The 1966 edition of the leading medical textbook states that pregnant women can safely smoke half a pack of cigarettes a day. Yet today, women who smoke during pregnancy are among the most vilified figures in public health campaigns. Laury Oaks argues this shift is not due solely to medical findings indicating that cigarette smoking may harm the fetus. Also responsible are a variety of social factors that converged more than a decade ago to construct the demonized category of the “pregnant smoker.”

This book charts the emergence of smoking during pregnancy as a public health concern and social problem. Oaks looks at the emphasis public health educators place on individual responsibility, the current legal and social assertion of fetal personhood, the changing expectations of pregnant and prepregnant women, and the advent of antismoking campaigns. She explores how public health educators discuss “the problem” with one another, how they communicate with pregnant smokers, and how these women themselves understand the “risk” of fetal harm. Finally, Oaks discusses the various meanings of “objective” statistics on the effects of smoking on the fetus, exploring the significance of cultural context in assessing the relative importance of those numbers. She argues that rather than bombarding pregnant women with statistics, health educators should consider the daily lives of these women and their socioeconomic status to understand why some women choose to smoke during pregnancy. Without downplaying the seriousness of the health risks that smoking poses to women and their babies, the book supports new efforts that challenge the moral policing of pregnant smokers.