A plea to the pregnant

Jennifer Lint reviews information gathered during her research into health risks associated with pregnant women who smoke. She is a third-year medical student at OHSU. (Baker City Herald/S. John Collins)

“One of the most staggering statistics I found was women who smoked during pregnancy,” she said.

Lint is a third-year medical student at Oregon Health and Sciences University in Portland, and this week she finishes her four-week rural rotation at Eastern Oregon Medical Associates in Baker City.

Part of that rotation is to design a project focused on the community.

In those health statistics she found that, in 2007, Baker County’s rate of pregnant smokers was 30 percent, as opposed to 12 percent for Oregon. The county figure is a little lower for 2009 — 25 percent according to the DHS Tobacco Fact Sheet — but Lint still saw it as a huge public health issue.

• Reduces blood and oxygen flow and increases the risk of serious conditions such as placenta abruption or placenta previa

• Doubles the chances that membranes will rupture prematurely and increase the risk of the baby being born prematurely by 30 percent

• Increases the risk of the baby weighing less than 5fi pounds, which can increase the risk of illness and death

• Reduces the baby’s lung function

• Makes the baby 1.4 to 3 times more likely to die of Sudden Infant Death Syndrome (SIDS)

• Can increase the risk of the child developing colic, asthma and childhood obesity

In her research, Lint found that the most effective strategy to help pregnant women stop smoking is “behavioral intervention.”

“I started talking to the staff nurses at EOMA,” she said.

The smoking issue isn’t a new one. On the initial visit, a staff nurse spends 40 minutes gathering a health history from the pregnant patient, and one of those questions is about smoking.

“To do some education, assessing where they are in their readiness to stop,” said Kelly Jacobs, a staff nurse at EOMA.

The packet Lint has put together follows an approach with five “As” — Ask, Advise, Assess, Assist and Arrange — that encourages pregnant women to give up smoking, or at least cut down on the number of cigarettes they smoke.

At their first appointment, the patient develops a “quit plan” by writing down reasons to stop smoking, their goal (quit or reduce), activities to do instead of smoking and a list of places and people to avoid while trying to quit.

Also, the nurses and doctors can talk about resources that help smokers quit.

The Quit Line (1-800-QUIT-NOW) connects the caller with a Quit Coach who provides educational materials, helps develop a plan for quitting, and helps find local programs and resources. Callers are encouraged to call their Quit Coach whenever they need too — all the calls are free and there is no limit.

At each prenatal visit, the patients will be encouraged to review their goal and report on their progress.

“Where are you in your quit plan and how can we help you?” Lint said, illustrating a possible approach.

“At every visit she knows people will be checking up on her,” said Becky Sanders, nursing supervisor at the Baker County Health Department, who has offered Lint guidance with this project.

The goal is to increase the chance of a healthy baby.

“What this is about is support,” Lint said. “We know it’s a really difficult thing we’re asking, to quit smoking. But what other point in life will there be a bigger incentive?”