For instance, even though the dangers of mercury are well established, only four out of every 10 doctors said they discuss the contamination with pregnant women.
Since 2004, the U.S. Environmental Protection Agency and the Food and Drug Administration have warned pregnant women to avoid eating high-mercury fish such as swordfish and shark and to limit consumption of albacore tuna. In addition, the American Congress of Obstetricians and Gynecologists issues statements to its members on the importance of patients avoiding mercury in fish.
Yet an estimated 300,000 newborns each year – one out of every 14 – are exposed to levels of methylmercury that exceed the guidelines that the EPA set to avoid neurological effects in fetuses. Mercury in the womb has been tied to reduced IQs and other effects on developing brains.
Dr. Naomi Stotland said warnings over mercury could result in women eating less fish, which is a low-calorie protein rich in omega-3 fatty acids critical for a baby’s brain development.
“Mercury in fish is a tricky one,” said Stotland, who practices at San Francisco General Hospital and was lead investigator on the survey. “Fish is such a good protein source for women, and they're probably not eating enough of it. I give out printed materials that direct them to fish with lower levels of mercury,” such as sardines, herring, pollock, shrimp and scallops.
“Most of my patients don't even read food labels. Are they carrying around the fish list? I worry, and I know other colleagues worry, that women will replace fish with processed hamburger. I don't think it's such a simple message.”
Dr. Jane Hightower, who practices internal medicine in San Francisco, agreed that the warnings are confusing but said ob/gyns should take more time to learn about food and contaminants.
“To make ends meet, there are too many patients crammed into the schedule. Food science literature and environmental toxicant literature are difficult to sort out, and the doctors are not being taught about nutrition or contaminants in school,” said Hightower, who has authored a book and several scientific journals reports about unhealthful levels of mercury in fish.
Despite evidence that environmental factors contribute to many health problems, medical students report fewer than six hours of environmental health training, according to University of Texas School of Medicine researchers.
“The whole medical establishment needs to look at themselves and start evaluating old practices that might not be so safe for the patient in the long run," Hightower said.
Class differences
Flynn holds pre-pregnancy counseling sessions with her patients, who are mostly middle-to-upper class women living in San Francisco. She gets a lot of questions about environmental chemicals, sometimes from prospective mothers and sometimes from the mothers of young patients. She said the role of the ob/gyn is changing as environmental chemicals are gaining more attention as agents of defects and disease.
Twenty-five years ago, “people were not quite as cognizant. Now they ask for the resource, or a reputable web site. Before the internet that was not an option,” she said.
Flynn goes further than most by telling women they can reduce BPA exposure by not buying canned foods and beverages with resin liners, and that they can avoid cosmetics and plastics containing chemicals called phthalates.
In contrast, at San Francisco General Hospital, Stotland sees low-income patients on California's Medicaid program. Stotland doesn't get the questions that Flynn often encounters.
“Most of my patients don't ask me about environmental exposures. They don't ask about cosmetic products, bisphenol A or organic foods. Most don't have high-speed Internet access, and don't read articles and get alerts.”
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10 Comments
Add CommentDoctors already do. What the hell is this piece trying to further?
Reply | Report Abuse | Link to thisThis 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.
Reply | Report Abuse | Link to thisThe uneducated have a right to know.
Reply | Report Abuse | Link to thisThe 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".
Reply | Report Abuse | Link to thisYes, 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.
Reply | Report Abuse | Link to thisThe 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.
Reply | Report Abuse | Link to thisPlastic 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'
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.
Reply | Report Abuse | Link to thisNeither 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'.
Reply | Report Abuse | Link to thisThe 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.
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.
Reply | Report Abuse | Link to thisMaybe,the government needs to spread more common sense
Reply | Report Abuse | Link to thisto the public.