Teratogens - who carries the responsibility?
We Are Surrounded by Teratogens: Toxins, Pollution and Responsibility
Most people probably don't use the word teratogen very often. Many do not know what a teratogen is.
We are much more familiar with phrases such as "congenital abnormalities", "causes birth defects", "toxic in pregnancy" or "may harm an unborn baby."
I hear them occasionally on the news, usually when a toxic substance has been identified. An example is the recent stories about polluted rivers and the chemicals found in them that can cause birth defects.
It sits wrong with me when we know this, yet too little seems to happen.
Then I heard about microplastics.
They have been found throughout our environment. We don't make an individual decision each morning to expose ourselves to them. They are simply part of the world we live in today.
What else are we exposed to without consciously recognising or choosing it?
Pollutants travel from factories, agriculture and industry. Chemicals enter soil and water. Traffic and industry affect the air we breathe. Some substances remain in the environment decades after they were released.
They can find their way into our water, our food, our homes and eventually our bodies.
And some can cross the placenta or otherwise affect the environment in which a baby develops.
The baby that should be safe in its mother's womb.
Yet even the womb cannot provide complete protection from what we have put into the world outside it.
Suddenly, the question of teratogens becomes much bigger than:
What did the mother do?
When something goes wrong during pregnancy, we often look at the mother, pointing a finger when we have not considered her journey. We look at her and question the choices she made.
What did she eat?
Did she smoke?
Did she drink?
What products did she use?
Did she follow pregnancy advice?
Is she fit to be a mother?
But what happens if we turn the investigation around?
Instead of beginning with the mother, follow the exposure backwards to the source of the toxins that may have harmed her child.
Mother and developing baby
↑
Food, water, air, home or workplace
↑
Environment
↑
Pollution or contamination
↑
Industry, agriculture, manufacturing or another source
Now the questions change.
They become questions about responsibility.
Who manufactured the substance?
Who released it?
How did it enter the environment?
When was it first suspected of being harmful?
Who knew?
And what happened when they knew?
A woman can make choices during pregnancy, but she cannot personally test the air she breathes, the water from her tap or everything that has entered the food chain.
She cannot avoid a danger that nobody has identified or warned her about.
So perhaps instead of asking only:
"What should pregnant women avoid?"
we should also be asking deeper, more difficult questions:
"Why are pregnant women being exposed to it in the first place?"
And:
"When was it first known to be harmful?"
This may be one of the most important questions we can ask.
Knowledge rarely appears overnight. There may first be a suspicion, followed by laboratory findings, animal studies, reports of reproductive effects, environmental monitoring and eventually evidence in human populations.
Evidence may strengthen, be disputed, investigated further and eventually lead to warnings, restrictions or regulation.
But sometimes action can be slow. Evidence can be challenged. Other priorities can take precedence. The right questions may not be asked soon enough.
There is a difference between exposure to something nobody could reasonably have known was harmful and continued exposure after evidence of harm had begun to accumulate.
Perhaps every environmental teratogen therefore has two histories:
The history of the exposure.
And:
The history of what we knew about it.
Put those timelines beside each other and responsibility may start to look very different.
Are teratogens telling us something about our environment — and about ourselves?
This thought keeps coming back to me.
Perhaps teratogens are not only a pregnancy issue.
Perhaps they are also a signifier of what we have done to our environment.
We have manufactured chemicals, burned fuels, produced plastics, intensified agriculture, created waste and released substances into the environment on an enormous scale.
Many of these things have transformed our lives in ways we believe are for the better.
But now we are learning that there has also been a cost.
Sometimes we discover that cost only years later.
A substance persists.
It accumulates.
It travels through water or soil.
It enters the food chain.
It appears somewhere we never expected to find it — somewhere it should never have been able to reach.
Eventually, we may discover that something we created can interfere with biology itself.
That makes me think differently about the developing baby, and about the safety of the womb.
We describe the foetus as vulnerable, and of course it is. Development is taking place at extraordinary speed. Cells are dividing, organs are forming and biological systems are being established.
But perhaps that vulnerability can also tell us something.
If an environmental exposure can interfere with those processes, should we see that only as a warning for pregnant women?
Or is it a warning to everybody?
And if we acknowledge that a substance can interfere with the development of a child, another question follows:
How much evidence of harm are we prepared to accept before we act?
When nature "hits back"
When I first began thinking about microplastics, I remembered those old science-fiction films where humans interfered with nature and eventually nature "hit back".
Of course, nature doesn't make decisions or seek revenge.
It is much simpler than that.
Toxins have consequences.
If we change our environment, we then have to live within the environment we have changed.
What we release into it can return to us through the air we breathe, the water we drink and the food we eat.
Potentially, it can reach the next generation before they have even entered the outside world.
That is what troubles me.
When we know that environmental exposures may harm human development, why does meaningful action sometimes take so long?
What level of harm have we collectively decided is acceptable?
And who gets to make that decision?
Perhaps the warning, then, is not simply:
Protect pregnant women from the environment.
Perhaps it is:
Protect the environment so that it does not become a source of harm to pregnant women, their children — and ultimately all of us.
Because that baby is not separate from us.
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That baby is one of us.
And perhaps that leaves us with questions much bigger than pregnancy:
What is the developing child telling us about the health of the world we have created?
What are we willing to accept?
Who takes responsibility?
And when harm was foreseeable or preventable:
Who should be held to account?
