Editor’s Note: Amanda is featured in the CDC’s Tips From Former Smoker’s campaign, which features real people living with the effects of smoking-related diseases or exposure to secondhand smoke at www.cdc.gov/tips.

Amanda began smoking in the 5th grade. Everyone in her family smoked. And while she knew the dangers of smoking, she didn’t believe it would ever affect her or the children she dreamed she’d have.

“I wanted to fit in, and I had really easy access to cigarettes as my entire family smoked. I never thought I would become addicted or have any problems that come from smoking.”

Her addiction continued even when she learned she was pregnant. “I had this whole plan made for my life. Becoming pregnant before I was married and finished with college definitely wasn’t part of the grand plan,” she says. “I never thought I’d smoke while I was pregnant. I had always told myself that I would quit before pregnancy, or I’d quit as soon as I found out I was pregnant.”

But the struggle ensued when that day became a reality. “When I found out I was pregnant, I was under a lot of stress. Cigarettes were my ‘go to’ for stress relief. I tried to quit smoking so many times while I was pregnant. There were days when I would throw my cigarettes out and tell myself I was done; promise myself I was never going to smoke again.”

But “later, something stressful would happen and I’d go buy more cigarettes, or I’d get one from someone I knew. I wasn’t able to stop.”

Deep in denial

Amanda knew smoking was damaging her body, and likely her baby’s body. Still she thought, “it won’t happen to me.”
“I knew that babies were born with poor health because of smoking. I also knew a lot of people who smoked while they were pregnant, who all had healthy babies—not premature babies.”

To her credit, Amanda worked with a public health nurse in a smoking cessation class to try to quit smoking. But when her healthcare providers asked if she still smoked, she hesitated to share how much she was smoking.

“They would always ask in a way that made me feel like I was being judged, like, ‘you’re not smoking now, right?’ Sometimes I would be honest and they would tell me that I really should quit, but more often I felt like I couldn’t really be honest about how much I was smoking.”

Amanda wishes her care providers would have been less judgmental: “Something like, ‘quitting smoking can be difficult, and being pregnant doesn’t mean it will be easier to quit. Help is available; is that something you’re interested in?’ Something like that may have worked, but most of the time I didn’t feel comfortable answering honestly about my smoking.”

Facing premature birth

Then came the day when Amanda faced the reality that her daughter was going to be born early. “My water had broken prematurely. Even on my way to that hospital I didn’t think she was going to be born early. I thought I would be on bed rest, and that my baby would be fine, even if she had to be in the NICU. When they told me that her oxygen levels were low and that I was going to have an emergency c-section, I couldn’t believe it. Even up to that point I did not think she was going to be born early.”
Amanda was 31 weeks pregnant when she heard her daughter cry for the first time.

“She had such a tiny little cry, like a kitten. I had been working as a nanny with a lot of babies. Her cry was just so soft; it wasn’t that loud scream you typically hear from infants. Her cry was small, and so was she. She weighed just 3 pounds and 1 ounce.”

The realities of birthing premature sank in fast. “I didn’t get to see her for a couple of hours. They kept telling me to relax, and that I needed rest. I had only been able to hear her little cry and catch a glimpse of her before they took her away. I had just gone through surgery, but I really, really wanted to see my baby.”

“When they finally let me see her, I wasn’t able to hold her. During the coming days and weeks I was only able to hold her once, maybe twice a day for 20 minutes to do kangaroo [skin-to-skin] care. Otherwise, I could only put my hand in her incubator was she was having a diaper change or feeding.”

Having her daughter in the NICU changed Amanda’s life. “I had to drop out of college. I was in the hospital with her the whole time because the only chance I had to touch her was when she needed a diaper change or a feeding.”
Being with her daughter in the NICU was stressful. “I was very scared. I was unsure. I was angry with myself about the whole situation. And I was really scared for her. The NICU was full and there were babies coding throughout the day. Babies died while I was there. For the most part, my baby did really well in the NICU, but just being in that situation brought a lot of fear.”

Becoming an advocate

Living with the consequences of smoking during pregnancy has lead Amanda to speak out to other women.

“I would definitely recommend that they stop smoking. You think it’s not going to happen to you, but it very well could. There are so many resources to help women quit.”

Her main message: “You can have a healthier baby if you stop smoking before you get pregnant, but quitting any time during pregnancy can help your baby get a better start on life. Smoking doesn’t take your stress away. You may feel like it does, but whatever is stressing you out will still be there after that cigarette.”

“What’s really stressful is having a child in the NICU.”

Managing stress

Women can quit, Amanda says. “There are a lot of programs and resources out there to help you quit.”

For Amanda, the time to quit came to her during a church service. “I knew it was time to stop. I quit with a lot of prayer and support from my family.” She relied on the skills she learned in working with her public health nurse, including stress reduction techniques. She also motivated herself by her desire to break her family’s legacy of smoking. “I just knew that it was time quit. I didn’t want my kids to smoke. I didn’t want them to see me smoke. I want to be around for them.”

“If you can’t quit for yourself, quit for your baby. Look wherever you can for support and know that you can quit. You really can.”

Amanda still has stressful days, but now she relies on exercise to work through her frustrations.

There’s Help Right Now for Quitting
• Call 1-800-QUIT-NOW
• Call 1-855-DÉJELO-YA
• Read this Quit Guide
• Text QUIT to 47848 and receive motivational texts


Carolyn Davis Cockey, MLS, LCCE, is founding editor of Healthy Mom&Baby, Senior Director of Partnerships & Publications at AWHONN, and a Lamaze-certified childbirth educator in Sarasota, FL.

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