74,000 Newborns. One Year. One Chemical Class. Here Is What Pregnant Women Should Do. Antepartum, During Each Trimester, Postpartum

A global study links phthalates to preterm birth and infant death. The steps to reduce exposure are clear and start before conception.

Two plastic chemicals may be linked to nearly 2 million preterm births in a single year. Here are 21 steps pregnant women can take to lower their exposure. Link in the post.

Every year, across 200 countries, researchers estimate that nearly 2 million babies are born too early because their mothers were exposed to chemicals found in food packaging, personal care products, and plastic household items. These are not hypothetical future risks. They are happening now.

A study published in eClinicalMedicine analyzed global data from 2018 and estimated that DEHP, a plasticizer used to make plastic flexible, was associated with 1.97 million preterm births and 74,000 newborn deaths. A closely related chemical, DiNP, which manufacturers have been substituting for DEHP in recent years, showed a comparable burden: roughly 1.88 million preterm births. The researchers also estimated over 1.2 million years lived with disability from DEHP-linked prematurity alone. (1)

The word “Plastic” is misleading

When most people hear “reduce your plastic exposure,” they picture water bottles and grocery bags. That is not where the real danger is. Phthalates hide in your shampoo, your nail polish, your scented candle, the cling wrap on your deli cheese, and the fragrance listed on the back of your lotion. The word “plastic” makes this sound like a packaging problem. It is a chemistry problem, and it is inside products you use every day without a second thought.

The numbers are so large they can feel abstract.

They should not.

In the United States, about 1 in 10 infants was born preterm. Preterm babies face elevated risks of cerebral palsy, breathing problems, developmental delays, vision loss, and hearing problems. What the 2026 NYU Langone study makes clear is that chemical exposure in everyday products is contributing to that burden in ways that are measurable, global, and preventable.

The good news matters here.

Phthalates have a short half-life.

They leave the body within days of reduced exposure.

That means the actions you take before and during pregnancy and the advice you give to patients can make a real difference.

Here is the evidence and what it means, organized by when in your pregnancy journey each step applies most.

What the Research Shows

Phthalates work by disrupting the endocrine system, the body’s hormone production and signaling network. Exposure during pregnancy has been linked to placental dysfunction, uterine inflammation, and ruptured membranes, each of which can trigger preterm labor. The Lancet Planetary Health published a separate US-based analysis using data from nearly 5,000 mother-child pairs in the NIH ECHO program, finding that DEHP, DiNP, and related compounds were associated with reductions in gestational age and increased preterm birth risk. (2)

Research from the EAGeR trial, which followed 1,228 women attempting pregnancy, found that preconception phthalate exposure was associated with lower fecundability, meaning a reduced ability to get pregnant, as well as markers of inflammation, oxidative stress, and disrupted reproductive hormones including lower estradiol and higher FSH. (3) The problem begins before pregnancy starts.

A 2021 intervention study in pregnant women showed that urinary phthalate metabolite levels dropped 20 to 40 percent when women followed written recommendations for dietary and lifestyle changes. (4) Behavioral intervention works. The challenge is that full elimination is not realistic: over 90 percent of the general population has measurable phthalate exposure due to the chemicals’ presence in thousands of consumer products. Reduction is the goal, not perfection.

The 21 steps below are organized by when they matter most — before conception, in the first trimester, and throughout the rest of pregnancy — and each one is grounded in published evidence, not generic wellness advice. If you are pregnant, planning to be, or caring for someone who is, this is the most actionable chemical-exposure checklist you will find anywhere.

The rest of this post is for paid subscribers.