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Women need more counseling from obstetricians on environmental toxins

Harold Mandel's picture
environmental toxins

Environmental toxins often have the power to tragically undermine the reproductive health of women. These toxins are all around us. Women need to be reminded about this problem and encouraged to attempt to do something about it. Yet, it appears obstetricians often let their patients down by failing to take the time to counsel them about environmental toxins.

Many obstetricians feel counseling on environmental health hazards could help patients

A study was designed to describe the attitudes, beliefs, and practices of obstetricians in dealing with the issue of prenatal environmental exposures to toxins reported the journal PLOS One. The researchers did a national online survey of American Congress of Obstetricians and Gynecologists (ACOG) fellows and 3 groups of obstetricians. The vast majority of obstetricians at 78 percent agreed that they can decrease patient exposures to environmental health hazards by counseling them.

Obstetricians often fail to take an environmental health history

However, 50 percent of the obstetricians reported that they rarely take the time to take an environmental health history. Furthermore, less than 20 percent of the obstetricians reported routinely asking about environmental exposures which are commonly found in pregnant women in the United States. Alarmingly only 1 in 15 reported they had any training dealing with the topic. There were several barriers to counseling on this matter which included:

1: A lack of knowledge of and uncertainty about the evidence

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2: Concerns that patients lack the capacity to reduce harmful exposures

3: Fear of causing anxiety among patients

U.S. obstetricians surveyed overall recognized some impact of environmental exposures on reproductive health. However, they often lacked training, time, and tools to counsel their patients. In view of a recognition of the positive role which physicians could play in prevention there should be greater efforts to break down barriers to counseling patients with more aggressive education regarding this problem. .

This was the first national survey of U.S. obstetricians’ attitudes in dealing with counseling pregnant patients about environmental health hazards reports the University of California San Fransisco. Obstetricians overall have not been using their limited time with patients as a vehicle to discuss how they might avoid exposure to toxins.

Doctors are often uncomfortable about discussing environmental toxins with patients

Doctors often expressed feelings of discomfort about making firm recommendations to pregnant women about environmental toxins because they felt they didn’t know enough or were too uncertain of the evidence. It is of concern to doctors that patients often have more pressing and immediate health concerns dealing with diet, sedentary lifestyles, obesity and chronic medical conditions such as diabetes. Physicians are often afraid of frightening their patients about the chemicals found in the workplace and in thousands of household and industrial products, because it’s almost impossible to completely avoid exposure to them.

The evidence is compelling that pregnant women are often exposed to toxic chemicals and there’s an association between these exposures and adverse health outcomes in children. Clearly better physician training with more evidence-based guidelines could help women to be more proactive, without the fear of inappropriately alarming their patients. With toxins in the environment becoming a more serious problem than ever before clearly there should not be any time wasted in providing physicians with better training to help them deal with this matter.