SAN FRANCISCO – When Dr. Darragh Flynn sits down with her pregnant patients, she preaches healthy habits: Don’t smoke or drink, eat nutritious foods and take vitamins.

She also advises them to avoid gasoline fumes, pesticides, certain types of fish and some household cleaners and cosmetics.

“It's only for nine months,” she tells them. “Let someone else put gas in the car.”

But Flynn is in the minority. A new nationwide survey of 2,600 obstetricians and gynecologists found that most do not warn their pregnant patients about chemicals in food, consumer products or the environment that could endanger their fetuses. More than half said they don’t warn about mercury, and hardly any of them give advice about lead, pesticides, air pollution or chemicals in plastics or cosmetics.

Many doctors say their priority is to protect pregnant women from more immediate dangers, and that warning them about environmental risks may create undue anxiety. Some say they don't feel confident in their ability to discuss the topics.

“We're worrying about pre-term labor, obesity and hypertension,” said Dr. Jeanne A. Conry, an ob/gyn at Kaiser Permanente in Roseville, Calif., and incoming president of a national medical society. “Obesity trumps almost everything. We put our time and energy there, and don't dwell on some of the other things we should be aware of.”

More than 100 chemicals
Virtually all pregnant women have chemicals in their bodies that might harm fetal development.

Monitoring of pregnant women found about 100 different chemicals, with 43 of them in all women tested. Lead, mercury, toluene, perchlorate, bisphenol A, flame retardants, perfluorinated compounds, organochlorine pesticides and phthalates are among the chemicals, according to the U.S. Centers for Disease Control and Prevention's nationwide testing program. 

Studies suggest that for many these compounds, low-level exposures in the womb seem to disrupt development of the brain or reproductive systems. Others may raise the risk of birth defects, or lead to cancer, immune problems, asthma, fertility problems or other disorders later in life.

Yet that information is not reaching most women who are pregnant or may become pregnant.

Almost all of the doctors in the new, nationwide survey, conducted by University of California, San Francisco researchers, said they routinely discussed smoking, alcohol, diet and weight gain. Eighty-six percent also said they discuss workplace hazards, and 68 percent warn about second-hand smoke.

But only 19 percent said they talk to their pregnant patients about pesticides and only 12 percent discuss air pollution. Forty-four percent said they routinely discussed mercury with pregnant women. Eleven percent said they mention volatile organic compounds, which are fumes emitted by gasoline, paints and solvents.

Even fewer physicians warned their patients about two chemicals in consumer products that are often in the news: bisphenol A (BPA) at 8 percent and phthalates at 5 percent. Nine percent of the doctors told their patients about polychlorinated biphenyls (PCBs), industrial compounds often found in fish.

The results show a disconnect between environmental health research and what the physicians do – and do not – tell their patients, said Patrice Sutton, a research scientist at University of California, San Francisco's Program on Reproductive Health and the Environment who helped design the survey. The goal of the study, which was discussed at a recent conference but is not yet published, was to try to break down obstacles that keep health messages from pregnant women.

9 Comments

1. 1. sjn 06:10 PM 12/10/12

   This is where doctors' training was with diet & nutrition 30 years ago, when my friends in medical school were complaining about the same lack of training & information. Look how central such information is today - environmental health hazards need to make the same leap.

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2. 2. em_allways_right 09:31 PM 12/10/12

   The uneducated have a right to know.

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3. 3. jgrosay 05:27 PM 12/11/12

   The thing many don't realize is that any pregnancy has risks, also as never having had a pregnancy has, but different in nature and in prevalence, chemicals just may add some special risks, both for woman and child. The Roman word for wedding, "Matrimonium" would mean making a woman deliver or having offspring, and may contain an implicit forcing, some women having fear of pregnancy and of delivery, this may be, according to what Goethe hints in "Elective affinities" in the causes of Anorexia Nervosa, some girls attempting to get rid of the pains of delivery by rejecting anything giving them an image close to a pregnant woman, for example, being overweight. In some languages of India, pregnancy may be equivalent to "Being loaded" or "Carry or bear a burden", the idea is explicit in the Bible "When approaching delivery, women think her last time is coming, but after it, they get the most intense possible joy of having brought a new creature to the world".

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4. 4. greenhome123 07:24 PM 12/11/12

   Yes, I believe that doctors should tell their pregnant patients to try to reduce exposure to harmful environmental chemicals. Also, for parents who have recently had children with birth defects, their doctors should have a list of environmental toxins that they question the parents if they have been exposed to. Millions of these environmental toxin/birth defect surveys could help better identify which toxins cause which birth defects. I was born with clubbed feet. Before I was born my mom had worked in a rubber factory and was exposed to a lot of chemicals.

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5. 5. sunnystrobe 06:53 AM 12/12/12

   The word 'Doctor' means 'the learned one'. How come that whenever it comes to nutrition, the learned Doctors' expertise has been sorely lacking? Academic textbooks typically lag about half a century behind recent research findings. This is exactly the last sixty years in which the petrochemical chemistry industry has taken over the processed food mega market.
   Plastic ain't fantastic when it ends up in little bodies, what with its gender-bending & brain-fogging hormone-disruption power, and that at fiendishly tiny exposure rates...
   Prevention is MUCH better than NO cure, later.
   But doctors are notoriously ignorant about anything other than symptoms!
   Doctor Hippocrates of Cos' medical principle: to let food be the medicine , is more topical than ever in our time, in which the food industry has often turned food toxic, and this out of sheer profit thinking.
   But we can still vote with our feet, and eat natural fruits and vegetables, can't we?
   Yes, WE CAN 'CAN' the CAN!
   For a fresh approach to avoiding pitfalls in daily eating habits, visit 'Youthevity.com'
   

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6. 6. Chezsven 09:02 AM 12/12/12

   Toxic chemicals in the environment need regulation. It takes guts for these gynecologists to speak out, joining the pediatricians who have already signed on regarding the risk toxic chemicals pose to small bodies. Why? The chemical lobby is powerful and has deep pockets. Endocrine disruption happens when the baby is in the womb. (Think a brain gets wired wrong.) Toxic chemicals can also cause cancer. Shame on any legislators who do not support the Safe Chemicals Act. This bill will soon be presented to the Senate. What can you do? Contact your senator today and ask him/her to co-sponsor this important legislation.

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7. 7. Fossilnut 05:28 PM 12/15/12

   Neither a gynecologist or pediatrician is qualified to 'speak out' with any type of authority. their knowledge is qite limited and confined to basic 'dos and don'ts'.
   
   The EPA does a good job of using actual SCIENCE to make rcommendations.
   
   Everybody and their dog has an 'opinion' on what is good or bad for us.

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8. 8. outsidethebox 08:43 AM 12/18/12

   Women have been told for decades that they shouldn't drink or smoke during pregnancy yet many still do. When you get down to the level of switching cleaning agents or what kinds of fish you might eat it's hard to see a doctor's warning of that type having much practical effect.

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9. 9. hus163 05:05 AM 1/21/13

   Maybe,the government needs to spread more common sense
   to the public.

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