Position Statement on the P2i Initiative and Environmental Toxins in Pregnancy

Dear Oregon Birthworkers,

The Oregon Affiliate to the ACNM acknowledges the upcoming P2i media event and certification conference

scheduled for February 14-15, 2025. As healthcare providers committed to evidence-based practice and holistic

care, we want to share our position regarding this initiative and its potential impact on our practice and patients.

Background

Environmental toxins significantly impact human health throughout the lifespan. While research demonstrates

correlations between environmental exposures and various health conditions, including autism spectrum

disorder and other chronic childhood conditions, causative relationships remain unestablished. Recent studies

have highlighted concerns about toxic metal content in commercially available prenatal vitamins, particularly

regarding lead and mercury levels.

While we support efforts to address environmental health concerns and improve regulatory oversight of prenatal

supplements, we emphasize the following key points:

• We support systemic approaches to environmental health improvement through evidence-based policy

change and legislative action.

• We advocate for increased consumer protections and improved regulation of prenatal supplements while

maintaining accessibility for all patients.

• We emphasize the importance of avoiding fear-based messaging that may cause unnecessary anxiety

among pregnant people.

• We maintain that healthcare decisions should be based on evidence rather than commercial interests.

As this media event approaches, we recommend that midwives:

• Prepare to address patient concerns about environmental toxins with evidence-based information

• Consider each patient's social determinants of health when discussing supplementation and testing

options

• Maintain a balanced approach that acknowledges environmental health concerns while avoiding fear-

based decision-making

• Stay informed about the latest research and recommendations regarding environmental exposures during

pregnancy

We will continue to monitor developments in this area and provide updates as needed. For questions or

concerns, please contact the Oregon Affiliate of the ACNM.

In service and gratitude,

The Oregon Affiliate of the ACNM