The little we know about e-cigarettes suggests that it's safest not to use one while you're pregnant.

The problem with e-cigarettes is that, so far, they are unregulated. This means they have not been tested officially to check their safety. As you're using one, you can't be sure what's in the vapour you're breathing in, or "vaping". This means that neither can you be sure which chemicals are reaching your unborn baby.

Despite this, it's very likely to be less harmful to your baby if the alternative for you would be smoking tobacco.

Conventional cigarettes contain nicotine, as well as up to 4,000 other toxins. E-cigarettes usually contain nicotine, water and propylene glycol, but they can contain other, hidden toxins.

Nicotine narrows your blood vessels, which means that less oxygen and fewer nutrients reach your baby via the placenta. This could affect how well your baby grows.

As well as nicotine, e-cigarettes contain water and propylene glycol. Propylene glycol is used as an additive to keep food and cosmetics moist. It is also used in asthma inhalers as a carrier solution for the medicine. In e-cigarettes, the propylene glycol acts as a carrier for the nicotine. Propylene glycol on its own and in small amounts is safe for you to consume.

As you draw on the e-cigarette, the liquid is drawn into a chamber. This heats the liquid and turns it into a vapour, which you breathe in, or "vape". A hit of nicotine goes straight into your lungs, and is quickly absorbed into your bloodstream.

The trouble is, you can't be sure which other toxins you're breathing in, even if the ingredients are labelled. So you can't know which toxins are reaching your unborn baby.

Some e-cigarettes are sold as nicotine-free. But the Medicines and Healthcare Products Regulatory Agency, which investigates the safety of medical devices, found problems with the quality and labelling of e-cigarettes, as follows:
Some e-cigarette liquid and vapour contained traces of toxins, including cancer-causing chemicals nitrosamines and formaldehyde.
Some e-cigarettes that were labelled as containing no nicotine had low levels of nicotine. So even if you thought you were using a nicotine-free e-cigarette, you may, without knowing, be inhaling nicotine.
There was variation in the amount of nicotine delivered, so you may be inhaling more than you think with each puff.

If you're using e-cigarettes to help you quit smoking, it's best to discuss your options with your midwife. She'll support your efforts to kick the habit. Your midwife may recommend nicotine replacement therapy (NRT) instead of e-cigarettes.

NRT includes nicotine gums, patches, inhalers, tablets, lozenges, and sprays. There's not much research about how safe NRT is in pregnancy either. But the advantages of NRT are that it's subject to strict quality control and is available on the NHS.

It's understandable if you find e-cigarettes a more satisfying way to cut down or quit smoking your usual cigarettes. They're made to look and feel like a cigarette. However, the best advice remains to ditch the nicotine habit altogether, and not to use tobacco, e-cigarettes or NRT.

As more research, education and awareness about the health risks and dangers of smoking become available, more and more people are seeking safe and effective ways to stop smoking. Some of the ways people have sought help for smoking cessation is traditional therapy and Nicotine Replacement Therapy (hereafter referred to as NRT). NRT includes products such as nicotine patches and nicotine gum. In 2012, a research study indicated that NRT helped increase initial successful quitting by 50 to 70% of that specific sample.

Electronic Cigarettes: General Concerns

Another type of NRT growing in popularity are electronic cigarettes (also known as e-cigarettes), which heat and vaporize a mixture that contains varying levels of nicotine, depending on the cartridge, propylene glycol, glycerol, and flavors. While, most studies do confirm that electronic cigarettes contain significantly fewer toxins then normal cigarette’s, their effectiveness and usefulness are still under debate and study.

An issue of contention is that the nicotine levels are unregulated, and the FDA report revealed that some cartridges did not accurately report the amount of nicotine found in them. The same report claimed the presence of certain toxins and tobacco impurities that are found to be possibly cancer causing. However, other studies reported that they did not find these toxins or cancer causing agents in their e-cigarettes samples tested. Some studies also have reported a positive effect on quitting that is at least on part with other NRT methods.

Electronic Cigarettes and Pregnancy
Are Electronic Cigarettes Safe During Pregnancy?
But what about for those who are pregnant?

Like much of the research surrounding electronic cigarettes, there is not a lot of conclusive data on the use of electronic cigarettes and pregnancy. However, given the information available there are a few conclusions one may draw concerning this topic. For example, NRT utilizes nicotine for the purposes of smoking cessation. Nicotine can be very dangerous for the developing fetus and can lead to various harmful birth complications, which is why smoking during pregnancy is never considered safe.

Electronic cigarettes, which have significantly fewer toxins and nicotine then cigarette’s, still are introducing nicotine to the system. Adding more concern, if the FDA study is true, the user may not always even be aware of the amount of nicotine. Nicotine can move through the blood stream and disrupt the healthy development of the baby, as well as disrupt oxygen flow, raise blood pressure and constrict the blood vessels, impacting the supply of nutrients going to the baby.

Nicotine has also been linked to high risk pregnancies, premature birth, lower-birth weight and fetal injury. With all this in mind, if you are a smoker and you become pregnant steps need to be taken to reduce smoking and, ideally, quit. However, since many of the NRT’s used still involve nicotine, most aren’t considered safe or recommended.

The FDA reported Nicotine gum as Category C, meaning the risks aren’t low enough to be excluded in consideration of utilizing it. Transdermal treatments, such as patches, were sorted into category D, with evidence of risk being found. If electronic cigarettes function in the same way in introducing Nicotine into your system, the same consideration needs to be taken and kept in mind that none of the NRT’s are considered “safe” for pregnancy.

However, it should be noted that the American College of Obstetrician and Gynecologists reported that if all other non-pharmacological recourses have failed, patches and gum may be necessary. Some studies have shown that NRT’s have less of a risk of lower birth rate then cigarettes. When this statement was made e-cigarettes had yet to come to the forefront.

With the conflicting studies on the nature of e-cigarettes and the lack of studies done on e-cigarettes and pregnancy, one should conclude that e-cigarettes are by no means a proven safe method to quit smoking while pregnant and any decision to use them should be done under doctor’s direction and care. As of now, e-cigarettes are not considered a “safe alternative to smoking.” If attempting to become pregnant, it is highly recommended to begin treatment for smoking cessation before conception.