Nobody's asking anybody to approve of pregnant women smoking. Sorry this has turned into a bit of an essay:
I think this is an area where it's difficult for people generally to think rationally because it brings together two areas that have a fuckton of emotional baggage attached (some of it deliberately manufactured). It's worth breaking down into:
1) rights / the law
Bodily autonomy should be an absolute fundamental human right for everyone. The only exception should be where a person lacks capacity to make their own decisions and in those cases there should be thorough oversight to ensure that every decision is made in the person's best interests. Human rights apply to everyone, whether they are sensible or foolish, kind hearted or a total git, whether they have a foetus growing inside them, are capable of having a foetus growing inside them or neither of these. Paedophiles and terrorists have human rights. Women deserve them too.
There are several states in the US, as well as some South American countries, which can serve as examples of what happens when pregnant women are criminalised for things they have done in pregnancy. I posted a link a couple of weeks ago when this subject came up, I'll see if I can find it again.
2) societal attitudes
As well as all the overt anti-choice propaganda, and the less extreme 'I'm pro-choice but ...' type attitudes, there is a strong societal belief that pregnant women need protecting and are not capable of making decisions for themselves, or that if the decisions they make for themselves might harm their foetus there is a genuine conflict of rights and it's the duty of upstanding citizens to prevent them from making the wrong choice. This is why there are loads of stories of women being denied service when they want to buy alcohol, coffee, soft cheese, common household medicines ...
There are also extremely strong societal attitudes against smoking generally, and especially smoking in pregnancy. There is no doubt that smoking is extremely dangerous, increases the risks of pregnancy, and harms the health of everyone around the smoker. There has though been a deliberate effort to manipulate attitudes to be ever more strongly anti-smoking to encourage more smokers to quit and discourage young people from starting. The 'spoilt identity' of the smoker is a major tool in tobacco control's toolbox. It's had some success but really, it's stopped working now for the smokers who are left, especially for pregnant women who smoke. Nobody on the planet wants to be that person.
Of course you judge. You've been taught to. Nobody wants to police your thoughts but rather a lot of people want to manipulate them.
3) what actually helps
We've been vilifying pregnant smokers for years yet the rate of smoking at the time of delivery remains stubbornly at 10%. Anybody who actually cares about the health of women, babies and children should focus hard and urgently on what works, not what makes them feel better. Stigma is now actively getting in the way of women seeking help and women's success at quitting. The smokers who are left, including those who are pregnant, are overwhelmingly poor or have MH issues or both.
Women who smoke in pregnancy need non-judgmental support. It has to be OK for women, pregnant or not, to ask for help to quit and the support has to be there when they need it. Women need up-to-date accurate information on all available methods, including the relative risks of NRT and ecigs and the best ways to use them to successfully quit smoking.
Women need support whatever method they use to quit and they need to be respected as people whose own health matters, whether they are pregnant or not. It should never ever be forgotten that that the major harm from smoking is to the smoker themselves, even pregnant smokers. They are the ones who have the 50% chance of premature death, losing on average a decade of life. Smokers' lives matter, whether they are male or female, pregnant, 'pre-pregnant', infertile, post-menopausal blah de blah. It's not enough to shame women into quitting for 9 months for the sake of their foetuses if they then fail to quit long term for their own health. Women are people and their health matters, even after they have finished popping out the sprogs.
I've got a thread in site stuff requesting a webchat on smoking in pregnancy by someone really sensible. I started it because I think MN lets down a massive bunch of women who could be getting support here. MNHQ have said they are thinking about it so if you feel this is something you could support, please do give it a bump.