to carry meds in my state, so she reserves use of IM pitocin whenever possible. I do not know what herbs she uses nor do I know anything about their effectiveness.

That is my background. For homebirthers, would you risk yourself out? For midwives, would you risk me out? I need some clarity. I can't seem to look at this objectively. I don't want to be blase and naively assume that everything will be all roses and tulips...but I do not want to make a decision based on fear, either. I am so kicking myself for letting it go this far. I'll spare you the excuses and whys and wherefores. Just know that I am sorry.

I had not intended to have another ultrasound, but I am considering it now just to see how badly I've damaged this baby's placenta and to check the baby's growth. Midwives - is there any information from an ultrasound at this stage that would factor into your decision if I were your client?

Thanks for listening..

[Astraia]

I really wouldn't worry about it that much.

I know LOTS of women my mom's age (and older!) who homebirthed and smoked the whole pregnancy.

Heck, ciggs used to be recommended by dr's to have smaller babies

Tell your MW about it so she'll be more prepared to keep an eye on bleeding and watch the babe's heartrate a bit more closely during labour, but otherwise.... I'd say go for it!

(not a professional opinion, obviously, just a personal one).

[mwherbs]

well you are past most of the time of concern- you are not going to have a pre-term baby. most likely everything is going to be fine- and whew you got that off your chest-

what do you think your midwives will think if you tell them? I wouldn't care, but I have also found that either the keeping of the smoking secret or the craving it'self has caused some distress for most of the smoker women in labor I have been around and if they just went ahead and smoked even a puff or 2 they got past that , but I don't know what your midwives would think or how they will react. I do think it is a good idea to quit and that the issues for a baby in arms are now what come to the front of possible concerns like more frequent respitory illness and illness in general and your clothing will have the tobacco residue even if you don't smoke over the baby and it has an effect.

I would say take some extra antioxidants- vit C and E and eat some berries or make berry smoothies to help off set the oxidizing effects and take care of yourself

[MidwifeErika]

I wouldn't risk you out for some earlier binge smoking (I have worked with smoking moms before). It is excellent that you have quit! If you think your midwife would handle this ok, I would recommend talking with her about it. It will likely make you feel much better to get it off your chest to her.

[IxIa]

Smoking is exceptionally difficult to quit, I know this firsthand. I was under tremendous stress during my second pregnancy and I embarrassed to say I smoked the entire 9+ months. Though I think trying to quit or reduce the amount you smoke if the best choice and I absolutely don't condone it, my second was born totally healthy at 41 weeks at a birth center and weighed 10lbs 5ozs.

You should probably tell your mw so she's prepared, but I would think by this point in your pregnancy the most damaging effects would be evident by now.

[mwherbs]

so have you actually quit ?

and something else I didn't address is the bleeding- if you have quit less likely to bleed some of it comes from what nicotine does to circulation - eat your veggies - greens 3-5 servings a day and like I said before the berries---

I would also say after the pregnancy get some testing done like thyroid and also look for inflammatory markers- sometimes smokers persist because they are self-treating something else (yes I know there is the addiction ) like an auto-immune disease or low thyroid

take care