SEVERAL months ago, a FilipinaA YOUNG woman, pregnant with her second baby, was referred to me for labile blood pressure. Uncontrolled hypertension is risky both for mother and baby and has to be treated promptly.

Both parents and two elder brothers are hypertensive so there is really a strong family history of hypertension. There’s nothing much we could do about the family’s genes one inherits. This is a nonmodifiable risk factor. But this patient had one risk factor which is of her own making. At the time she saw me, she was still smoking almost a pack of cigarettes a day.

And what really instantly consumed my usually abundant patience to zero level was the fact that after an exhaustive lecture, or probably sermon, on the ill effects of smoking on both her and her baby, she was still not apparently convinced to lick the habit. She even said sarcastically, “But doctor, I was smoking all throughout my first pregnancy, and our baby is okay.” That was one of the few times I saw red in front of a patient and told her, “You don’t deserve to become a mother.

Obviously she took offense and has not seen me again. She has also not gone back to the obstetrician who referred her to me. She was due to deliver last week of November this year, and I hope she and her baby are doing well. I hope too that she understands that sometimes a doctor has to give an unreasonably stubborn patient a jolt to detach her from a potentially fatal attachment to some vices which define the modern unhealthy lifestyle.

Smoking during pregnancy really drains a physician’s patience and compassion for the patient because it not only affects the person holding on to the vice but an innocent victim which the unborn baby is. It affects the mother and the baby’s health before, during, and after the birth of the baby.

I ask the smoking pregnant woman to visualize the harmful nicotine, carbon monoxide and numerous other poisons one inhales from a cigarette entering the bloodstream and going directly to the baby. These cigarette poisons harm the baby by doing the following:

• Depriving the growing baby of sufficient amount of oxygen it needs;

• Increasing the baby’s heart rate;

• Increasing the risk of miscarriage and stillbirth;

• Increasing the risk of premature births or being born with low birth weight;

• Increasing the baby’s risk of developing all sorts of lung problems.

There is never any safe level of smoking during pregnancy. Even a few sticks a day will have harmful effects on the baby. The more cigarettes smoked, the greater the baby’s risks of developing various health problems.

Passive smoking

Even passive smoking, such as when the husband smokes, can also be harmful to both mother and baby. It is sometimes ironic that the innocent passive smoker gets to inhale more of the cigarette’s poisons. The smoke coming from the burning end of a cigarette or cigar actually contains more harmful substances (tar, carbon monoxide, nicotine and others) than the smoke inhaled by the smoker.

Here are some ways to help pregnant mothers lick the habit during pregnancy and forever:

• Discard matches, lighters and ashtrays.

• Designate one’s home a nonsmoking area and commit to make it so.

• Politely leave the company of people who smoke, so they get the message that they should not smoke in her presence.

• Drink fewer caffeinated beverages and alcohol since these may stimulate one’s urge to smoke.

• Change one’s habits that encourages one to smoke. If one smokes while driving or when feeling stressed, one must try other activities to replace smoking.

•Try sugarless mints or gum to quell the urge to smoke.

• Keep busy to keep the mind off smoking such as exercising or doing a hobby.

• Avoid places where many people are smoking such as bars or smoking sections of restaurants.

The important thing is for an expectant mother to make that all-important decision to quit smoking for good, not only for her baby, but for herself. This is the least a responsible parent could do for her unborn baby.