Last month, the American College of Obstetricians and Gynecologists issued a warning about chemicals in consumer products and what those chemicals might be doing to fetuses and babies.
By Stephanie Soucheray
When Kelley Turlington, 35, was thinking about getting pregnant, she made some lifestyle changes. First, the Durham restaurant server and small-business owner got rid of all of her plastic Tupperware and replaced it with glass containers. Next, she checked her makeup against the Environmental Working Group’s website, which lists toxic ingredients in common consumer items. She even read a book called Organic Pregnancy.
“I feel like when it comes to fertility, especially at my age, you have enough problems without adding to it with environmental toxins,” said Turlington, who is now a mother to Lucinda, 17 months. “If there are several things you can do to up your odds of a healthy pregnancy, why wouldn’t you do that?”
Though Turlington said about half the other moms she knows are of similar minds when it comes to protecting themselves and their children from environmental toxins, she didn’t take any of these measures because of something her prenatal provider said.
“I remember my midwife talking about avoiding mercury in fish,” said Turlington. “But she didn’t even mention BPA,” a synthetic used in the manufacture of some plastics.
That may soon change. A new statement from the American College of Obstetricians and Gynecologists released last week warns women and their health care providers that environmental toxins are damaging fertility.
In a joint statement released with the American Society for Reproductive Medicine, the ACOG asked doctors to advocate for government policy changes that will limit toxic environmental agents (see below for infographic).
While the connection between adverse fertility outcomes and the environment has long been known, this is the first time the ACOG is urging physicians to assist in changing policy.
“Lawmakers should require the US Environmental Protection Agency and industry to define and estimate the dangers that aggregate exposure to harmful chemicals pose to pregnant women, infants and children and act to protect these vulnerable populations,” said ACOG’s president, Jeanne A. Conry, in the written statement.
The ACOG said miscarriage, childhood disease, lowered sperm count and preterm birth can all be consequences of chemical exposure before conception or during pregnancy. While some toxins – like mercury, tobacco and alcohol – are regularly discussed by doctors, many potential toxins are not. They may not even be known: There are more than 84,000 chemicals on the market today, and while some like bisphenol A (BPA) are known as hormone deregulators, most are untested.
“In the current system, most chemicals are approved and enter the market with no toxicity testing of any kind and the public is not aware of what they are, what products they are in or how they might be exposed,” said Heather Patisaul, a professor of biology at NC State. “It’s that lack of knowledge that fuels the current system.”
Patisaul works with mice exposed to BPA. Her lab has shown that female rats that have been exposed to BPA experience accelerated puberty and infertility. She said she was encouraged by the ACOG’s statement.
“[This statement] will help researchers like me because it will pressure governmental industries to pay greater attention to data arising from academic and other publicly funded labs rather than just industry labs,” said Patisaul. “The scope of the problem is enormous, and creating more awareness among physicians and the public will help people make more informed choices about what they buy and thus become exposed to.”
Besides the ubiquity of these chemicals, the other problem is the nature of endocrine disrupters. Unlike other toxins, dose does not necessarily make the poison when it comes to chemicals that disrupt hormones – even a small amount of these chemicals can cause the body to react as if given extra estrogen. This was the argument posed by people like Patisaul who disagreed with the FDA’s failure to regulate BPA packaging on food items last year.
“The chemical companies keep insisting that these chemicals are safe but, for the vast majority of chemicals on the market, have not produced evidence in support of that position,” said Patisaul. “Even more troubling is that formal risk assessments rarely include scientific data generated by academic labs, even in cases where there is evidence of harm, so the public rarely benefits from that information.”
Amy Bryant is an OB/GYN at the UNC Family Planning Clinic. She said the ACOG’s statement encouraged her to talk to her patients about environmental toxins in preconception visits.
“It is absolutely right that policy needs to change in order to look more closely at environmental toxins,” she said. “It makes sense for physicians to be talking about environmental exposures and risk. We already do to some extent, but this document gives us a little more impetus to work on talking about this [to patients].”
Bryant said it’s common in her practice to do some screening for environmental exposure when she and her colleagues ask women about their occupations. She talks about fish and mercury, but currently doesn’t address BPA.
For Turlington, her desire to live a clean and green life stayed with her throughout pregnancy and early motherhood. Her daughter has never had baby lotion formulated with sulfates or parabens on her skin, she’s been cloth-diapered and Turlington washes all of her plastic sippy cups by hand to avoid heating plastic in the dishwasher.
Turlington doesn’t think her measures are extreme.
“In five or 10 years, when we learn more about common chemicals that could be dangerous, I want to be on the right side of history,” she said.