INTERVIEW
Gilles Grangé, obstetrician and gynecologist at the Port Royal maternity hospital in Paris, has said it many times: "women who smoke are not to be made to feel guilty" during pregnancy. In Mélanie Gomez's program devoted to the question of smoking during pregnancy, he nevertheless wanted to shed light on the extent of the phenomenon, the risks to health and the means of control.
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How many women are affected?
At the age of 30, the smoking rate of the female population in France is around 30%. It is estimated that half of them quit in the event of pregnancy: there would therefore still be around 15% of women who smoke at the end of their pregnancy. "98% of smokers know that it is necessary to reduce [their smoking]", assures Gilles Grangé. "They all make an effort but they feel very guilty."
What are the risks for the health of the baby and the mother?
We now know that the mother's smoking increases the risk of miscarriage. Tobacco has a teratogenic effect on the very formation of the embryo, which can lead to malformations. It increases the risk of asthma and breathing difficulties. The likelihood that the baby will be stunted, a few hundred grams at birth, is also higher. "When we are full term it is not very serious, but when we are a little bit premature [...] it can be very much. The baby will be hospitalized in pediatrics while the mother will be at the maternity."
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Pregnancy does not particularly increase the risks of tobacco for the health of the mother. The latter will however continue to accumulate a dangerous dose in the long term. But "it's never too late to quit smoking," says the gynecologist.
What are the most effective methods?
The consultation with a tobacco specialist is a first step to stop smoking. It allows you to take stock and consider treatment. Theoretically, all large maternities must offer a specialist consultation in tobacco.
The use of a tobacco substitute is possible according to Gilles Grangé. If the presence, on the nicotine patches, of a pictogram advising the use in pregnant women seems rather dissuasive, "nicotine is much less toxic than tobacco". The gynecologist considers the patch or the electronic cigarette as a lesser evil. At the mention of the possible effectiveness of "natural" medicine, such as acupuncture or hypnosis, or financial incentives, he adds: "There is no wrong way".
Finally, the support of the spouse seems to be the best way to convince the pregnant woman to stop smoking: "When the spouse succeeds in weaning during pregnancy, then it is won for the pregnant woman".