Helping all kids get the right start

As someone working in this field, I am far too familiar with the importance of maternal health to child development. During my pregnancy, I was constantly stressing myself out trying to make sure that I was eating all of the right things, exercising enough, gaining enough weight—but not too much. I tried my best—with all of my resources and supports—to increase the likelihood of a healthy birth. It’s hard to imagine smoking during my pregnancy—even back in 2008 when my daughter was born. Yet, in Michigan nearly one in five births in 2014 was to a mother who smoked during her pregnancy. That’s actually an increase from 2008.

Why, in 2014, were so many expectant moms smoking and why has it increased? The Right Start: 2016 Annual Report on Maternal and Child Health – Mothers Smoking During Pregnancy Increased Since 2008, Disparities Exist by Race & Place reveals that state efforts targeted to help pregnant women quit smoking are very minimal. Tobacco Settlement dollars continue to be redirected to support unrelated activities and the tobacco industry spends nearly $190 on marketing for every $1 dollar spent by the state on smoking prevention.

The American Lung Association grades Michigan an “F” in funding for smoking prevention and cessation and for access to these programs.
So, while over 19% of births in Michigan were to mothers who smoked during their pregnancy, less than 2% of mothers reported receiving classes or support for smoking cessation and only 5% of mothers who smoked during the last three months of pregnancy were referred to a smoking cessation program. And, most adult smokers started smoking before or at age 18. Evidence-based prevention and smoking cessation programs need to be supported, expanded and targeted.

Smoking during pregnancy—or even being exposed to smoke in a household—is extremely harmful for babies. It can cause a number of complications at birth, low birthweight in babies, birth defects and increase the likelihood of a sleep-related infant death. It can also result in babies being born too early.

In Michigan, according to the new report, preterm births are also on the rise. In 2014, over 12% of births were considered preterm (less than 37 weeks gestation), which is more than a 20% rate increase from 2008. Babies who are born too early or too small often face adverse health outcomes both in the short- and long-term. For example, children who are born preterm and whose mothers smoked during pregnancy are at a higher risk of chronic lung disease and asthma.

Maternal and child health outcomes vary by race and ethnicity and geography. While White women have the highest rates of smoking during pregnancy, the rate of smoking increased the most for Latina mothers. The rate of babies born too early has also increased for Whites, African-Americans and Hispanics with African-Americans having the highest rate of preterm births. Higher smoking rates also tend to be found in counties with smaller populations and seem to be concentrated in the lower northern part of the state. Information on maternal and child health is also available online by county and for Michigan’s 69 largest cities and townships at the Kids Count Data Center.

All mothers want the best for their babies. Because of institutional and geographic barriers, efforts to prevent and help expectant mothers quit smoking need to be targeted and evidence-based. Smoking is one of the most preventable behaviors. We need to do more to ensure that moms and babies are healthy.