In a nutshell
No, e-cigarettes are not recommended as safe during pregnancy.
Though they're now regulated in the UK, studies question their safety - although manufacturers still claim they are safe. So, the current advice is to avoid.
What health professionals say
NHS health professionals do not recommend e-cigarettes in pregnancy. The British Fertility Society has also recommended women "avoid all kinds of smoking" during pregnancy.
Emma Lees-Laing, a Midwifery Manager at pregnancy charity Tommy's, confirms:
“We advise you to follow the NHS advice. Our advice would be to speak to an NHS Pregnancy Stop Smoking Advisor or nurse at the Smoking Helpline (0800 169 9 169) that has been specifically set up for pregnant women."
Why is vaping unsafe for pregnant women?
The use of nicotine products is generally considered unsafe for everyone, especially pregnant women, due to a variety of health risks.
In July 2018, the NHS reported on an early study that claimed the use of e-cigarettes during pregnancy could potentially increase the risk of SIDS (Sudden Infant Death Syndrome).
The study, which was tested on unborn rats (not humans), looked specifically at rats with a serotonin deficiency.
(Serotonin, in addition to affecting mood, also helps to regulate breathing and helps the nervous system 'autoresuscitate' when there's a lack of oxygen.)
The study found that "nicotine exposure affected the ability to respond to lack of oxygen in rats with an induced serotonin deficiency'.
How would this then affect babies? "The concern is that a similar effect could happen in babies born to mothers with a pre-existing serotonin deficiency who use nicotine products during pregnancy."
It's worth noting that it was the combo of the 2 (serotonin deficiency and nicotine exposure) that affected the rats, whereas both on their own did not show the same results.
Is vaping better than smoking regular cigarettes during pregnancy?
OK, so, we know there's a bit of an urban myth going around that vaping is at least a tiny bit better than smoking regular cigarettes during pregnancy.
However, what evidence we do have on the subject (not nearly enough) suggests otherwise.
The vapour from e-cigs could affect a baby's coordination, memory and learning skills in later life, according to research from New York University's department of environmental science.
The vapour has also been linked to a higher risk of learning difficulties or attention deficit hyperactivity disorder (ADHD) – just like babies born to women who smoked regular cigarettes during pregnancy.
"Women may be turning to e-cigarettes as an alternative because they think they're safe. Well, they're not," said Professor Judith Zelikoff.
It's important to know, however, that the research was done on mice rather than humans. Pregnant mice were exposed to e-cigarette vapour without nicotine during the study and the chemicals were found to be more damaging to a baby mouse's developing nervous system than tobacco.
"What people don't realise is that even without nicotine there are many things that are given off when you heat up and vaporise these products," Prof Zelikoff said.
Are e-cigarettes and vape pens regulated?
Vape pens and e-cigs are now regulated by the MHRA (Medicines & Healthcare Products Regulatory Agency), as of 2016.
So, there are certain requirements brands have to meet in terms of telling you what's inside, and there are certain limits of nicotine they can't exceed.
Regulated brands will reveal proper information about the quality, effectiveness and any health risks of e-cigs.
The bad news? Not all e-cigarette makers will opt for their product to be licensed, so if you are vaping, make sure you choose a licensed brand so you know what you're smoking.
What ingredients do vape pens and e-cigs contain?
The ingredients in an e-cig vary brand by brand, as does the amount of nicotine.
Many brands seem to contain water. One brand, Vape Mate, say their e-cigs contain just 4 ingredients, which are thought to be pretty common across brands:
- Vegetable Glycerin - made from palm or coconut oil, you'll typically find this 'sugar alcohol' as an additive in foods. If consumed in large amounts, it can have cause diarrhea, or less commonly, headaches, nausea and vomiting
- Propylene Glycol - a synthetic chemical that's in the same class as alcohol, and is added to food, medical, hygiene and cosmetic products. Because it has a low melting point, it has been found in the coolant substance, antifreeze.
- Flavourings - it's all very 'hush hush' what's in the flavourings, though we've reached out to a few brands to find out what 'secret' ingredients they contain. We'll let you know if we hear back
A 2018 paper in Frontiers of Physiology says that, while the above are often considered safe for oral consumption, they've not been checked for inhalation purposes.
They also found that the chemicals that make up some flavourings (including cinnamon and vanilla) were shown to be toxic to our white blood cells when inhaled.
Interestingly, we haven't (so far) found many examples where the 'flavourings' are explored in any details - aside form this study.
Many brands don't list these chemicals on their websites, either, and say their flavour combos are 'trade secrets'.
Indeed, when we contacted manufacturer E Lites as a quizzical customer back in 2016, we were still none the wiser. Haden Webster, E Lites Contact Centre Team Leader, told us at the time:
“Unfortunately I cannot answer your question as this is a closely guarded secret due to the competitive nature of this industry.”
Aside from nicotine, could any of these ingredients harm my unborn baby?
Public Health England says, despite some manufacturers’ claims that electronic cigarettes are harmless, there has been evidence they could include nasties such as:
- Small amounts of formaldehyde and acetaldehyde, which are carcinogenic to humans
- In some cases vapour contains traces of carcinogenic nitrosamines
- Toxic metals such as cadmium, nickel and lead.
Initial tests have shown levels are much, much lower than in normal cigarettes - around one-thousandth of the level.
However, it's suggested that even at very low levels over a period of years, they could be damaging to your health.
Frustratingly, it's not clear if they might cause any long-term damage to your unborn child.
A previous study from 2014 also found dangerous chemicals in some makes of e-cigarette, including Ethylene Glycol, which is poisonous and also commonly found in antifreeze.
The study took place in Germany, and we're going to guess it was an unregulated brand, so again, if you do vape, it's important to research the brand you're vaping.
Do all vape pens and e-cigs contain nicotine?
As it happens, some e-cigarettes don’t contain any nicotine at all. If you find you’re not craving the nicotine in cigarettes, ask yourself if you really need them in the first place.
There have been limited studies to determine whether the nicotine found in an e-cigarette is at a high enough dose to affect your unborn baby.
The doses are smaller than in cigarettes and you can opt for a low dose version. Again this varies by brand, some are labeled as light whereas others are measured in mg.
That said, according to Public Health England, the amount of nicotine indicated on a cartridge isn’t a reliable indication as to how much nicotine you are inhaling.
Should I be worried about people vaping near me when I’m pregnant?
The manufacturers argue that because e-cigs don't burn tobacco, there's no smoke and no carbon monoxide for you to passively breathe in, and not enough nicotine emitted for you to be affected.
However, the 2016 study referenced above suggests the vapour could be harmful, so you'd be best to try to avoid breathing it in or standing too close to someone vaping.
Is it OK to ask someone to stop vaping near you?
MFMer Butterfly31 found herself in just that situation. “I’m currently having driving lessons and I've got a new instructor who smokes e-cigarettes a few times throughout the lesson. My mum and in-laws say I should say to him not to smoke it but I don't feel like I can.”
With a little encouragement from other MFMers in our forum, Butterfly31 found the confidence to tell the instructor how she felt.
“I have spoken to him as I didn't want to take the chance and he has agreed not to smoke and said he understood my concerns which is good.
"It was awkward having that discussion but he was actually fine about it so hopefully won't be an issue.”