Essay Sample Smoking During Pregnancy: High Risks for Mother & Baby

Introduction

Smoking while pregnant exposes women and their unborn children to increased risks of health complications or even death. The hazards that are likely to occur to pregnant smokers include premature labor and miscarriage. Moreover, one is highly likely to give birth to a low-weight baby compared to non-smokers. Unfortunately, low-birth babies rarely survive because they are as well at more significant risks of dying and are vulnerable to contagious infections. Those of which by luck, survive normally develop breathing complications and long-term health conditions in their adulthood. According to the Center for Disease Control and Prevention (CDC), smoking and other forms of opioid use disorder is a severe health issue across the United States. More reports state that between 1999 and 2014, the number of pregnant women with substance use disorder at labor and delivery increased four times. CDC further clarifies that there is a significant link between substance use, in this case, smoking and severe health conditions during pregnancy, including and preterm birth, stillbirth. The connection extends to neonatal abstinence syndrome (NAS) and maternal mortality. Therefore, I will focus my discussion on stillbirth and maternal mortalities because of substance use through smoking, management measures by the government, and research institutions in the USA.

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Stillbirth as Health a Concern of Smoking during Pregnancy

Maternal smoking associated with increased risk of stillbirth, and there have been just a few studies to ascertain whether smoking results in threats of the antepartum and intrapartum stillbirth differently. Besides, the studies also sought to know whether smoking cessation initiated by the federal government of United States reduces the risk. According to Bjornholt et al. (2016), any form of single smoking increases stillbirth risks both in overall and in antepartum stillbirths. From their report, women who decided to quit substance smoking at the beginning of their second trimester of pregnancy had reduced risks of stillbirths. These scholars further explained that it is a rare unfortunate birth outcome in high-income countries estimating at 2.1-3.6 cases per 1000 birth outcomes. The estimated stillbirth rate across the universe is higher due to the increased number of cases in developing countries (Bjornholt et al., 2016).

The federal government of America and professional health research institutes are working hard over the years to minimize maternal smoking. A dose-response effect of smoking during pregnancy confirms the high risks of stillbirths. To mitigate these risks, a reduction in current maternal smoking prevalence in pregnancy must continue to be a public health priority (Marufu et al., 2015). On the other hand, CDC has an overarching five-point strategy to manage substance use and other drug harms. The organization is taking specific measures to prevent maternal substance use among pregnant women. Besides, the organization is set to ensure that all expectant women with substance use disorder get proper medical care to reduce cases of stillbirths. The organization has established guidelines for prescribing opioids for chronic pain, including information of expectant women and those who may become pregnant soon.

Elsewhere, President Obama signed into law the Family Smoking and Tobacco Control Act on June 22, 2009. This legislation changed the scope of tobacco policy drastically by mandating the Food and Drug Authority (FDA) to regulate the distribution and consumption of tobacco products. FDA would go-ahead to practice regulatory procedures used in regulating food and pharmaceuticals since the enactment of the Pure Food and Drug act in 1906. The Act gives FDA vast control on all tobacco products for sale within the country. A more significant part of the legislation targets cigarettes and smokeless tobacco products in specific. FDA, under the Act, created a branch called Center for Tobacco Products in response to its mandate to implement the provisions of the Act. Therefore it created eight divisions, each responsible for the protection of particular aspects of the public health goals. For instance, setting performance goals, reviewing the application for new tobacco products, and modified claims on risks associated with the products, and requirements and control on warning labels. Additionally, one of the divisions also caters for the establishment and enforcement of advertisements restrictions.

Potential Stakeholders Supporting Health Policy Brief

The United States, as a developed nation, should be having limited cases of stillbirths due to maternal smoking during pregnancy. However, smoking is among the most modified causes of poor pregnancy outcomes in this country. These outcomes have close relationships with maternal, fetal, infant morbidity, and mortality. Therefore, the compassionate intervention by the obstetrician-gynecologists is so critical in prenatal smoking cessation. These professionals are the most suitable stakeholders who can steer the smoking cessation agenda across the United States to help prevent fatalities resulting from maternal smoking during pregnancies. They are capable of rolling out an office-based protocol that has a systematic identification criterion of identifying women who are expectant or may be expecting soon yet smoking. After the identification, they offer treatment for the women or offer them referrals to increase quit rates.

The professionals will also offer a short-counseling session with pregnancy-specific educational materials and a referral document for smokers' quit lines. They believe that this session is the most effective way to implement the smoking cessation strategy. Epidemiologically, increased public education and public health campaigns followed by rigorous application of the Family Smoking and Tobacco Control Act have significant effects. There has been a reduction in the number of cases of smoking among women in the reproductive age. Therefore, the efforts that the federal government is putting in the health sector to fight maternity morbidity and mortality caused by premature infant deaths and stillbirth is quite commendable. The government, through the proposed potential stakeholders, should heighten the precaution and preventive measures beyond what it is already doing to help CDC achieve its set goals.

Pending Legislation on Smoking Cessation

As much as the Family Smoking Prevention and Tobacco Act mandated the FDA to regulate Tobacco products across the United States, there were too many jurisdiction's power restrictions. The Act mandated the FDA to market and advertising cigarettes and smokeless tobacco that FDA itself adopted back in 1966, but the Supreme Court nullified that provision. In 2000, the apex Court ruled out that provision citing that the congress had not at the time given the FDA the authority to take such action. Instead, the marketing and advertisement provision had a new dimension with including areas to exercise power and within given jurisdictions. For instance, the new law dictated that; there would be bans on outdoor advertising within 1,000 feet distance coverage from either school compound or playgrounds.

Additionally, there would be a ban o sponsorship of sports and other entertainment events with the tobacco companies. There would also be bans on sample and sales of cigarettes in packages holding less than 20 sticks of cigarettes. Lastly, the law described jurisdiction limitations like an advertisement to take place in adult facilities only and limited audio and visual publications. Another essential aspect that the new legislation emphasized was the 18 years age bracket definition of an adult. The provision resulted in consideration of the use of tobacco products to adults alone. Therefore, the original marketing and advertising regulation that the Family Smoking Prevention and Tobacco Control Act defined to FDA changed to allow new provisions of the Act.

Plan for the Health Policy Brief

Smoking cessation is an already existing policy that needs new dimensions because its effectiveness is stagnating since its inception. The United States has capacity just like any other developed nation to register minimum utmost cases of stillbirth fatalities due to maternal smoking during pregnancy. Therefore, the proposed changes in the policy emphasize expertise capacity building considering the population of the United States. That is to say, the federal government, through its health agencies, should invest more finances in building capacities of the obstetrician-gynecologists who conduct smoking cessation processes. Considering the nature of the health sector in the country, the government has good policies. Still, there is a problem in their implementation due to cost factors. The government should take the lead while the professionals willingly take their part in the review and implementation of smoking cessation to manage the stillbirth menace. I approve of the advancement of this policy while urging the government to invest more in its provisions. The investment is essential because it will minimize general tobacco usage and reduce stillbirths due to maternal smoking.

Conclusion

As maternal smoking, while pregnant, generally risks the mother and the unborn baby's life, it is a common headache for the people of the United States. The federal government and corporate bodies like CDC are working towards the reduction of fatalities due to maternal smoking. While CDC is doing medical research and giving recommendations on policymaking, the government is doing much in the implementation of these policies. Through its expertise in the health sector and enactment of legislation to control substance taking, the government is already making visible efforts in the fight against maternal smoking. However, as years go by, the amendments on procedures on the measures taken in the battle against substance use may hinder the success of this war. Therefore, my proposed plan points out the changes in FSPTA, which will widen the scope of the FDA's work. The changes in the smoking cessation process to ensure the utmost minimal stillbirth cases due to maternal smoking.

References

Bjornholt, S. M., Leite, M., Albieri, V., Kjaer, S. K., & Jensen, A. (2016). Maternal smoking during pregnancy and risk of stillbirth: results from a nationwide Danish registerbased cohort study. Acta obstetricia et Gynecologica Scandinavica, 95(11), 1305-1312.

Marufu, T. C., Ahankari, A., Coleman, T., & Lewis, S. (2015). Maternal smoking and the risk of stillbirth: systematic review and meta-analysis. BMC public health, 15(1), 239.