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Catching Fire: Inflaming Our Passion to Pass the Safer Chemicals Act

12:03 pm in Uncategorized by RH Reality Check

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Written by Kirsten Moore for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.<

They lied to state legislators about flame retardants. They distorted the science about the effectiveness of flame retardants. They manipulated firefighters, some of our most trusted public servants. And they have harmed the reproductive health of women and families.

Who? The Chemical Industry.

It might seem like hyperbole, but the egregious behavior of chemical companies in the service of preserving and expanding the market for flame retardants is documented in a jaw-dropping investigative series from the Chicago Tribune, detailing deeply disturbing practices at the heart of the chemical industry. 

Flame retardants are associated with reductions in fertility, poor sperm quality, neuro-development delays in children, and cancer. And because the chemical industry has been so deceptive and successful, flame retardants are found in strollers, nur
sing pillows, couches, chairs, cell phones, TVs, computers, and automobile cushioning – just to name a few places. In fact, 97 percent of Americans have flame retardants in our bodies. Even baby belugas in the arctic have flame retardants in their bodies!

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The “Big Chop” – How a Haircut, Congress, and the Toxic Zombie Toolkit Can Make You and the Planet Safer

7:27 am in Uncategorized by RH Reality Check

Written by Jendayi Phillip for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Photo by Barron Fujimoto.

It’s spring – the flowers are blooming, the skies are blue, the weather is spring-tastic, and Earth Day is just around the corner! So, how are you celebrating? Some of you may be planning to plant trees, others might be getting down and dirty by starting a community garden or collecting trash in your neighborhood park. But me, I’m getting the “big chop,” cutting inches off my hair.

You might be asking yourself, isn’t that a bit much for Earth Day? Okay, so I must admit I did not do this so much as a way to celebrate Earth Day, but more as an important step to protect my health from my toxic products.

My bathroom counter has countless hair care products that have been part of my vocabulary since I was a child, things like, perm, grease, holding spray, heat protectant, just to name a few. Regular use of these products and bi-weekly trips to the hair salon has become a major part of my lifestyle and my look, but that’s all about to change.

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A Chemical Blowout: Frizz, Formaldehyde and Infertility

8:07 am in Uncategorized by RH Reality Check

Written by Kimberly Inez McGuire for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

The first whispers of summer are in the air, foretelling sunny days, sultry nights, and trips to the beach. For better or worse, it also means that many women crowd into salons and spas in a frenzy of pre-summer health and beauty rituals. And it’s no small task to prepare for all the bared skin and exposure to the elements—that’s right, ladies and gents, I’m talking about the Brazilian.

No, not that Brazilian. I’m talking about the Brazilian Blowout (also known as Keratin Treatment), a salon procedure that claims to “improve the health and condition of the hair,” “eliminate frizz,” and “smooth the cuticle.” These are tantalizing promises to a curly-haired woman like me. Between my Irish ringlets and Puerto Rican kink (thanks, Mom and Dad!) my hair can be a handful—and the swampy, sticky DC summers don’t help. Neither do the countless women’s magazines, ugly duckling movies, and makeover TV shows that portray hair like mine as a problem, a “before” picture in desperate need of a stick-straight “after.” So, when I see photos of Jennifer Aniston, Halle Berry, and Nicole Richie rocking smooth, shiny locks, I hear the siren call of hassle-free hair and think, “Why not?”

In a word? Formaldehyde. Yes, that same stinky soup that held the dissecting frogs in 10th grade biology is now available in your local high-end hair salon. Initially, this rather disturbing information came to light late last year when salon workers reported headaches, eye irritation, difficulty breathing, and nose bleeds, all symptoms of short-term formaldehyde exposure. When Oregon Occupational Safety and Health Administration (OSHA) tested samples of Brazilian Blowout products, they found dangerous levels of the chemical, including in products explicitly labeled “Formaldehyde Free.”

Investigators have concluded that the process of applying the solution to hair, and then using a blow dryer and flatiron, aerosolized the formaldehyde, making it easy for salon workers and clients to inhale. This is a great discovery if you’re looking for an effective biological weapon, but definitely bad news for women’s health. Formaldehyde is a known carcinogen, and scientific studies have linked it to miscarriage, stillbirth, menstrual disorders, and female infertility. Just last week, the beauty industry’s own scientists finally acknowledged that they cannot guarantee the safety of formaldehyde-containing hair straighteners. And by the way, this is just the tip of the iceberg in terms of toxic cosmetics targeted to women of color. … Read more

Assisted Reproductive Technology: Let’s Focus on One Healthy Baby at a Time

7:13 am in Uncategorized by RH Reality Check

Written by Jennifer Rogers for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

The hubbub of Kate Plus 8 and Nadya Suleman is largely over. One year ago, articles covering multiple births and stories of in vitro fertilization were front-page news, but today I’m hard-pressed to name even a celebrity who has had a high-order multiple in the last few months. While I take this as good news, the data on assisted reproductive technologies (ART) tells a slightly different story.

Assisted reproductive technology includes fertility treatments in which both eggs and sperm are handled in the laboratory—this includes in vitro fertilization (IVF). It is well-documented that women who undergo IVF are more likely to deliver multiple-birth infants than women who conceive without assistance.  In fact, almost half of all IVF pregnancies result in multiple-birth deliveries.[i] Pregnancy with multiples is usually a direct result of multiple embryo transfer. This means that two or more embryos are transferred to a woman’s uterus at one time. And although the percentage of triplet-or-more births has declined from 6 percent to 2 percent from 1998 to 2007, the percentage of twin births remained stable at about 30 percent.

Because the use of ART has doubled since 1998, many of us now know a friend, family member, colleague, or, at the very least, know of a celebrity who has undergone the procedure. We have become accustomed to the idea of twins, a remarkable conceptual change given the relative rarity of natural twin births in humans. But the problem is that, in comparison to singletons, pregnancy with multiples, including twins, raises health risks—for both a woman and her infant. For women, these risks include higher rates of cesarean section, maternal hypertension, preeclampsia, hemorrhage, and death. Infants are more likely to require neonatal intensive care, and experience higher rates of low birth weight, preterm birth, and cognitive and physical impairments.

Single embryo transfer (SET), however, nearly eliminates pregnancy with multiples because only one embryo is transferred and, thus, decreases the health risks for a woman and her child as well.

Compounding these health risks is an economic consideration, something made more pressing in the midst of health care reform and our economic crisis. Policymakers, health care providers, and insurance companies are paying more attention than ever to the bottom line, and we know that—at least in the short term–multiple versus single embryo transfer is less expensive. In fact, if we kept our current insurance policies and, at the same time, created a universal SET policy, it would cost patients an extra $100 million to achieve the same pregnancy rates.

But this would be a short-sighted and eventually hugely expensive misunderstanding of the issues. Because of the long term health risks associated with multiple births, moving to SET-alone would save in overall healthcare costs.[ii] For instance, in the United States alone, maternal and newborn hospital charges per family were $9,845, $37,945, and $109,765, respectively for singleton, twin, and triplet births.[iii] Thus, creating policies that promote single embryo transfer (SET) are becoming the talk of the ART town. These estimates indicate an elective SET policy could improve the overall health of women and infants while at the same time save million of dollars in health care costs.

So, why hasn’t SET become the standard of care?

This question raises several issues.  The first problem lies with current federal policy. The Fertility Clinic Success Rate and Certification Act of 1992 requires fertility clinics to only report their pregnancy and birth success rates. This regulation creates incentives for physicians to transfer multiple embryos to ensure better success rates. Although the American Society for Reproductive Medicine (ASRM) has released voluntary guidelines that recommend physicians transfer only one embryo and no more than two to women 35 and younger,[iv] the emphasis on better numbers versus better health means that providers are still willing to transfer more embryos despite the potential risks to a woman and her newborn. This practice also assumes that multiple embryo transfer leads to higher pregnancy rates. Although, in the past, this has been the case, more recent research suggests single embryo transfer does not compromise the pregnancy rate, especially for younger women with high quality embryos.[v],[vi],[vii][viii]

Second, many insurance companies do not cover IVF treatment in the United States. In fact, two states—California and New York—have laws that specifically exclude coverage for IVF. For instance, California’s law requires health care plans that cover expenses on a group basis must “offer coverage for the treatment of infertility, except in vitro fertilization.” And even in states where infertility is covered, coverage may be limited to a one-time only benefit for expenses arising from the procedure. This means that many patients bear the full cost of IVF and, thus, feel pressure to transfer multiple embryos in order to achieve a pregnancy on their first try. And having twins is less costly initially than having successive singletons. Older women may even feel more pressure to have twins because they may not be able to become pregnant a second time.

Third, the health risks arising from pregnancy with multiples, even twins, is not widely known. As a culture, whether through shows like Jon & Kate Plus 8 or the popularity of celebrity twins, we celebrate and even glamorize multiple births. However, studies show that when IVF patients receive information about the health risks, they are more interested in pursuing SET.[ix],[x]

Thankfully, instead of working reactively to propose regulations or new policies based on outlier cases (i.e. Ms. Suleman and her octuplets), there are proactive steps women’s health advocates can promote built on support and honesty to help improve the health and well-being of women and their children. Forward thinking policies—like encouraging SET—are concrete solutions to these issues.

As we implement health care reform, we have a unique opportunity to require insurance coverage of infertility diagnosis and treatment, including STI screening and treatment (a leading cause of infertility) and multiple IVF cycles. Studies have found that if insurance covers multiple embryo transfers, patients are more willing to choose SET. This coverage must also be coupled with patient education on the health risks associated with multiple births. Research has found time and again that accurate information about the risks associated with multiple embryo transfer can lead both women and men to choose SET.

We also need better and more robust data collection. We can change our policies to define “success” in terms of healthy pregnancies, safe births, and healthy babies, rather than the superficial live birth count currently used in federal law. Clinics should be rewarded for responsible medical practices such as the quality of the counseling they provide women and men before they begin down the ART path. This also means providing individualized care—because, for some women, especially women of advanced age or those who have previously gone through IVF with no success, SET may not be the answer.

Last, but not least, as reproductive health advocates, we must look closely at the benefits ART provides in alleviating the burden of infertility as well as the challenges it presents in exacerbating poor health outcomes and high health care costs. We must provide women and men the tools—education, support & respect—to make the best decisions for themselves and their families. An open and honest conversation about ART can lead to policies that support the health of women and children, help bring down our long-term medical costs, and better speak to the personal crisis of infertility. Free from sensationalism, we can do all three.

[i] http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5805a1.htm?s_cid=ss5805a1_x

[ii] Petok, W. D. (N.D.). Single Embryo Transfer: Why Not Put All Your Eggs In One Basket? American Fertility Association. Retrieved from http://www.theafa.org/library/article/single_embryo_transfer_why_not_put_all_your_eggs_in_one_basket/

[iii] Collins, J. (2007). Cost efficiency of reducing multiple births. Reproductive BioMedicine Online, 15, 35-39.

[iv] American Society for Reproductive Medicine [ASRM] (2009). Guidelines on number of embryos transferred. Fertility and Sterility, 92, 1518-9.

[v] Stillman, R. J., Richter, K. S., Banks, N., & Graham, J. R. (2009). Elective single embryo transfer: A 6-year progressive implementation of 784 single blastocyst transfers and the influence of payment method on patient choice. Fertility and Sterility, 92(6), 1895-1906.

[vi] Saldeen, P., & Sundtrom, P. (2006). Maintained pregnancy rate after introduction of elective single embryo transfer in women 36-39 years. Fertility and Sterility, 86, S76.

[vii] Anderson, A. R., Graff, K. J., Distefano, J., Seegers, J., Whelan III, J., & Crain, J. L. (2006). When is a single embryo transfer appropriate? Fertility and Sterility, 86, S191.

[viii] Komaba, R., Maeda, M., Sugawara, N., & Araki, Y. (2007). The effective prevention of multiple pregnancies by elective single embryo transfer. Fertility and Sterility, 88, S154.

[ix] Newton, C., & McBride, J. (2005). Single embryo transfer (SET): Factors affecting patient attitudes and decision-making. Fertility and Sterility, 84, S3.

[x] Hope, N. J., Phillips, S. J., & Rombauts, L. (2010). Can an educational DVD improve the acceptability of elective single embryo transfer: A randomized controlled study. Fertility and Sterility, 90, S67.

Abortions After IVF: Scandal Created By Anti-Choice Politics

11:01 am in Uncategorized by RH Reality Check

Written by Robin Marty for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

There are few people who want a baby as badly as those who have struggled with infertility, especially those who have undergone fertility treatments.   So the shocked reaction from many media outlets in the United Kingdom to news that approximately 80 pregnancies from in vitro fertilization (IVF) procedures eventually ended in abortions isn’t terribly surprising.  What is surprising, however, is the vitriol in which many attacked the women that they claimed just whimsically decided they didn’t want to be mothers any more.

“Dozens of IVF babies aborted ‘after women change their minds about becoming a mother’” claims Daily Mail, as if the decision to terminate a pregnancy was taken with the thought and introspection of deciding to wear a different colored sweater, or go out for dinner rather than stay home and cook.

Dozens of women are aborting babies conceived by IVF because they have changed their minds about motherhood, figures suggest.

Many are in their teens, twenties and early thirties, implying that numerous abortions were carried out for social reasons, rather than on health grounds.

Relationship breakdowns, fears about motherhood and simple changes of heart are all likely to have played a part in the terminations.

"Women Undergoing IVF, Get Abortions on Second Thoughts" accuses Top News, because after spending months or years trying to get pregnant, and then lots of money for treatment, obviously they didn’t think it all through to start with.  

Eighty women a year undertake expensive IVF, and then terminate the pregnancies, just because they have doubts about being a mother.

Yesterday, the startling data ignited anger that some women were cruelly treating test-tube babies like "designer goods".

Rationales offered for abortions, some sponsored by the NHS for around £5,000, were dreaded to comprise a simple change of mind.

Others were separated from their spouses, or were weighed down by families to begin a family too early.

One IVF mother aborted her twins after finding out that her husband was not loyal to her.

Other women are believed to undergo IVF not for a baby, but just to show they can have one.

Unmentioned by either of these articles, but made clear by a report from the BBC, is that these 80 abortions included procedures done due to medical problems with the fetus, or selective reduction in order to enhance one or two fetuses’ chances for better full term birth.  Although the other articles mention the abortions occur most often in the 18-35 age range, implying more healthy babies that were aborted, the BBC also points out that that is the age range for a majority of the pregnancies in the first place, making higher abortion rates inevitable.  The conservative press made leaping assumptions about the women who abort, but the BBC spoke of not jumping to conclusions about the reasons behind the choice.

…Susan Seenan of the Infertility Network UK advised caution.

"Anyone who has undergone IVF knows what a long and difficult experience it can be. To make the decision to then terminate that pregnancy cannot be one that anyone takes lightly. I would imagine there are some pretty good reasons."

Laura Riley, a spokesperson for the British Pregnancy Advisory Service, said: "Women and couples who have had donor insemination or IVF to become pregnant are unfortunately no more immune from the harsh vagaries of life than others who are lucky enough to be able to conceive naturally.

"Any woman can experience overwhelming life difficulties, such as intense relationship pressures or the diagnosis of a serious or lethal fetal medical problem. These may mean that she feels unable to continue with the pregnancy."

At this point, the information has not been released as to the reasons for the abortions, although a breakdown is expected for sometime next week.   We do know that the 80 abortions rate less than 1 percent of the successful IVF pregnancies in the country in the last year.  Knowing that approximately 3-5 percent of all pregnancies have identifiable fetal abnormailties that can be determined prior to birth, the idea of assuming the majority of abortions are being performed on women who just liked the idea of getting pregnant more than they enjoyed the actuality of having a baby is laughable.

For women who struggle with fertility, just trying to conceive a child has already been a full effort, fraught with setbacks, disappointments and roadblocks.  But to finally become pregnant, only to find out that your child may have a neural tube disorder making it incompatible with life, or a trisomy that means that should you even manage to carry the child to birth it would be doomed to a short and painful life, or a heart defect making it unlikely to even survive the process of labor itself?  The pain, frustration and loss is unimaginable.

IVF isn’t just a one time process, where you show up, have some eggs taken out, and go about your way.  It requires multiple screenings with doctors, with various meetings throughout your cycle to monitor follicles, check for ovulation, do a retrieval, insert the fertilized eggs, and run betas to check for pregnancy.  It requires daily shots of hormones, countless restrictions on activities, and a full-time commitment to the procedure.  To imply that the women simply weren’t that interested, that motherhood was some sort of whim that they can easily discard, and that they were only in it to prove they could get pregnant, or that they only wanted "designer," perfect babies, is offensive not just to anyone who has struggled to conceive, but to women in general.

But it plays perfectly with conservative crowd, who ceaselessly push the image of the fickle woman who can’t make a decision on her own.  The one who, if left to her own devices would suddenly decide at 7 months pregnant that she was tired of carrying a child and didn’t want to be a mom, and would go out and get an abortion if it were easily available so she could have a drink and go to a concert.

It’s this myth of the woman who has to be protected from her own inability to make good decisions that anti-choice activists feed on.  They use it in their legislation, claiming that forcing a woman to look at an ultrasound before an abortion is just giving her full information, protecting her from not having enough facts.  As if somehow without their help she wouldn’t understand that she was pregnant.  They use it when they pass bills that force women to have mental health evaluations before they can get an abortion, because a woman can’t be trusted to make a decision on her own.  And they use it when they pass laws saying a doctor can lie to a woman about fetal abnormalities, because a woman might not realize it is always in her best interest to carry a child to term, no matter what.

These anti-choice myths are the stuff that abortion restrictions are made of — laws made to protect women from themselves at a time when conservatives think they are too vulnerable to think clearly about what’s best for them.  And now they are using women who have struggled with fertility, struggled with conception, and worked harder than almost all their peers to get pregnant, abusing these women’s tragic stories to try and undermine choice even more as they further their own agenda.

I’ve worked hard to get pregnant.  I’ve suffered through infertility and loss.  I only hope I will be lucky enough not to have to face the trials many of these women did, and that if I do, my actions will not be used against me by anti-choicers desperate to score points.

“Slow Death by Rubber Duck:” What We Don’t See Can Hurt Us

6:46 am in Uncategorized by RH Reality Check

Written by Miranda Spencer for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

By now most of us have heard about the dangers of the hormone-mimicking chemical bisphenol-A (BPA), found in common items such as baby bottles and the lining of canned foods, and the international movement to ban it.

If those headlines have got you wondering about other connections between human health and toxics in the environment–and especially if they haven’t–Slow Death by Rubber Duck: The Secret Danger of Everyday Things (Counterpoint Press) is the perfect primer on the topic.

By “the environment,” the authors — Canadian environmentalists Rick Smith and Bruce Lourie — means not so much the visible pollution outside the home but invisible chemicals inside it.  The ones with unpronounceable names and funny acronyms like phthalates and PFOA, created by modern chemistry and placed in products – such as rubber duckies – to make them flexible, flameproof, fragrant, slippery, and/or germ-free.  As the book documents, these products and chemicals not only have become ubiquitous parts of our lives but are actually part of us, residing in our bloodstreams and possibly penetrating our DNA.  A growing body of research shows that even in infinitesimal amounts, these synthetic compounds are linked to a host of chronic health problems in kids and adults, from asthma and obesity to infertility and breast cancer.

But this sobering book is no bummer. Smith and Lourie heave created an ingenious work that’s simultaneously practical, comprehensive, accessible, hopeful, and humorous in a Grist magazine sort of way.

The book pivots on a bit of a gimmick: The authors, taking a leaf from Morgan Spurlock’s “Supersize Me,” perform experiments in which they deliberately expose themselves to seven common toxics including pesticides, brominated fire retardants, and the (natural) element mercury, then compare the levels in their bodies before and after lab tests. Sure enough, their levels rise substantially. But unlike Spurlock, who ate every meal at Mickey D’s for a month, which most of us never do, Smith and Lourie engage in activities most Americans do everyday, such as eating tuna sandwiches, sitting on ScotchGuarded furniture, washing with antibacterial soaps, using shampoo, and cooking on Teflon pans.  Rick and Bruce R Us.

Importantly, each chapter presents a fascinating narrative outlining the scientific, sociocultural, and political history of one of the classes of chemicals in question. I found it particularly distressing to learn that the dangers of most of them have been known for years, and yet rather than discontinue manufacturing them, companies have a tendency to contrive new uses and marketing campaigns (pouring old poisons in new bottles, as it were).

Best of all, the book outlines both personal and professional actions readers can take to reduce our exposure to these substances and even help eliminate them from our bodies. The final chapters alone, offering detoxification advice and resources for further study and action, are worth the price of admission ($25, hardcover).  (I wish, though, they’d mentioned websites and companies that sell alternatives and substitutes for chemical-laden products, such as Debra’s List.)

Slow Death by Rubber Duck is of special interest to women because so many products –especially those used by and marketed to us, from beauty products to frying pans –hold particular harm from a reproductive angle. They tinker with our hormones, infiltrate our breast milk, and can affect the fetuses we may carry and any young children we already have. As the authors write, “Children are most at risk to the many serious ailments linked to toxic chemicals….their developing bodies cannot tolerate chemicals in the same way that adults’ can.”

Considering that 82,000 chemicals are currently in use in the United States but “only 650 are monitored through the [U.S. Environmental Protection Agency’s Toxic Release Inventory], only 200 have ever been tested for toxicity, and only five have been banned under the Toxic Substances Control Act,” the old saw “Buyer Beware” is an understatement.   But thanks to concerted activism, a movement to tighten regulations (such as the introduction by Sen. Dianne Feinstein last year of the Ban Poisonous Additives Act of 2009 ) and ultimately eliminate such substances is going full steam.  After reading this book, you’ll want to jump on that train.  Or at the very least, grab that “rubber” duckie out of Junior’s mouth.