| Description |
Robust evidence demonstrates that toxins in the water, air, food, and living environments in the US are linked with health consequences ranging from birth defects, to altered development, to reproductive cancers. Pregnant women, developing fetuses, and babies are disproportionately vulnerable to environmental toxins. Despite abundant research and the engagement of many professional health care organizations on this issue, the American College of Nurse Midwives (ACNM) has not published its position on environmental contamination, and its patient handout on the topic is a decade old. The aim of the project was to create and propose two documents to ACNM for adoption: 1) an organization position statement on environmental health, and 2) an updated patient handout on avoiding toxins. These aims are in line with ACNM's mission is to lead the profession in education, clinical practice, research, and advocacy. It is ethically and professionally important for Certified Nurse Midwives (CNMs) to address environmental toxins because they are ideally-positioned to decrease exposures through patient interventions and political activism. Implementation of this project was executed through first contacting ACNM regarding its interest in the proposed documents. After approval, existing literature, position statements by other healthcare organizations, and recommendations by leading researchers were reviewed and summarized. Next, local and national experts were interviewed to fill missing gaps. A position statement was drafted and submitted to ACNM's established process for developing new documents. ACNM's 2006 Share With Women (SWW) patient handout, Environmental Hazards during Pregnancy, was updated with guidance from local experts to reflect current research. It and was submitted to the Journal of Midwifery and Women's Health (JMWH). Evaluation of the project was met through the timely submission of these two documents. Official adoption of the documents is beyond the project's control. However, the position statement passed an internal review process and is undergoing external peer-review by five CNMs who are current members of ACNM, as well as review by leaders from the Program on Reproductive Health and the Environment (PRHE). The Chair of Documents for ACNM's Division of Standards and Practices is guiding the position statement's revision process in preparations for its anticipated presentation for vote at ACNM's June, 2015, Board of Director's meeting. The SWW handout is currently undergoing an internal review process by JMWH. Ongoing revisions of the documents will be made based on reviewer recommendations. In summary, ACNM has not yet published its position on this significant health issue, and its patient handout has not been updated since 2006. These gaps were identified and addressed through the use of current, evidence-based information. Both documents have been submitted for adoption. If ACNM adopts these two documents, it will be responsible for sustaining them and updating them as new information arises. |
