Tech + Health

10.26.13

Medicine Bedevils Pregnant Women With Too Many Warnings About Risk

A well-meaning medical community is worrying pregnant women silly with indiscriminate warnings about environmental hazards, writes Lenore Skanazy.

A recent study showing that breast milk procured online is often tainted has many moms experiencing a familiar emotion: fear. It’s part and parcel of modern parenting, and starts the minute the pee stick changes color, basically announcing, “Congratulations! And start worrying!”   

Will do! It’s hard not to, when the very first time a pregnant woman meets with her obstetrician, he just may ask, “Do you use strong smelling/fragrant personal care products, such as perfume, deodorant, nail polishes?”

Uh…wha?

“Products that have strong scents or fragrance as an ingredient may contain chemicals that have been linked with negative health effects, such as cancer and infertility.”

He’s so busy reading from his Environmental Exposure Assessment that he may not notice his patient opening the window and preparing to jump. At least, that’s what I’d be doing, figuring I’d already doomed my kid to an early death thanks to a shpritz of Shalimar. 

Unfortunately, the perfume/deodorant/nail polish query is a real question that doctors are being urged to ask in a kind-hearted but insanity-inducing attempt to eliminate every single risk—some gigantic, some infinitesimal—that pregnant women face. As if expectant moms aren’t second-guessing themselves enough!

Just recently the American College of Obstetricians and Gynecologists (ACOG) along with the American Society for Reproductive Medicine issued a report telling its doctors to warn women about exposure to chemicals.

This would make sense, if there was a cut-off somewhere along the vast “deodorant using—crop dusting” continuum. While the president of ACOG,  Dr. Jeanne A. Conry, notes that her organization does not “specifically address” things like nail polish and perfume, its report says, “Environmental chemicals are pervasive in all aspects of patients’ lives, including those found in air, water, soil, food, and consumer products. As a result, among pregnant women, daily exposure to various toxic chemicals is now the norm.” That sounds like a lot to worry about. In fact, it sounds like every aspect of our normal lives.

“The problem is that we live in a complicated environment in which these chemicals are floating around, and it’s very hard to say, ‘This one is responsible and this one isn’t,’” says Joan Wolf, an associate professor of Women’s and Gender Studies at Texas A&M University and author of Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood. Given that swirl of chemical complexity, the message we get is “Better safe than sorry,” which, Wolf says, “is crazy-making. People don’t even know what that means: Does it mean I shouldn’t even leave the house?”

Patients and their doctors are encouraged to regard everything pregnant women do, eat, wear, and breathe with alarm.

Whatever it means in theory, in practice it means that patients and their doctors are encouraged to regard everything pregnant women do, eat, wear, and breathe with alarm. That’s exactly the fear that was already sucking the joy out of pregnancy.

What, exactly, are today’s moms-to-be worried about? “Everything!” says Emily Oster, a University of Chicago economics professor and author of Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong—and What You Really Need to Know. “I get a lot of emails from pregnant women [that contain] some combination of powerlessness and terror.” Those feelings are due, in part, to the notion that if an expectant mom is super vigilant, she can control her pregnancy. The corollary being, if she slacks off, even a teensy bit, anything that goes wrong is her fault. 

But doesn’t it make sense to control chemical exposure? Of course it does. As the ACOG report wisely notes: Women who work with heavy chemicals, or in pesticide-sprayed fields, are indeed at more risk than your average expectant mom. So it makes sense for doctors to ask their patients, “Do you work in copper smelting? Do you live near a chemical plant?”

If the answer is yes, the doctors are advised to tell their patients to try to avoid those hazards, which may or may not be possible. But still—it’s a rational concern.

What’s less rational is telling doctors to “educate patients on how to avoid toxic environmental agents” when we don’t even know if nail polish is a lovely little luxury or a never-noticed risk.

ACOG’s heart is in the right place: It only wants safe moms and healthy babies. But its advice is going to make a lot of women even more sure that they’re doing something terribly wrong… even if they’re not quite sure what.

Lenore Skenazy is an adjunct fellow of the Risk Analysis Division of the National Association for Public Policy Research, and founder of Free-Range Kids.