Does Smoking Affect Getting Pregnant? 9 Ways Cigarettes Impact Women's Reproductive Health

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: how smoking impacts your chances of getting pregnant and your reproductive health.

Q: I’ve been a smoker since high school. I’ve tried to quit a few times but so far it’s been tough. I know all about the risk of lung cancer (believe me, my parents tell me all the time), but someone just mentioned in passing that smoking has some negative side effects for women, particularly in regards to reproductive health. Is this true? What am I looking at future-wise? Now I’m freaking out that I can’t have kids!

A: Not only is cigarette smoke the single most avoidable cause of mortality in the United States, but even if it doesn’t kill you, it can make you very sick. And I’m not just talking about lung cancer here. Smoking tobacco has been associated with other cancers, heart disease, and other chronic lung issues ... and that’s just the tip of the iceberg.

There are certain health risks that are specific to humans born with female reproductive systems. It’s important to know about these risks if you’re a smoker, or if you hang out with smokers (because second-hand smoke is a real thing). We’re about to get deep into it, but just so you know: healthcare professionals are clear that smoking is really damaging to women’s sexual and reproductive health, and also has dangerous repercussions for children of smokers. Let us count the ways.


Smoking has been connected with many fertility challenges. Researchers have found that smokers have a harder time getting pregnant — if you smoke, your chance of conceiving each cycle can go down by up to 40 percent, depending on how much you smoke.

And if you have a partner who owns a penis who smokes, his fertility is at risk as well. Male smokers have a lower sperm count, and the sperm that they do have contains more malformed sperm. Also, nicotine gets into semen and messes with the motility of those little swimmers. Finally, there’s indication that smoking is correlated with male impotencebetween 40 and 80 percent of men who are impotent are also smokers, compared to 28 percent of non-smoking men.

Pregnancy Risks

Of course, fertility risks are just that — risks — and many smokers do get pregnant. Unfortunately, smoking during pregnancy comes with its own potential scary health outcomes.

Ectopic Pregnancy

Smokers are more likely to get an ectopic pregnancy, which is where the embryo implants in a place other than the uterus (usually one of the fallopian tubes) and starts to grow there. This is very dangerous, because other parts of the body aren’t equipped to deal with a rapidly growing humanoid, not to mention able to feed it and otherwise care for it. Ectopic pregnancies require emergency surgery and sometimes the removal of the fallopian tube and ovary.

Spontaneous Abortion

Women who smoke during their pregnancy are more likely to experience a miscarriage, also called a spontaneous abortion, which is when the fetus dies before it’s been cooking for 20 weeks. The risk of birthing a stillborn baby is also higher in smokers, which is when the fetal death occurs after the 20 week mark. Research indicates that around 25 percent of stillbirths are connected to smoking mothers.

Difficulties With The Placenta

Smoking pregnant women are more likely to experience challenges with their placenta. These include placenta previa, which is where the placenta starts growing too close to the uterine opening, covering the cervix. This can result in bleeding during or before birth. Smokers are also more likely to experience placental abruption, which is where the placenta separates from the uterine wall too early, leading to a premature birth or stillbirth. Finally, the placenta is more likely to rupture prematurely (aka before labor even starts) in smoking moms, which also results in a premature birth. All of these placental situations are very dangerous to both mom and child.

Challenges For Babies

Babies can be very affected if their mothers smoked while they were pregnant. Babies of smokers are more likely to be born premature, have low birth weight, which is the leading cause of infant mortality, and be more likely to die of SIDS (sudden infant death syndrome), which is when a baby that seems healthy just dies while sleeping. Horrifying. There’s also higher instances of some birth defects, like cleft lip or cleft palate.

Unfortunately, many of these health risks remain the case with second-hand smoke as well. Exposure to second-hand tobacco smoke in utero is associated with lower birth weight, premature birth, and spontaneous abortion. Babies exposed to second-hand smoke once born are more likely to be asthmatic and to get ear infections. They’re also at higher risk for SIDS.


Smoking also affects breast milk in both quality and quantity. If the mother smokes heavily while breastfeeding, researchers have found that the amount of nicotine and other toxins the baby ingests can be on the level of one cigarette a day. This can result in developmental delays, low weight, as well as just making the baby sick. Smokers also produce less breast milk than non-smokers. And the worse news is that all these bad things can happen with exposure to second-hand smoke too.

Other Reproductive Health Risks

But it doesn't stop there folks! There are plenty of other reproductive health risks to smoking.


Researchers have found that women who smoke are at higher risk than non-smokers to develop many types of gynecologic cancer (including cervical cancer and ovarian cancer).

Hormonal Changes

Smoking can also lower your estrogen levels, which is one of the hormones that dictates your menstrual cycle. Lower levels of this hormone can lead to osteoporosis and heart disease.

Birth Control Side-Effects

If you are on a combined hormonal birth control (one with both estrogen and progestin hormones), you’re already at a higher risk of heart disease. If you also smoke, your risk of having a heart attack is 20 times higher than a non-smoker who is on the same pill. Taking an oral contraceptive while smoking is also associated with higher risk of stroke as well as blood clots.

The Bottom Line

At the end of the day, it’s up to you whether you smoke or not. Addiction can be immensely powerful, and quitting rarely if ever looks like someone just deciding one day to walk away and being successful. People choose to start smoking for innumerable reasons that should not be discounted — they like the way it makes them feel, it helps them mitigate stress, their friends are doing it, they think it’s sexy, whatever.

Lots of human research shows that just telling people about potential future health risks isn’t always enough to get them to stop doing something that they take pleasure in now. If you are interested in quitting smoking to protect your health (and the health of your potential future wee ones), it’s important to know that quitting is super difficult! It may take you many tries, and that’s totally normal and okay. Getting people you love and trust to support you (and not be the friend in the club offering you a smoke when you’re already buzzed) is critical, and finding a doctor or a program to help is a good idea too.

The good news is that if you stop using tobacco products, your body can reset rather quickly, making all these scary risks drop way down. For instance, if you stop smoking when you’re pregnant, you can reduce the low birth weight of your baby significantly. Similarly, if you stop smoking, your risk of ovarian cancer will eventually go back to that of a non-smoker.

Just remember, when you’re really jonesing for a puff, that you’re working actively to protect your health and the health of future generations. That is pretty f***ing powerful!

Images: AMC; Giphy