reproductive health

Just to let you know I am also micro-blogging on Twitter as: nycdoula

Follow me if you are interested in hearing about my adventures as a doula in NYC, in addition to news and articles related to reproductive health, and resources for mamas and papas, and mamas and papas to be.

Phytoestrogens are medicinal compounds from plants that interact with our bodies’ estrogen receptors, mildly mimicking estrogen’s effects.  Women are becoming increasingly interested in taking phytoestrogens as an alternative to Hormone Replacement Therapy (HRT) for menopause, feeling that phytoestrogens are natural options that are milder and safer for the body.  Many studies have been done on the efficacy of phytoestrogens.  A new study has analyzed 174 of those studies, in a meta-analysis, combining the results of all the studies and analyzing them together for the purpose of a new research objective.  In this case, the authors (Tempfer et al. 2009) reviewed the side effects of phytoestrogen treatments, compared to placebo or no treatment, in randomized controlled trials.  Side effects were reported by 38% of the 4806 people taking placebo or no treatment (the control groups), and 36.7% of 5502 people taking phytoestrogens.  Therefore the overall difference in side effects was not significant.  When the occurences of different side effect categories were analyzed, those taking phytoestrogens were only found to have a moderate increase in gastrointestinal side effects.  No increase in gynecological, musculoskeletal, neurological, or unspecific side effects were found in those taking phytoestrogens.  The bottom line - phytoestrogens have a safe side effect profile.  [And they are awesome.]

The Canadian Medial Journal recently published a study that looked at 2889 planned home births attended by registered midwives, 4752 planned hospital births attended by the same midwives, and 5331 hospital births attended by physicians in British Columbia between 2000 and 2004.  Not to my surprise, they found the risk of infant death following home births did not differ from that of hospital births.  Not to mention, they found that women who had planned home births had significantly lower risk of obstetric interventions including electronic fetal monitoring, pitocin, epidurals, episiotomies, forceps, and cesarean sections.  They also found these women had a significantly lower risk of adverse outcomes such as major perineal tearing, postpartum hemorrhage, and infections.  Newborns born at home were less likely to require resuscitation at birth or oxygen beyond 24 hours.  Homebirth may not be for everyone, but the belief that it is somehow less safe is innacurate, and fueled by hospital medical staff who are ignorant of homebirth.  Ask any doctor if they’ve ever seen a homebirth.. the answer is more than likely, no.

I keep a close eye on the daily science headlines from a variety of sources, and one topic that I never stop seeing new news on is breastfeeding - and its benefits to both child and mother.  Just a few in the last year, I believe, will illustrate enough.

Benefits to Child:

NY Times article covering a large-scale study (over 15,000 participants) that found that at 6.5 years of age, the breastfed children scored significantly higher on vocabulary, word matching and verbal I.Q. tests compared to formula-fed children.  Additionally, teacher ratings were consistently higher for the breastfed children.

Breastfeeding transfers immunity to babies through antibodies made from the mother, and researchers are beginning to figure out the mechanism.  This transference of antibodies is why breastfed babies have much lower incidences of GI infections compared to formula-fed babies.

Benefits for Mother:

NY Times article covering a study that found breastfeeding reduces the risk of rheumatoid arthritis in the mother.  Women who breastfed up to a year decreased their risk by 25% and women who breastfed for over a year reduced their risk by 50%!

Breastfeeding for 6 months or more has also been associated with a lower risk of certain types of breast cancer - luminal cancer as well as triple-negative cancer, which is very aggressive and particularly difficult to treat.  Another research group is suggesting that lactation-based therapies could provide a component to a natural, non-toxic, anti-cancer therapy.

WHY then, may I ask did a recent study find that 94% of the nearly 1300 hospitals surveyed in east coast states from Maine to Mississippi are distributing formula samples to new mothers, even though multiple studies have shown that hospital-based distribution of formula samples is associated with reduction in exclusive breastfeeding rates, and opposition to this has been voiced by The American Academy of Pediatrics, World Health Organization, Centers for Disease Control and Prevention, and The American College of Obstetricians and Gynecologists??

Effluent from a wastewater treatment plant in Montreal was found to contain:

(measured in nanograms of hormone per liter of water)

90ng/L Estradiol - a natural estrogen, prescribed for HRT (Hormone Replacement Therapy)

53ng/L Norethindrone - used in BCPs (Birth Control Pills), HRT, and menstruation regulation

30ng/L Levonorgestrel - used in BCPs and morning after pills

The latter two are synthetic progestagens, compounds which mimic progesterone.  Human and animal excretion is considered the primary source of natural and synthetic estrogens and progestagens found in aquatic ecosystems.  Some of these hormones have been shown to reach our drinking water as well.  These hormone levels are sufficient enough to have endocrine-disrupting effects in wild aquatic ecosystems, which are receiving the effluent.  In some fish, exposure to as little as 1ng/L of a hormone can result in hermaphroditism, feminization and decreased fertility.  The numbers found in the Montreal effluent were between 30 and 90 times that amount!  Pretty scary.

Study Reference: Viglino L., K. Aboulfadl, M. Prevost, S. Sauve. 2008. Analysis of natural and synthetic endocrine disruptors in environmental waters using online preconcentration coupled with LC-APPI-MS/MS. Talanta 76: 1088-1096.

Wow. If I didn’t urge you to see “The Business of Being Born” when it was playing in very select theaters, I’m definitely urging you to see it now. For free. Online. It doesn’t get much easier than that. I just watched it for the 2nd time and it was as amazing, emotional and thought-provoking as the first time. Two of my favorite birth scholars, Robbie Davis-Floyd and Michel Odent are in the film.  Also, the documentary is set in NYC, so many of the names, faces and places are familiar to me. If Abby Epstein and Ricki Lake didn’t make this, I would have. Seriously.

The Guardian reports on a study conducted by scientists with the Arctic Monitoring and Assessment Programme (AMAP) that likely explains the strikingly high number of baby girls being born relative to the number of baby boys in some areas of the Arctic.  To be more precise, double the number in some communities in Russia, Greenland and Canada.  According to the article, in one village in Greenland only females have been born in recent years. 

AMAP scientists have measured high levels of polychlorinated biphenyls (PCBs) in the blood of pregnant Inuit women.  Traditional diets among the indigenous Inuit people in the region are often high in animal fat, which contains dangerous levels of bioaccumulated pollutants including estrogen-mimicking PCBs.  PCBs have been shown to mimic human estrogens and therefore act as endocrine disruptors, which can negatively impact reproductive development and fertility. 

Strangely, these persistent organic pollutants appear to cross the placental barrier and change the gender of the developing embryo in the first few weeks following conception.  What the article doesn’t explicitly state is that those individuals would actually be, genetically-speaking, still male (XY karyotype), but the exposure to high levels of xenoestrogens (foreign estrogenic substances from the environment) would presumably cause the developmental rerouting toward the formation of a female body.

PCBs do not only impact human reproduction.  Bioaccumulated polluntants have a magnified effect on those species at the top of the food chain, such as polar bears, which have been shown to have high rates of hermaphroditism.  This creates a situation where you have a species already endangered primarily due to global warming that now has anatomical and physiological barriers to reproduction within the already dwindling population.