In more rational times, before the anti-tobacco hysteria began in earnest, women who smoked continued to smoke and enjoy other normal pleasures of life without guilt during their pregnancies. Many even smoked during labor to help them relax and take the edge off their pain. If their doctors mentioned smoking at all, it would be to advise them to perhaps cut down if they were heavy smokers, something which most did intuitively because they didn’t “feel” like smoking as much.
But pity the poor North American smoker today who becomes pregnant, because she will be told that if she continues to smoke at all (or have any alcohol or caffeine) during her pregnancy, she is putting her developing fetus at high risk of death or disability.

Nothing could be further from the truth, as the following annotated bibliographies will show.

Though there is considerable evidence showing that on average the babies of women who smoke during pregnancy weigh on average a few ounces less than babies of women who do not smoke and that the rate of low birthweight babies is somewhat higher for smokers, there is no credible evidence for the hyperbolic claims that the babies of smokers have a higher mobidity and mortality rate. Quite the contrary, the babies of women who smoke during pregnancy have a better survival rate ounce for ounce, a somewhat lower rate of congenital defects, a lower rate of Down’s syndrome, a lower rate of infant respiratory distress syndrome and a somewhat lower rate of childhood cancer than do the babies of non-smokers.

Dr. Richard L. Naeye, a leading obstetrical researcher who studied more than 58,000 pregnancies, states unequivocally:

“We recently found no significant association between maternal smoking and either stillbirths or neonatal deaths when information about the underlying disorders, obtained from placental examinations, was incorporated into the analyses. Similar analyses found no correlation between maternal smoking and preterm birth. The most frequent initiating causes of preterm birth, stillbirth, and neonatal death are acute chorioamnionitis, disorders that produce chronic low blood flow from the uterus to the placenta, and major congenital malformations. There is no credible evidence that cigarette smoking has a role in the genesis of any of these disorders.”