Why is it so dangerous to smoke during pregnancy?

Cigarette smoke contains more than 4,000 chemicals, including truly nasty things like cyanide, lead, and at least 60 cancer-causing compounds. When you smoke during pregnancy, that toxic brew gets into your bloodstream, your baby's only source of oxygen and nutrients.

While none of those 4,000-plus chemicals is good for your baby (you would never add a dollop of lead and cyanide to his strained peaches), two compounds are especially harmful: nicotine and carbon monoxide. These two toxins account for almost every smoking-related complication in pregnancy, says ob-gyn James Christmas, director of Maternal Fetal Medicine for Commonwealth Perinatal Associates at Henrico Doctors' Hospital in Richmond, Virginia.

The most serious complications — including stillbirth, premature delivery, and low birth weight — can be chalked up to the fact that nicotine and carbon monoxide work together to reduce your baby's supply of oxygen. Nicotine chokes off oxygen by narrowing blood vessels throughout your body, including the ones in the umbilical cord. It's a little like forcing your baby to breathe through a narrow straw. To make matters worse, the red blood cells that carry oxygen start to pick up molecules of carbon monoxide instead. Suddenly, that narrow straw doesn't even hold as much oxygen as it should.