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7.40 MB | 18:27 Min
Dr. G. Alan Marlatt is an expert in the field of addictive behaviors, and is the director of the Addictive Behaviors Research Center at the University of Washington.
Dr. Michael Broder wrote the book The Panic Free Pregnancy. He is also an Assistant Clinical Professor of Obstetrics and Gynecology at the David Geffen School of Medicine at UCLA.
Welcome to your Pea in the Podcast. I’m Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey as someone’s mom.
This week, you know you have to quit…
“I started smoking when I was probably about 15 or 16.”
Well, of course you have to quit smoking, but what do you mean you have to watch what you eat?
“It wasn’t so hard the donuts, I could give those up pretty easy but I could not eat one French fry.”
In this Pea in the Podcast, we’re breaking bad habits. You can do it!
It’s the time you’ve been waiting for all of your life. You’re pregnant; you’re eating for two so you can gorge on hot fudge sundaes and cheeseburgers without guilt, right? Well, that’s what Lynn thought for a few glorious weeks.
“You first start out and you’re like I can eat ice cream, I can eat all this stuff that’s taboo, but now I can say oh, but I’m pregnant so it’s okay. I found out I had gestational diabetes at 13 weeks already.”
For Lynn, that diagnosis meant rethinking a lifetime of poor eating habits.
“Oh, I ate all the good stuff, French fries, chips all those were my favorites. I wasn’t big into desserts, but a donut now and then at work would be okay, but oh my gosh, the French fries and the chips and that kind of stuff, non-stop.”
If Lynn kept that up very long, her gestational diabetes would soon be out of control, bad news for both her and her baby. It was time to do something about the way she’d always eaten.
“Okay, I don’t want to give myself shots so what’s my alternative? I had to meet with nutritionist and dietician and everything and she was like you can probably just eat differently. Whoa, that was hard enough in itself to learn what foods you could and couldn’t eat and then to have to give up all your favorites, of course.”
That’s the hard part, isn’t it?
Dr. G. Alan Marlatt is a professor, and he’s the Director of the Addictive Behaviors Research Center at the University of Washington. He says bad habits are about feeling good.
“It’s pretty clear that things that feel good immediately, that make people more relaxed or euphoric or feeling just more confident about themselves will strengthen the habit.”
For many people who smoke, that describes their experience to a T. When Saren got pregnant with her daughter Belle, she was one of them.
“I smoked about a pack a day if I’m honest with myself. If anybody asked me I would have said half a pack but I smoked a pack.”
Cigarettes had been something Saren had enjoyed for a decade.
“I started smoking when I was probably about 15 or 16 and it was mostly because a lot of my friends did. It was kind of just like a rebellion kind of thing, but I didn’t want my parents to know.”
But when she found out she was pregnant, she knew she wanted to stop.
“I wanted to quit because I knew that it wasn’t good for the baby. I didn’t want to have an unhealthy baby but it was more for the long term after the baby was born that I was the most concerned because I didn’t want to smell like smoke, I didn’t want my baby to smell like smoke. I didn’t want to have to worry about being in the car and not being able to smoke with her there. In the very beginning it was, of course, I didn’t want her to get the affects of the smoke because I knew it was bad for her. But in the long term it was I didn’t want to have the after affects after she was born.”
UCLA Obstetrician and author of the book The Panic Free Pregnancy, Dr. Michael Broder says Saren had the right idea.
“If you smoke, quitting smoking is the single best thing you can do for yourself and for your pregnancy. There’s no doubt about that. I mean smoking is probably one of the number one or two causes of preventable injury or illness in this country, maybe overweight as the other one. So I can’t say enough about how important it is to not to smoke during pregnancy, I mean period not to smoke but during pregnancy there are many things that are worse during pregnancy if you smoke.”
Dr. Broder says the problems your cigarettes cause for your baby are very real.
“The most common problem would be a growth restricted or small for gestational age baby when it’s born. So babies just don’t gain weight normally when it’s to a mother that’s smoking. Then there are all kinds of other things that are much less common, but still aren’t good. So quitting smoking, avoiding that particular habit is a good thing to do.”
So what do you do? Dr. Marlatt says for a habit like smoking a mom-to-be may want to throw away their pack of smokes immediately, but for others it’s not that easy.
“Just having a motive to quit isn’t enough. I like the expression where there’s a will there’s a way. You need both the will, which is the motivation to protect your child and your own health but you have to figure out what way is going to work for you.”
For those moms-to-be, Marlatt says you need to make a plan.
“Well, what we do when we help people quit smoking is first of all you need a quit date. So it may be that you find out that you’re pregnant at a certain day, then the quit date should be at least within a week.”
Marlatt says that week gives you time to learn some things about yourself that will help you succeed.
“We have people keep track of their smoking and rate how pleasant it is, how rewarding it is on a scale of 1 to 7 and then write down the situation and the mood that you’re in when you have the cigarette. We do this to identify what we call high-risk situations for relapse. You have to know what situations are going to cause you the most temptations after you quit. The reason we do that is we need people to make a plan ahead of time what they will do instead of smoking in those kinds of situations.”
Since smoking is often relaxing to a smoker, Marlatt says at the Addictive Behaviors Research Center they help clients find alternatives.
“We teach them other ways to relax; usually meditation is the most helpful, if you’re focusing on your breath instead of the smoke.”
For Saren, it took more than a week to quit…it took her a trimester.
“I found out I was pregnant about 8 days after it happened, so I think the reason that I didn’t automatically quit is because it didn’t seem real to me. I kept expecting them to come back and say oh no, you’re not pregnant. So I kept thinking well I’ll just keep smoking until I know for sure, which was completely stupid because that was the time when it was most crucial to the baby when I should have quit. But after the first trimester when it finally sunk in that yes I am going to have a baby, I am actually pregnant and I’m not going to have a miscarriage then it was like, okay, now I need to quit.”
Marlatt says that kind of rationalization is very common when people are trying to break bad habits. But when Saren finally did decide to quit, she didn’t hold back.
“I actually quit cold turkey. It was because I got into an argument with my husband and he told me that he didn’t think I could do it. So that day I threw away that pack of cigarettes and I was done just to prove the point to him that I could do it, like watch me.”
For some people that kind of challenge is enough, but Dr. Marlatt says other people have to be more vigilant.
“Watch out for the PIG, the PIG stands for the problem of immediate gratification. That’s where you’re craving something or you’re upset and you want to go shopping just so you can feel better right away. These kinds of things are attractive in the short run but it’s going to cost you a lot in the long run.”
Obstetrician Dr. Broder stresses while he wants you to quit smoking right now, he acknowledges some people just won’t.
“If you can’t quit, then cutting down is a good idea. Even a pack a day is better than 2 packs a day. So women who can’t quit should consider the idea that even cutting down is worth doing. If you can’t do it on your own there are methods, patches and things like that that can be used to help and those are probably better in pregnancy than smoking.”
Dr. Broder says those nicotine replacement therapies are truly the lesser of two evils.
“If you’re smoking, you’re getting not only nicotine but you’re getting tar and other kinds of contaminants and carbon monoxide into the blood and all kinds of things. When you drop cigarettes and put on a patch, what you’re getting instead is just the nicotine. While it’s better to probably not even have that, the nicotine alone is probably better than all of those other things that you’re inhaling.”
Some moms-to-be also show struggle with alcohol addictions. For them, Marlatt suggests something the folks at Alcoholics Anonymous would be familiar with, thinking through the drink. He calls it the decision matrix.
“You have a choice, shall I drink during pregnancy, yes or no? Then for each choice for yes you say what are the immediate benefits that I will experience from quitting? Then also what are my immediate costs or things that I’m afraid of? Then you do the same thing on the other side if you continue to drink. Yes or no, what are the consequences both immediate and long term consequences? A lot of times that helps people sort out what their anticipated affects are to give them a clearer sense of choice about it.”
The March of Dimes suggests that you do not consume alcohol at all during pregnancy, because fetal alcohol syndrome can cause devastating physical and mental birth defects for your child. Dr. Michael Broder says drinking during pregnancy is a Russian roulette for your baby.
“There are lots of women who go on drinking binges, 10 drinks a day. 70% of women who drink that much do not have babies with fetal alcohol syndrome — 10 drinks a day! And yet some women who’ve had only a few drinks have babies — that drink only 2 or 3 drinks a day — have babies that are affected.”
That’s good information to have as you’re trying to think your way through the drink.
More on the decision matrix, Dr. Marlatt says this approach will help more than the mother-to-be trying to stay away from alcohol, it’s helpful as you’re faced with all kinds of challenges to your willpower during pregnancy…and your willpower *will* be challenged. Ask Lynn, who was forced to break her bad eating habits to control her gestational diabetes. Did she slip?
“Oh, yeah. But my doctor was really good about it. She actually, if I could explain, I actually had to write down all my numbers from testing and then fax them in to her every Monday and if I could explain why I had a high number reading or something like that, you know I had this for dinner so I know I can’t eat this anymore or whatever the case may be. She was really good at allowing me to have some slip ups like that. She didn’t come down on me too hard.”
Dr. Marlatt says that may actually be the secret to breaking a bad habit successfully.
“The people that were successful seem to have ways of managing lapses. So even though they might have a cigarette or 2 or a drink or 2, they try and instead of saying oh, this proves I can’t do it, I have no willpower, I give up, they would say well I made a mistake here, I had a cigarette, I was stressed out but I learned that I need to work on a better way to handle stress so I’m not going to give up on my attempt to quit.”
So Lynn didn’t let the occasional French fry get her down.
“I think it’s good if you have a doctor who can understand that you’re just human and if you have a slip up or even an intentional slip up, it’s okay. I think those points that my OB always kept making was we have to control them the vast majority of the time. You have one slip up in a week it’s not going to be the end of the world.”
Ultimately, Marlatt says it’s all about acquiring new coping strategies to replace the old. Whether the old coping tools were to eat a big old order of fries, or smoke a pack of cigarettes or order a drink or 2 or maybe buy a closet full of Manolo Blahniks. At the Addictive Behaviors Research Center, they teach several alternative strategies.
“Meditation, exercise, how to talk to others about your problems, how to get additional support. Then the last way is try to find somebody else or a group of other people that are working on the same problem. So a group of pregnant moms can get together and discuss their collective habits and how they’re handling them can be really helpful.”
Sometimes finding a group of supportive moms is harder than it sounds because some of you are embarrassed to reach out and admit you’re struggling.
“Yes, it’s embarrassing but once you get it out and people can be supportive and say oh, I’ve had that same problem and here’s how I handled it. It can really be helpful.”
Your obstetrician may be able to point you in the direction of a group of moms-to-be who can help you through your struggle with your bad habit or you can also find support on the web.
Do moms-to-be who break bad habits stay on the straight and narrow? Well, some do.
“Well, that depends. Some moms are likely to say wow I’ve been able to go several months now or maybe a whole stretch of 9 months without smoking, I’ve gotten through physical withdrawal, I’ve learned other ways to handle things are able to maintain their abstinence. But of course, it’s good not to have secondhand smoke around or just be smoking in front of your kids. Others just they can do it for 9 months and they feel like that’s it and they’re wanting to go back. So that happens quite a lot also.”
Saren picked up her smoking habit again when her baby was 4 months old, something she’s not happy about.
“I feel guilty. There are still certain things that I don’t do. I don’t smoke in the car because I don’t want her to be around it. I don’t smoke in the house. Usually if I do smoke during the day or whatever I’ll change my shirt when I come in or I’ll put on a jacket so it smells like smoke but I don’t. Even though I am sure I still do, I still can’t smell it anywhere other than the jacket.”
But breaking that bad habit again is always on her mind.
“I’m all about wanting to quit again because I’m trying to get pregnant again, but at the same time I’m going when I get pregnant I’ll quit. I don’t really need to quit until I get pregnant again.”
Marlatt says whenever Saren decides to quit, she still has reason to be hopeful about her chances of long term success.
“Take a look at what happened and then try again because for example with smoking among the general population it usually takes between 8 to 10 serious attempts before people are able to be successful. So each time you try it you learn something and you sort of get closer to the threshold of change. So it’s not the other way around. People saying oh, I’ve tried to stop drinking 4 times and I can’t do it. Hey, 4 times you’re getting closer to what the average number of times is before people are successful. So give yourself more leeway that way.”
Lynn says when you’re struggling to break your favorite bad habits, just keep your eyes on the prize.
“It’s amazing what you can do when you have such a great reason to do it. That was my whole thought process when I got GD so early was I have to do this for my baby. I think it’s a lot easier to make a change when someone else is involved.”
Especially when that someone else who’s involved is your baby.
We hope you’ve enjoyed this Pea in the Podcast: Breaking Bad Habits. Please visit our website, peainthepodcast.com, for more information about our experts, to find links and transcripts, and to register to receive tailored week-by-week shows for each week and stage of your pregnancy. It’s everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I’m Bonnie Petrie, thanks for listening.
A Special Thank You To…
Lynn in Wisconsin and Saren in Colorado for sharing their secrets for breaking bad habits during pregnancy in this Podcast.