When pregnant, I was lucky enough to receive excellent prenatal care. Still, I was bombarded—and frankly, sometimes overwhelmed—with messages about what to do and what to avoid during pregnancy. And despite doing my best to comply with the prevailing guidance, my son may have been born with a significant number of industrial chemicals or pollutants in his body.
So much for clean living.
And herein lies the conundrum that a new joint committee opinion on chemicals from the American College of Obstetricians and Gynecologists (ACOG) and the American Society of Reproductive Medicine (ASRM) recognizes and grapples with. Even those of us with access to the best prenatal care and the resources to make (sometimes expensive) changes to our lifestyles can’t completely eliminate exposure to chemicals that are harming our health and that of our families.
Why? To begin with, we don’t have adequate information. We don’t know enough about the chemicals to which we are exposed every day—in pesticides used to keep bugs away from our food, the hazardous materials in our workplaces, and even the shampoo we use to wash away the dirt and grime of the day.
Because of the lax—in fact, nearly non-existent—way chemicals are regulated in the United States, few chemicals have been tested to ensure they are safe for humans. What this means is that all pregnant women are exposed to a bath of chemicals that are affecting their health and the health of their developing fetuses. But the impact is more acutely felt by low-income women and women of color, who disproportionately live and work in areas with higher exposures to chemicals.
The committee opinion tries to address this inequity by encouraging OB-GYNs to provide anticipatory guidance to their patients about how to reduce exposure to chemicals. This guidance will ensure more women are educated about the potential impacts of chemicals and the simple steps they can take to reduce their exposure. The power of this guidance could be enormous. One recent study demonstrated that simple changes, such as eating organic or eliminating canned foods, can reduce exposure to Bisphenol A (BPA) by two-thirds and phthalates by one-half.
But what gives the ACOG/ASRM committee opinion such strong moral authority is its recognition that not all pregnant women receive the same care. Because of lack of insurance, lack of doctors in their community, and other social and economic barriers to quality health care, many pregnant women do not receive adequate prenatal care, including counseling on ways to reduce exposure to toxic substances. These are the same women who are at risk for higher exposure to chemicals because of where they live or work.
Regardless of what kind of prenatal care a woman receives, no woman should have to know the chemical safety profile of every product to which she may be exposed—through the food she eats, the sunscreen she puts on her skin, the solvents used in her workplace, or the paint in her apartment—and try to avoid it just so she can have a healthy pregnancy.
The only way to ensure all pregnant women see a decrease in exposure to chemicals is through comprehensive chemical policy reform. The Chemical Safety Improvement Act (CSIA) (S. 1009) is bipartisan legislation that offers an opportunity for such reform. While in need of improvement, the CSIA gives the U.S. public a chance to have a serious conversation about how to achieve effective chemical regulation.
Instead of wasting time debating whether to set gestational limits on abortion or allow your boss to exclude birth control coverage from your health plan, members of Congress could be having a meaningful discussion about what we can do to better protect maternal and fetal health for the women who choose to become pregnant and carry a pregnancy to term.
ACOG and ASRM join a growing chorus of medical organizations, including the American Academy of Pediatrics, the American Nurses Association, and the National Medical Association, who have determined that chemicals are having a detrimental impact on human health. And their committee opinion acknowledges that even perfect information and universal access to prenatal care can’t eliminate pregnant women’s exposure to harmful chemicals. Only Congress can.