News From Terre Haute, Indiana

December 15, 2013

Baby & Me: Mothers and the fight to quit smoking

New state program targets health risks, offers rewards for success

Sue Loughlin
The Tribune-Star

TERRE HAUTE — When Heather Owens learned she was pregnant with her first child March 3, she quit smoking within two days.

And on Nov. 3, just two days short of her due date, she gave birth to a healthy baby boy, Joseph, who was 7 pounds, 81⁄2 oz. and 20 inches long.

For many who have smoked, the temptation to start back up after giving birth is great. But Owens has resisted. “I think about it, but it’s not worth it,” said the 23-year-old Terre Haute resident.

She knows it’s bad for her son’s health, and she’s had a lot of support along the way from Carrie Evans at Union Hospital’s Family Medicine Center.

Now, Owens is participating in a new program offered in the Hoosier state called “Baby & Me — Tobacco Free,” which started in October. If she remains smoke-free, for which she is tested, she receives a $25 monthly voucher for a year to purchase diapers at a local store.

“Heather is the first recipient [of the voucher] in the state of Indiana,” said Evans, the Baby & Me program coordinator at Union Hospital Family Medicine. “It’s a big incentive.”

Union Hospital Family Medicine was awarded a state Department of Health grant to offer the program.

Previously, starting in April, Evans and Owens worked together in a program called Prenatal Substance Use Prevention Program. Baby and Me, which has a successful track record in other states, has replaced it.

The program’s goals are to get pregnant women to quit smoking, but just as important, “to keep them quit, especially post-partum,” Evans said. “We know that the majority of the time the women who are able to quit during pregnancy are tempted to go back after they have the baby, within that first month.”

 Baby & Me offers support that first year to help keep women from relapsing, Evans said.

Those who enroll in Baby & Me participate in at least four prenatal quit-smoking sessions; they must quit smoking by the third prenatal visit and stay quit during pregnancy; they also must stay smoke free after the baby is born, and if they do, they receive the monthly voucher for free diapers.

Now, Evans and Owens meet monthly, and Owens is tested at each visit to ensure she remains smoke free.

Evans works with clients one-on-one, and initially the focus is on education so mothers-to-be understand the dangers of smoking to their children, both before and after babies are born.

Evans also provides ongoing support. “My biggest role is to be their cheerleader and keep them going,” she said. “Heather knows she can call me anytime if she has a craving.”

Owens’ boyfriend continues to smoke, but now, he does it outside.

Any pregnant woman who smokes can participate, although participants at Union’s program must be Indiana residents, Evans said. “It is not income-based.”

There is no charge to participate.

Everyday smokers who quit within three months of becoming pregnant also qualify. “The fundamental idea is to help them quit and keep them quit long term,” Evans said.

Illinois also offers the program.

While Baby & Me —Tobacco Free is offered through the Family Medicine Center, clients don’t have to be patients there, Evans said. Family Medicine Center patients who are pregnant automatically are sent to Evans for a screening process.

She provides education, but if smokers don’t want to quit, they aren’t forced to participate. The program is voluntary.

“If we find tobacco use, they are able to work with me throughout the pregnancy to help them quit their addiction,” Evans said.

Early next year, Evans will be able to work with clients via telemedicine at the Clay City Center for Family Medicine and the Vermillion-Parke Community Health Center.

“It’s like skyping with them,” she said. She will be training staff at each location.

Evans noted that smoking during pregnancy is “a huge contributor” to infant mortality, and Indiana has the sixth highest infant mortality rate in the nation.

Gov. Mike Pence has described the state’s high infant mortality rate as “deplorable” and he has challenged public health officials to find ways to reduce the number of infant deaths.

According to Evans, Baby & Me is a step in the right direction.

“If we see the same success rate that has been seen in other states where this has been implemented, we’re going to see a drop in infant mortality rates,” Evans said.

Women who smoke during pregnancy are more likely to have their children die from Sudden Infant Death Syndrome (SIDS). They are also more likely to have miscarriages, stillbirths and children with birth defects.

According to the Indiana State Department of Health’s Tobacco Prevention and Cessation Commission website:

• Twenty to 30 percent of the cases of low birth weight babies can be attributed to smoking.

• Women who smoke during pregnancy have more than twice the risk of delivering a low birth weight baby.

• Babies of mothers who smoked during pregnancy have twice the risk of SIDS than infants of nonsmoking mothers.

n Women who smoke have a higher incidence of ectopic pregnancy.

• Pregnant smokers also have a 30 to 50 percent higher risk of miscarriage than nonsmokers.

Evans says she’s proud of Owens. “She’s done amazing,” she said. Evans knows how difficult it is because she used to smoke. While she quit during her first pregnancy, Evans started smoking again several months after she had her baby.

She finally quit for good about 11⁄2 years later.

“I’m not judgmental,” Evans said. She understands.

“It’s really hard, even during pregnancy. You’d be surprised how much temptation there is to go back to smoking,” Evans said.

Especially when someone who’s quits lives with a smoker, “The odds are really stacked against you. And so the fact Heather has continued on with this is just amazing. I’m really proud she was the first person in Indiana [to qualify for the voucher]. That’s awesome.”

For more information about Baby & Me-Tobacco Free, contact Evans, the program coordinator, at 812-478-4136.

Sue Loughlin can be reached at 812-231-4235.