I touched on this subject briefly in a previous post regarding my first pregnancy, but felt that it was something I wanted to elaborate on.
When I was pregnant last, with my youngest, I found that it was the most irritating speaking to health care providers about my smoking. More so than my two previous pregnancies.
When I first discovered I was pregnant with my last son, of course I went to see my nurse practitioner to confirm, and get a referral for an obstetrician. Once it was confirmed, she did the usual history ‘interview’ with me, one of the questions being if I was still smoking . I was honest with her, and told her that I was still smoking, and how much a day. She did NOT criticize, she did NOT give me a look of disgust, nor did she look at me like I was a bad person. Her response was “Okay, well I will go over the usual with you about the effects, and risks. At the end of the day, me pressuring you and making you feel guilty is not going to help you quit, so I will be here to support you.” She then proceeded to do her job and explain to me (nicely) the effects and risks if I continue to smoke. I knew I shouldn’t have been smoking, I knew that it wasn’t good for me or my baby. I knew that it wasn’t good for my daughter at home to watch me smoke while I had another baby in my belly. I just wasn’t ready to quit yet.
If only the next few months of meeting with different health care professionals would go as easily as they did with my nurse practitioner. My next encounter would be in the emergency room when I was 13 weeks pregnant. I started bleeding quite a bit, and went in because I was very concerned that I was having a miscarriage. The nurse asked me if I smoked, I said yes, and told her how many. Her response? “And people wonder why they have miscarriages? Maybe you should have quit smoking.” First of all, it is completely out of line to speak to a patient like that, regardless of their choices. I wasn’t being rude, or aggressive with her in anyway. Second of all, that was the last thing that I needed to be shoved in my face at that moment in time. Of course, I started balling my eyes out, absolutely devastated about what this woman just said to me. My husband had to go and ask for a different nurse because I was so upset. When the doctor came in to do an ultrasound, he didn’t say anything to me, but looked at me as if I was the worst person in the world when he brought up me smoking. He did an ultrasound (in his words) to “confirm a miscarriage”. He was wrong though, there was my baby, strong heartbeat and all. No signs of miscarriage. I was told to go home, and touch base with my family doctor or my nurse practitioner the next day. As he walked out the door, he said “Oh and you should quit smoking if you don’t want to actually have a miscarriage”. Yet another jab through my heart. All these people did, was make me want to go sit outside and chain smoke until I calmed down. I knew I couldn’t do this of course, but I still went outside to have a cigarette because it felt like it relaxed me.
A few weeks later, I got to meet with my obstetrician. He was very nice, and of course had to go over my pregnancy history, and my smoking history. He talked to me again about the risks and the effects, but never really made me feel guilty or tried to pressure me about it. He knew that I realized I should quit, but that I obviously wasn’t ready, I was still too addicted, and still ‘enjoyed’ smoking. I felt like although he did not agree with my decision, it wasn’t like he was treating me any different because of it.
I asked a couple of my friends, and a family member who also smoked while pregnant, and they had been through very similar situations, one of which who switched obstetricians because hers was so rude to her.
If I had any advice to give to any health care professionals, it would of course be to continue to explain the risks, and the effects of smoking while pregnant, but to do so with respect, and kindness. By being rude, harsh or trying to give “tough love” is not beneficial to anyone, it makes the pregnant woman feel even worse than she already does. It does not help to fight the addiction, it makes the addiction take control even more.