interview by Karin Gunther Russ
Coordinator of CHE’s Fertility and Reproductive Health Working Group
Dr. Jeanne Conry of American Congress of Obstetricians and Gynecologists
Congratulations on receiving the Pacific Southwest EPA’s award for Children’s Environmental Health! What first brought you into environmental health work?
I had been working on preconception health care since 1998 when the American College of Obstetricians and Gynecologists, District IX (California) collaborated with the March of Dimes efforts to create guidelines on preconception health to meet Healthy People 2000 goals. The same group of professionals got together as a preconception health council in mid 2000. Reducing preconceptional exposure to chemicals was not part of the plan at the time.
Dr. Hani Atrash from the CDC was at the preconception health council, and connected me with Dr. Tracey Woodruff at the UCSF Program on Reproductive Health and the Environment (PRHE). Tracey came to the group and started doing her talks, and I knew we had to address environmental exposures and reproductive health.
What is your primary mission in your work?
Currently, physicians are not used to incorporating the results of environmental health studies into their clinical practice. More and more research is showing that chemicals and other environmental factors are negatively impacting fertility, pregnancy and fetal development. Clinicians need to be able to access that information, but in a practical way.
We are used to having access to clinical guides, such as Drugs in Pregnancy and Lactation, that show the drug, the studies, and the effects. The plan is that the NavigationGuide from PRHE will provide that information for clinicians in a readily usable form.
How would you describe the Navigation Guide?
The Navigation Guide uses a systematic method to evaluate the quality of evidence and strength of recommendations about the relationship between the environmental exposures and reproductive health. The Navigation Guide is designed to review the best studies on many different chemicals, rate them on their impact on reproduction, and provide recommendations for practice. Researchers are currently working on the Navigation Guide to establish proof of concept.
What are the most important recent developments in your work, scientific or otherwise?
As the president-elect for the American Congress of Obstetricians and Gynecologists (ACOG), I’ve been facilitating a survey of environmental health practices by OB/GYN doctors. The survey asks about their knowledge of environmental factors that affect reproduction, their comfort level in counseling clients on these issues, and what environmental information they currently incorporate into their practice.
Another exciting development is a meeting between ACOG leadership, PRHE members and representatives from federal agencies that play a role in regulating chemicals in the US. The goal is to impress upon the regulatory agencies the major impact that chemicals can have on reproduction. My goal is to bring this information back to ACOG so that we can incorporate information and distribute to our Fellows.
What have been some of the greatest recent challenges?
Physicians are so busy with patient care, it’s difficult to get them involved in looking at environmental health research. The most challenging part is trying to get physicians to understand the research. The way physicians look at studies and environmental scientists look at studies are completely different. A physician assumes that a chemical, like a pharmaceutical, has gone through in vitro studies, in vivo studies and human studies. Getting people past the obstacle of the lack of double-blinded controlled studies in reproductive health is the biggest hurdle. The Navigation Guide will help.
What or who continues to inspire you in your work?
My patients. I’m a women’s health advocate. Our patients rely on us for information. They come to us because they trust us. We are inspired to learn more about environmental hazards to protect them.
And my children inspire me. I look at my daughter and son and want to provide guidance for the next generation.