Many of her patients clean buildings and houses or work in nail salons, and struggle with staying away from harmful chemicals. She encourages individual solutions such as cooking at home and avoiding processed foods packaged in plastic. She's trying to push baking soda and vinegar instead of toxic cleaning products.

Even though Stotland's patients are low income and probably at higher risk, she said she wasn't talking to them about environmental health until recently. Many doctors in the response comments of the survey said they were concerned about making patients feel overly anxious.

“The social circumstances are so burdensome. Some colleagues think the patients are already worried about paying rent, getting deported or their partner being incarcerated,” Stotland said.

Some doctors urge stronger role
There are many scientific uncertainties about the dangers to fetuses, so clinicians can only proceed with caution.

For example, Conry said there is a lot of research on the effects of BPA, particularly in lab animals, but doctors don’t know how to interpret the results. “So, it hasn't resulted in a change in practice patterns.” Research on environmental chemicals is difficult for clinicians to understand because it differs from what they are used to with pharmaceuticals, she said.

Almost every obstetrician and gynecologist has a desk reference for pharmaceuticals, she said, but “it doesn't have any sections on environmental toxicants. There isn't an easy resource for physicians to use.”

“In the case of pharmaceuticals, the onus is on the pharmaceutical company to do the research with toxicity testing, randomized control trials and post-exposure observational studies," Conry said. "With environmental chemicals, the manufacturer puts out a product, and the onus is on the regulatory bodies, environmental groups and lay public to find problems and study the effects.”

Conry, who will become president of the American Congress of Obstetrics and Gynecologists in May, urges a stronger role for physicians. She is co-author of a paper with Stotland, Sutton and four others concluding that physicians should intervene as early as possible to help women prevent harmful exposures.

For the first time a year ago, the ob/gyn society stepped into a policy-influencing role in environmental health issues. Its president, James N. Martin, wrote a letter to the EPA urging the agency to consider links between prenatal exposure to the insecticide chlorpyrifos and birth defects before deciding whether to ban agricultural uses.

In the new survey, 89 percent of the doctors said guidelines from the American Congress of Obstetricians and Gynecologists would be the most helpful in gaining information on environmental health.

“As a society, we have a lot of work to do both in terms of informing women of dangers and helping them find alternative jobs when they're pregnant,” Stotland said. “This is society's job. Clinicians can't fix the problems in their offices.”

This article originally ran at Environmental Health News, a news source published by Environmental Health Sciences, a nonprofit media company.

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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