Mums-to-be have been advised to stay away from all sources of chemical exposure to protect their unborn children. In their new report, the Royal College of Obstetricians and Gynaecologists (RCOG) warns against exposure to a wide range of chemicals found in household products, certain foods and food packaging and cosmetics.

The paper highlighted the potential dangers associated with chemical exposure, which included pregnancy complications, pregnancy loss, birth defects and a wide range of diseases, such as asthma, cancer and cardiovascular disease.

Some of the risks are already well documented. Currently pregnant women are advised to avoid certain foods that can carry harmful bacteria and parasites, excess vitamin A and caffeine, and to refrain from smoking and drinking.

And now the new report is taking it a step further to include a more extensive list of things to avoid, from using a non-stick frying pan to moisturising your skin.

Main recommendations

  • Use fresh food in preference to processed food;
  • Avoid ready meals and convenience food that comes in cans or plastic containers. The packaging should also not be used for food storage at home;
  • Reduce the use of beauty and personal care products, such as moisturisers, hairsprays and fragrances;
  • Avoid taking over-the-counter medicines unless necessary;
  • Avoid new purchases of certain household items including new furniture, fabrics, non-stick pans and cars for the duration of pregnancy and breastfeeding;
  • Reduce your exposure to household pesticides and fungicides;
  • Avoid paint fumes;
  • Remain cautious with products described as ‘natural’ or ‘herbal’.

Hidden dangers in food

The report discussed the risks of DDT and PCB chemicals, which accumulate in fatty tissue and can be found in oily fish. Current recommendations already advise pregnant women not to exceed 2 portions of fish per week due to mercury contamination.

The authors also revealed that many people were unaware of the pesticide residue present in some foods and how the chemicals found in food packaging, including drink cans and plastic containers, can leach into the contents. The two chemicals in question included Bisphenol A (BPA) and phthalates.

Precautionary approach

Prof Sharpe, co-author of the paper, said: “For most environmental chemicals we do not know whether or not they really affect a baby’s development, and obtaining definitive guidance will take many years.

“This paper outlines a practical approach that pregnant women can take, if they are concerned about this issue and wish to ‘play safe’ in order to minimise their baby’s exposure. However, we emphasise that most women are exposed to low doses of chemicals over their lifetime, which in pregnancy may pose minimal risk to the developing baby.”

Confusing and unhelpful?

Their ‘safety first’ approach has already been criticised by a number of organisations, who have expressed their concerns about the advice not being clear enough, while others have accused the RCOG of scaremongering.

Prof David Spiegelhalter from the University of Cambridge, told the BBC: “These precautionary ‘better safe than sorry’ recommendations are not necessarily cost-free. They may feed anxiety, and detract attention from the known harms of bad diet, smoking and excessive alcohol. And it is unclear how any benefits can ever be assessed.”

In her response to the report, Tracey Brown of Sense about Science said that “Pregnancy is a time when people spend a lot of time and money trying to work out which advice to follow, and which products to buy or avoid. The simple question parents want answered during pregnancy is: ‘Should we be worried?’

What we need is help in navigating these debates about chemicals and pregnancy. Disappointingly, the RCOG report has ducked this.

As the report itself shows, there are many unfounded rumours about links between particular substances and pregnancy outcomes. By contrast, we have plenty of evidence that stress is a major risk factor in pregnancy. Researchers and professional bodies should not be adding to it.”

The Royal College of Midwives (RCM) added to the criticism:

“There needs to be more scientific and evidence-based research into the issues and concerns raised by this paper.”

But the RCOG responded to the accusations by telling the BBC: “We are trying to empower women, not scare them. There is a void at the moment in terms of information about chemicals.”

The evidence is not clear

Currently there is no official advice on safe levels of chemical exposure from everyday household and personal care products during pregnancy and breastfeeding.

The report goes on to say “It is unlikely that any of these exposures are truly harmful for most babies, but in view of current uncertainty about risks, especially those relating to ‘mixtures’, these steps will reduce environmental chemical exposures.”

Prof Scott Nelson, Chair of the RCOG Scientific Advisory Committee, added in a press release: “While pregnant women should be aware of potential risks, there is still considerable uncertainty about the extent of the exposure effects and any women with concerns about certain chemical exposures should consult their obstetrician or midwife.”