GARY — Colby Birdsong, holding her 11-month-old daughter, blew into a device that looked like a Breathalyzer.
"Take a deep breath for me," said community health worker Pamela Wade. "Blow for as long as you can."
The carbon-monoxide test would determine whether Birdsong had been smoking over the past month.
The clinic, Community HealthNet, recently became the first site in Northwest Indiana to offer Baby & Me Tobacco Free, a program that essentially pays pregnant women to quit smoking. The moms get a $25 voucher for diapers every month they remain free of tobacco during the first year of their child's life.
Research has found that about two-thirds of the moms enrolled in the program nationally quit smoking. The state has identified Baby & Me Tobacco Free as a way to decrease Indiana's high infant mortality rate.
Tobacco use during pregnancy can cause birth defects, preterm labor, low birth weights and sudden infant death syndrome.
"Anytime you can get a mother to not do harmful things during the pregnancy, you're going to increase the risk you'll have a successful outcome in the pregnancy and fewer risk factors that can lead to infant mortality in the child," said Dr. Janet Seabrook, executive director of Community HealthNet. The federally funded health center has locations in Gary, Hammond and Merrillville.
Ninety mothers and 10 partners are currently participating in the program, which was launched thanks to a $10,000 grant from the March of Dimes. Six women have given birth and not gone back to smoking.
Wade, the program coordinator, meets with the moms monthly to discuss strategies for not using tobacco, including keeping a journal to identify emotional triggers and satisfying the oral fixation with gum or candy. The women often develop their own coping mechanisms: a couple of them crochet as a way to keep their hands busy; one mom does spoken-word performances of her journal entries.
Smoking is actually what alerted April Howse, of Gary, to the fact she was pregnant. She would smoke a Black & Mild, and her stomach would turn and she'd start gagging.
Even so, she was addicted. Then she found out about Baby & Me Tobacco Free.
"I wanted to quit, not only for the Pampers, but for my baby's health as well as my own," the 31-year-old said. "It gives you that extra push."
Howse, whose baby is due in August, recently gave up the habit. She says the urge to smoke lessens with time.
"I fight my cravings by eating, mostly fruit and fast food," she said. "I'm not going to lie; if I can get me a Polish deep-fried and some fries, I forget all about the smoking."
Birdsong, of Gary, didn't think she was going to be able to quit this time around. She'd given up smoking while she was carrying her now 11-month-old daughter, Zaniyah. But when she got pregnant just a month after Zaniyah was born, she got stressed and picked the habit back up.
Wade encouraged Birdsong to track what triggered her to smoke. When those emotions arose, Birdsong would do healthier activities, like pray, listen to music or call a friend. She went from smoking 20 cigarettes a day, to five, to two.
Some days were easier than others; pregnancy hormones certainly didn't help. But she persevered.
Birdsong, 27, said Wade provided more than just smoking cessation, acting as a therapist of sorts.
"She was a mentor and a friend," Birdsong said in Wade's office the other day, causing the health worker to choke up. A poster on the wall listed the chemicals present in cigarettes: arsenic, lead, formaldehyde.
"She would call me and check on me, see how I was doing. She gave me hope."
Zaniyah wiggled around on her mother's lap, babbling and making grunting noises
"You came in with hope," Wade said. "Nothing beats a failure but a try. That's all we needed you to do, was just try. You accepted the challenge, you really did."