In 2004, the Greater Kansas chapter provided a program grant of $21,126 to Catholic Charities to offer smoking cessation services directly to pregnant women.  At the Prematurity Summit in Topeka last November the need for additional smoking cessation services for pregnant women was highlighted.  The March of Dimes also advocates for provider reimbursement for these important services through Medicaid and private insurance coverage. 

The March of Dimes supports the efforts of the Office of Health Promotion at the Kansas State Health Department to expand training opportunities in smoking cessation counseling.  A training event in Salina in February of 2005 was attended by over 50 physicians and clinic staff.  An additional 200 health care providers will be targeted for training later this year.

The March of Dimes is focusing on smoking cessation as a part of their prematurity campaign because an estimated 13-22 percent of women continue to smoke while they are expecting, according to the Surgeon General’s Report of 2001.  The report also finds that these women are more likely than non-smokers to deliver their babies prematurely, before 37 weeks of gestation.  Exposure to smoke in the womb doubles the risk of having a low-birthweight baby, a baby that is born less than 5.5 pounds.  Low-birthweight babies face an increased risk of serious health problems such as cerebral palsy, mental retardation and learning problems. Further, a recent study in Sweden found that babies of mothers who smoked in early pregnancy were 40 percent more likely to have autism than babies of non-smokers. 

Perhaps more alarming, the Surgeon General’s report finds that infants of women who smoke during pregnancy are 20-30 percent more likely to die before birth or within the first month of life.  Also, the risk of SIDS (Sudden Infant Death Syndrome) triples for babies whose mothers smoked during pregnancy.  In fact, according to the U.S. Public Health Service, if all pregnant women in the United States stopped smoking, there would be an estimated 10 percent reduction in infant deaths.

If a woman has not stopped smoking before becoming pregnant it is not too late.  Smoking cessation during the first trimester can reduce the risks of preterm delivery to nearly that of non-smoking women.  According to the American College of Obstetricians and Gynecologists (ACOG), women who stop smoking at any time up to the 30th week of pregnancy have babies of higher birthweights than women who smoke throughout pregnancy.  The fewer cigarettes the mother smokes the lower the risks to her unborn baby.

Smoking during pregnancy can also cause complications for the mother.  The Surgeon General’s report of 2004 found that evidence of a cause and effect relationship can be found between maternal smoking and placenta previa, a condition in which the placenta is attached too low in the uterus and covers part or all of the cervix, and placental abruption, in which the placenta separates from the uterine wall before delivery.

The March of Dimes supports the 5A approach to smoking cessation counseling, which can improve cessation rates by 30-70 percent among pregnant smokers, according to the ACOG.  5A counseling is performed by a trained clinician such as an obstetrician, gynecologist or family practice physician.  The 5As are:
1. Ask about tobacco use
2. Advise to quit
3. Assess willingness to make a quit attempt
4. Assist in quit attempt
5. Arrange a follow-up visit

Of course, cigarette smoking harms a woman’s own health.  Quitting smoking will make  parents healthier – and better role models for their children.  Visit the following Web sites for further information about smoking cessation: http://www.americanlegacy.org/, http://www.helppregnantsmokersquit.org/ and http://www.smokefree.gov/.

The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education, and advocacy to save babies and in 2003 launched an eight-year campaign to address the increasing rate of premature birth. For more information, visit the March of Dimes Web site at http://www.marchofdimes.com/ or its Spanish Web site at http://www.nacersano.org/.