As a society, we're well attuned to birthing horror stories. It's "like pushing an apartment block, with wrap-around balconies, though your asshole," my mother used to tell me. There's even a recognized psychological disorder: tokophobia, or a paralyzing fear of giving birth.
Now, a decade-long anthropological study from Australian National University finds that teenage girls have internalized this fear so deeply that they've resorted to dramatic measures. Associate professor Simone Dennis found that they were actively turning to cigarettes while pregnant, believing that it would lead to smaller babies and subsequently less traumatic births. In some cases, the girls began smoking when they found out they were pregnant.
"I wouldn't call it a trend," Dennis told Broadly, "but it was definitely common enough for me to pick it up as a pattern. In every place I went, I'd find at least a few girls talking about it."
While the scientific community has yet to decide whether a glass of wine in the first trimester is definitively bad for you, a clear medical consensus has existed for decades around smoking while pregnant: Don't do it.
Smoking while pregnant increases the risk of infant mortality by an estimated 40 percent; it can also contribute to labor complications, miscarriages, premature or still births, low birth weight, and respiratory problems during childhood. But many women do smoke while pregnant. In Australia, the figure hovers around 14.5 percent of expectant mothers, although accurate figures are difficult to obtain because of the social stigma associated with lighting up while pregnant—it's estimated that up to a quarter of pregnant mothers lie when asked if they smoke.
I ask Dennis about the profile of teen girls who smoke while pregnant. "Broadly speaking, these girls sat outside the middle classes, which is where anti-smoking legislation has been most successful. They were very young, aged between 16 to 19 years old. Most were not in full-time education or work, and they were in low socio-economic groupings."
A recurring theme emerged when Dennis interviewed young girls she found smoking while visibly pregnant in public places. "The message came back to me time and again that this was a strategy to reduce birth weight." Ironically, cigarette packet warnings reinforced, rather than challenged, their worldview. "You see warnings about smoking resulting in lower birth weight babies on packets, and this is often graphically reinforced with pictures of very small infants."
Why are these girls so scared of giving birth to larger babies? "Most were scared of splitting or tearing. Quite a big proportion of them had older sisters who'd given birth, or friends, and women tend to talk in horror story terms about their birth experiences." Fears of traumatic pregnancies were also exacerbated by the concern their vagina would never be the same again. "They were worried about not being able to present in the way they'd used to with men if they'd torn during birth."
Like most bad ideas, the decision to continue or take up smoking while pregnant didn't emerge in a vacuum, but was informed by family and friends. "Quite a few took up smoking for the first time when they got pregnant, and they'd take cigarettes from friends rather than smoking on their own. Often the girls would be born of smoking mothers, or there would be a long history of other women smoking while pregnant in the family, and they'd say, 'Nothing happened to me, I'm fine.'"
Another fear that emerged was of weight gain, which—given how our society fetishizes women who emerge from pregnancy as slender as they were before—is unsurprising. "By and large, they were petite girls anyway, so any weight gain was a terrifying prospect."
The girls profiled also reported feeling more comfortable smoking if they knew they'd be having female babies. "They thought that female babies would be able to get away with being petite, and that it would be advantageous to them later. It comes out of this gendered view that girls can be delicate and small."
Given all the moralizing that persists around teen moms to this day—let alone those caught smoking while pregnant—it's unsurprising that Dennis' survey respondents were used to being publicly shamed. "These are young women who are already subject to a lot of social stigma, due to their generalized socio-economic status. They were often the subject of stares or verbal remarks about what they were doing.
"But they were good at returning the remarks too. They were quite skilled at dealing with the position they were in, and there was a definite 'I'm doing this, so shut up' kind of attitude."