Don’t make pregnant women bear more burdens
The Royal College of Obstetricians and Gynaecologists' advice is well-meaning but top-heavy
I’m glad I’m not pregnant. This week, the official list of things for an expectant mother to worry about just got much longer, with a report by the British Royal College of Obstetricians and Gynaecologists (RCOG) warning that if pregnant women want to “play it safe” they should reduce their exposure to chemicals by avoiding fresh paint on the nursery walls. They should also stay away from certain cleaning products, air fresheners, pesticides and non-stick frying pans, tinned food and ready-meals. Don’t buy new carpets or cars. Oh, and they might also want to be careful about moisturisers, shower gels and sunscreens – which could, theoretically, pose a risk to the foetus. Or not. No one is quite sure.
I have some sympathy with the authors of the report, Dr Michelle Bellingham and Professor Richard Sharpe. They’re scientists, and they evidently believe in telling the public the truth, which is that there is indeed scientific concern about the effects of a build-up of common chemicals such as phthalates and Bisphenol A (BPA) upon a developing foetus. The trouble is that, as they admit, “obtaining definitive guidance will take many years”. So women can, if they choose, take precautionary measures in the meantime.
The authors’ approach is certainly honest: it may, in the future, turn out to be sensible. The problem is that it is not yet definitive, and much of what they warn against comes under the heading of “ordinary life in the modern world”. At the same time they tell women not to “wrap themselves up in a bubble”. Well you wouldn’t, now, would you – just think about the toxic chemicals in bubble-wrap.
Scientists are quite used to recognising risk, evaluating the size of it, and carrying on with life in a normal fashion. In my own experience, many pregnant women are not: our internal riskometer goes screwy.
I think of myself as a fairly level-headed person, but – while pregnant with my second child – I can remember blubbing hysterically late one night because I had eaten an underdone lamb chop, and therefore (according to the pregnancy advice) put myself at risk of something called toxoplasmosis. The more I Googled, the worse it got: toxoplasmosis, which triggers a “mild flu-like illness” a few weeks after exposure, can cause serious health problems for the baby, including blindness and mental disabilities. Before long, I was catastrophising about what could happen – and all because of me, greedily wolfing down that damn lamb chop, thinking only of my extraordinarily selfish self. Whatever happened, it would be all my fault.
I didn’t have toxoplasmosis. But the mantra of “whatever happens, it’s all your fault” repeats on a loop through many women’s brains throughout pregnancy, fed by constant health injunctions. Pregnancy is your first introduction to a lifetime of maternal guilt.
True, there are a small minority of women who are utterly immune to this message, and behave with criminal fecklessness during pregnancies: binge-drinking, taking drugs and chain-smoking, regardless of the potential life-long effect on their child. They represent the most urgent challenge for doctors and midwives, and the most strongly persuasive forces of the NHS should surely be focused on them.
Then there are those expectant mothers who sail serenely through 40 weeks, doing what is broadly sensible and staunchly refusing to worry about the rest. And finally there is the large brigade of worriers, weaving around the known and the unknown risk, turning down a tuna sandwich here (too high in mercury) and a blue-cheese salad there (listeria? That’s the one), sipping on decaf coffee and constantly remembering that they are in charge of the ingredients for cooking up a new person.
Some of the advice in the RCOG report, I confess, I was already aware of. During my pregnancies, like many expectant mothers today, I tended to buy organic house-cleaning and beauty products, and instinctively stayed away from strong chemical fumes. The controversy over the safety of BPA has been going on for some time, and the baby industry widely advertises BPA-free products.
To anyone who is pregnant now, the big, proven advice still holds: drink alcohol very lightly or not at all, don’t smoke and take folic acid. Eat lots of fresh food and cook meat and fish well.
There is, of course, the risk that the new, precautionary list – so full of what Donald Rumsfeld once called “known unknowns” – will flood the airwaves with so many concerns and injunctions that the “known knowns” get lost in it. And – while I understand the motivation of the report’s authors – there is something unfair about the situation in which pregnant women find themselves. They have, essentially, been given a licence to worry about a wide range of exposures, without any clear conclusions as to whether such worries are worthwhile. I foresee a nation of distraught Mumzillas, fretting that they are doing something to damage their baby, while simultaneously being pilloried for prissy over-cautiousness. Yet if such common chemicals are indeed potentially harmful to unborn babies, it is urgent that the regulatory authorities make a considered appraisal of all available evidence, and take action if necessary. The RCOG report has raised many questions. It is time for more answers.
Jenny McCartney Telegraph.co.uk