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No Smoking Please: The Side Effects of Smoking
8 Ways to Kick the Smoking Habit
Avoid Alcohol
Just Say No to Drugs
Cut Back on Caffeine
Ultrasound
12 Benefits of Ultrasound

Parenting your little one begins even before birth as you strive to create a healthy womb environment for your growing baby.

No Smoking Please! Did you know that the smoke of one cigarette contains the poisonous gases of approximately 4,000 chemicals, some of which could kill or injure your baby and increase your risk of miscarriage? Among the many poisonous gases in cigarette smoke are nicotine (an addictive drug known to narrow blood vessels), carbon monoxide (an oxygen robber), benzene (a potential carcinogen), ammonia, and formaldehyde. The harmful effects of cigarette smoke on you and your baby increase with each cigarette smoked each day.

Some of the detrimental side effects of smoking during pregnancy include:

• Smoking robs babies of nourishment. Many studies have shown that infants of mothers who smoke have lower birth weights. The poisonous nicotine narrows uterine blood vessels, thus reducing blood flow to the baby in the womb. Less blood flow means less nourishment and, therefore, less growth for your preborn baby.
• Smoking robs baby of oxygen. Besides restricting blood flow to the womb, maternal cigarette smoking and breathing second hand smoke decreases the amount of oxygen available to the baby from the blood. The level of carbon monoxide in the blood of pregnant women who smoke is 600 – 700 percent higher than in those who don't smoke. Carbon monoxide is an oxygen blocker, meaning it prevents blood cells from carrying a full load of oxygen. Lack of oxygen can affect the development of every organ in the baby's body.
• Smoking injures little brains. New studies suggest that the developing baby's brain is injured not only by lack of oxygen, but also by the chemicals in cigarette smoke, which may be directly poisonous to developing brain cells. Children of mothers who smoked during pregnancy, especially those of mothers who smoked more than one pack a day, have been found to have a smaller head circumference as infants, decreased mental performance scores at one year, reduced IQs, and diminished academic performance scores in school compared to the children of mothers who did not smoke.
• Passive smoke hurts babies. New research shows that when pregnant mothers are exposed to second-hand cigarette smoke, their babies are at risk of having lower birth weights and show an increased risk of Sudden Infant Death Syndrome (SIDS), just as the babies of smoking mothers do. If father and mother both smoke, the risk of SIDS is nearly double.

NO SMOKING ALLOWED The bottom line is DO NOT SMOKE. If you smoke, seek help today and quit. It's easier to quit than be faced with a baby who has problems because of maternal smoking—not to mention the guilt you will feel knowing this can injure the baby. Insist that those around you respect life—your growing baby—and not smoke in the same room with you. If you work in a smoke-contaminated environment, ask for a reassignment (pregnant women have a legal right to work in a smoke-free environment).

While it's best to never smoke or to stop smoking before you become pregnant, the earlier you stop smoking, the healthier you and your baby are likely to be. Smoking is not a habit, it's an addiction. You can break habits fairly easily, but addictions are harder to kick. To stop smoking, try these suggestions:

1. Convince yourself. The facts are solid—statistically, the chances are high that your pregnancy will be more complicated and your baby less smart and less healthy if you smoke while pregnant.

2. Try stopping cold turkey. The best time to extinguish your last cigarette is the moment your pregnancy test turns positive, and some women do just that. Others find that sudden cigarette withdrawal makes them extremely anxious, and this is not good for baby either. A gradual weaning may make more sense. Some "lucky" women find that a natural aversion to the smell of smoke forces the issue, and the quit.

3. Try goal setting. If you can't quit on the first day you know you're pregnant, set a goal for tapering off, say by day 10. Plan a reward for your efforts that day. You might calculate how much money you would save in a year of not smoking and spend it on something special for yourself or your baby.

4. Cut down on how much poison you inhale. As you attempt to stop the smoking addiction, try taking fewer puffs. Or smoke only the first half of the cigarette. (More poisons are concentrated toward the end of the cigarette.) Better still, don't inhale. This can cut down your nicotine dose by a half.

5. Make it inconvenient to smoke. Buy only one pack at a time. Leave the pack somewhere inconvenient, like in the garage.

6. Fill the void. Think about what led you to start smoking. Once you identify the psychological reasons that may have led to this physiological addiction, the easier it might be for you to stop, or at least find a safer substitute habit.

7. Try healthier substitutes. If you need to hold something and keep your hands busy, try writing, drawing, painting, or working crossword puzzles. If you need something in your mouth, try chewing on carrot or celery sticks, cinnamon sticks or straws, try sucking on ice, healthy popsicles, or hard candy. Nibble on sunflower seeds or granola. Chew gum. If you smoked for relaxation, try listening to soothing music, reading, or paying for an occasional massage. Take a walk. Go swimming. If you smoked for pleasure, indulge yourself in fun at a non-smoking place: go to a movie or a non-smoking restaurant, go shopping, go visit a non-smoking friend.

8. Get professional help. If after two weeks you have made no progress on your own, you might want to contact a local quit-smoking resource or seek professional help to resolve deeper issues.

The harmful effects of alcohol on the developing baby were recognized in the early 1900's, when physicians observed an increase in the number of malformations occurring in babies born nine months after certain European drinking festivals. Unfortunately, any alcohol you drink will get into your baby's blood, just as it does into yours – and at the same levels.

Drinking can lead to fetal alcohol syndrome. Heavy alcohol consumption during pregnancy can cause fetal alcohol syndrome (FAS), a disorder encompassing a variety of abnormalities. FAS babies are lighter, shorter, and have smaller brains than normal babies. Sometimes their brains are malformed, and they may suffer mental retardation as a result. Babies with fetal alcohol syndrome have unusual facial characteristics – their eyes appear smaller than usual, their nose is short, their upper lip is thin, and they may have abnormalities of the hands, feet, and heart.

Drinking Can Lead to Low Birth Weight and Even Miscarriage. Studies show that maternal alcohol consumption can also cause pregnancy complications such as miscarriage, low birth weight, and pre-maturity. Like smoking, alcohol's most harmful effects are on brain development. The effects of maternal drinking on the baby have been dubbed "a life-long hangover."

What about an occasional glass of wine? While one occasional glass of wine with dinner may not be as dangerous, knowing how much is too much is a question no research has answered. Studies show that like smoking, alcohol has a dose-related effect. This means the more alcohol mother consumes, the more damage her baby is likely to suffer. Studies also demonstrate that both binge drinking (five or more drinks on one occasion) and regular drinking (an average of two drinks per day throughout pregnancy) definitely harms babies. (One drink means one ounce of hard alcohol, one 8-ounce glass of wine, or one 12-ounce glass of beer.) Obviously, the riskiest time to drink an alcoholic beverage is during the first trimester, compared to the risk at 36 weeks, when babies' organs are fully formed. An occasional, single glass of wine or beer in the last month is unlikely to harm your baby.

Best to refrain completely. It's important to rely on your common sense, as well as scientific studies. Perhaps the safest way is to refrain from drinking alcohol during your pregnancy. If you're at social gatherings where alcoholic drinks are served, drink like a child, because you are carrying one. Order your drink "virgin" (without alcohol), or enjoy flavored bottled waters.

Illegal drugs . When a mother takes any substance or drug, so does her baby. When a mother is addicted, so is her baby. After birth, this baby suffers symptoms of drug withdrawal (extreme irritability and jitteriness). Infants of mothers who use addicting drugs during pregnancy are more difficult to care for after birth, and may show lifelong effects of their mother's drug use.

Drugs affect a baby throughout pregnancy, but are most dangerous in the first trimester. Possible effects of illegal drugs on the developing baby include stillbirth, miscarriage, reduced birth weight, mental retardation, pre- maturity, and an increased risk in Sudden Infant Death Syndrome (SIDS). In fact, the risk of SIDS may be increased as much as twenty times in infants of opiate- abusing mothers. Researchers believe that drugs such as opiates and cocaine also harm developing babies indirectly by constricting blood vessels in the placenta and thus reducing the oxygen supply to the pre-born baby – a suffocation effect similar to that caused by nicotine.

Marijuana. Until recently, maternal marijuana smoking during pregnancy was not proven to be harmful to babies. Newer studies, however, suggest that marijuana can harm the fetus in all the ways mentioned above, thanks to its active ingredient THC. In addition, the smoke of a joint contains the same nicotine and carbon monoxide found in cigarettes, only in doses that may be greater than those found in commercially available tobacco products.

Amphetamines (speed). These addictive drugs are also harmful to the developing baby and increase the chances of pre-maturity and intrauterine growth retardation. Newborns of speed-addicted mothers show typical speed withdrawal symptoms (rapid heart rates and breathing) immediately after birth.

See a Professional. If you are addicted to drugs, make an appointment with a professional counselor or enroll yourself in a drug withdrawal program the day you discover you are pregnant. Even better, start these programs as soon as you decide to get pregnant.

During pregnancy you may want to give up or at least cut back on coffee and switch to pick-me-ups that don't cross the placenta. The concerns about caffeine in pregnancy stem from research that showed the offspring of pregnant animals given caffeine had a higher incidence of malformations. This statistical finding has yet to be proven in humans, but to be on the safe side, the U.S. Food and Drug Administration (FDA), advises pregnant women to eliminate or limit the consumption of products containing caffeine, including coffee, colas, tea, cocoa, chocolate, and some over-the- counter remedies. More recent research suggests that caffeine use during pregnancy may cause more problems than originally suggested by the early animal studies. Caffeine has now been implicated in miscarriages and low birth weight.

The harmful effects of caffeine revealed in these studies were the result of high doses of caffeine (the equivalent of 6 to 10 cups of coffee a day), and these studies are not considered definitive by any means. At this writing, there is no hard evidence that drinking a couple of cups of coffee a day while pregnant is harmful to the developing baby, but caffeine does stimulate an increased heart rate and metabolic rate in babies, just as it does in adults. Furthermore, caffeine may remain in the baby's bloodstream longer and at higher levels, because baby's immature liver cannot get rid of the caffeine as quickly as can mother's.

If your body is used to a daily caffeine lift, here are some ways to wean yourself (and your baby) off this chemical jolt onto a more natural pick-me-up.

• Don't percolate coffee or steep tea too long. A tea bag steeped one minute releases half the caffeine as one steeped for five minutes. In general, the longer coffee and tea are brewed and the darker the chocolate, the greater the caffeine content.
• Try herbal teas that are caffeine-free. Decaffeinated teas and coffees still contain a slight bit of caffeine. If you must drink coffee, use water-processed decaffeinated coffee, since chemically processed decaffeinated coffee contains harmful chemicals.
• Read the labels of any over-the-counter medicines you take. Many headache remedies contain caffeine.
• Know what you're drinking. Read soda-can labels, or inquire about the caffeine content of a soft drink before you decide to consume it.
• Try other warm drinks. If the warmth of the beverage is what satisfies you, try hot water (you can add lemon), warm milk, hot apple cider, or herb tea.
• Cut back slowly. If you are finding you can't begin your day without the morning-caffeine jolt you had been used to, cut down gradually. Brew your coffee using half decaffeinated and half regular coffee, and gradually decrease the proportion of caffeine coffee. (Even a small amount of caffeine will relieve the headache that sometimes accompanies caffeine withdrawal.)

What is ultrasound? Ultrasound uses sound waves at frequencies higher than the human ear can hear. The doctor or technician runs the ultrasound transmitter across your abdomen aided by a greasy substance that improves sound conduction. These sound waves bounce back off your baby much like sonar waves locating a submarine. These echoes are detected by a receiver, and then a computer translates the sound into a picture of baby on a screen. The "Doptone" device used for detecting your baby's heartbeat also uses ultrasound; the echoes are translated into the "swish-thump" you hear every month at your checkup. Other terms that refer to ultrasound include scan, sonogram, doppler (the physics term for the relationship between sound and the distance it travels), echo, and electronic fetal monitoring.

Why and when is it used? Ultrasound gives your doctor vital information and allows parents to "see" their baby on a TV screen. By eight weeks the image resembles a lima bean with a pulse; by fifteen weeks the ultrasound image can show baby's major organs; by the 20th week, the ultrasound pictures confirm the presence or absence of a penis, so the sex of your baby is apparent (though sometimes this is subject to misinterpretation). Ultrasound yields information that could influence how your pregnancy is managed and improve its outcome. (If you don't want to know your baby's sex, be sure to tell your doctor or ultrasound technician beforehand.)

How safe is ultrasound? Twenty-year follow-up studies of thousands of mothers and babies who received diagnostic ultrasound have shown no apparent harmful effects. Depending on the information desired, ultrasound can be performed at any time during your pregnancy and repeated ultrasound exams appear to have no harmful effects. Ultrasound is certainly safer than x-rays.

The other side of the safety question is a theoretical concern about what happens when these sound waves strike growing fetal tissues. When sound waves bombard laboratory tissues at high frequencies, they shake up the molecules, heat them, and produce microscopic gas bubbles in the cell called "cavitation." Whether this heat or these bubbles damage the cell is unknown, although studies suggest that the changes demonstrated in research test tubes are insignificant in babies. Yet this is enough to prompt the National Institutes of Health Task Force on Diagnostic Ultrasound to conclude: "We could find no evidence to justify the recommendation that every pregnancy be screened by ultrasound. In the face of even theoretical risks, where there is no benefit, then the theoretical risks cannot be justified."

Healthcare providers use the term "diagnostic" ultrasound, implying there should be a reason for doing the test. It's important that every parent, like every healthcare provider, approach every test wearing two hats: in the scientist hat you read or ask about all the benefits and risks of a particular test and try to weigh them against each other. In the parent hat you consider your feelings about the test, the information that is sought, and how this will affect the course of your pregnancy. Scientist, parent, and healthcare provider all participate in the final decision.

1. Verify whether or not the mother is pregnant, when pregnancy tests and the usual signs of pregnancy are unclear.

2. Detect a possible ectopic pregnancy . 3. Obtain a more precise determination of baby's gestational age when there is a discrepancy between uterine size and estimated due date. In the first half of pregnancy ultrasound can accurately date baby's gestation within 7 to 10 days. In later months it is not as accurate and is useless for dating the pregnancy.

4. Evaluate baby's growth if other signs, such as uterine size, suggest a problem.

5. Determine the cause of unexplained bleeding.

6. Confirm how baby lies in the uterus (breech, transverse, vertex) if the clinical signs are unclear late in pregnancy.

7. Detect suspected multiple pregnancies if mother's uterus is growing faster than expected.

8. Detect problems with the placenta, such as placenta previa (the placenta being positioned too low or over the cervix) and abruptio placentae (the placenta is separating prematurely, causing bleeding).

9. Measure the amount of amniotic fluid if mother is losing amniotic fluid or not replenishing it at a normal rate.

10. Detect abnormalities of the uterus, especially in women with a history of previous miscarriages or problem pregnancies.

11. Detect developmental abnormalities in the growing baby that would influence where baby should be delivered and what preparations need to be made beforehand. Abnormalities of heart, lung, and intestinal development can, if detected early, alert parents and healthcare providers to deliver the baby in facilities equipped to begin management immediately after birth. Oftentimes, early recognition and early treatment can be lifesaving.

12. Assist in medical or surgical procedures: amniocentesis, chorionic villus sampling, trying to turn a breech baby, fetoscopy, or intrauterine transfusion.