With everything pregnant people have to consider, the amount of air pollution they are breathing may not make it to the top of the list. But, experts say, it is an important consideration and something that expectant parents may not have much control over.

In an email to NM Political Report, Elizabeth Bechard, a senior policy analyst with Mom’s Clean Air Force, said air pollution can impact babies even before they are born.

While there is evidence that exposure to air pollution while pregnant can impact the unborn child, Dr. Mary Prunicki, Senior Director of Air Pollution and Health Research at Stanford University School of Medicine, said more studies are needed to fully understand the risks.

Prunicki has been researching how air pollution impacts health, including potential impacts of wildfire smoke on unborn children.

“There aren’t a lot of studies just looking at the babies from these mothers that are exposed to high air pollution, but it’s kind of analogous to cigarette smoking in pregnancy,” Prunicki said.

Smoking while pregnant has been linked to tissue damage in the baby’s lungs and brain, according to the Centers for Disease Control and Prevention. Some studies have also indicated that tobacco may contribute to miscarriage. Additionally, babies born to smokers are more likely to be born preterm and at a low birth weight.

Prunicki said prenatal exposure to air pollution can impact some key immune genes.

Prunicki was involved in a study published last year looking at these prenatal impacts of air pollution. The women who participated lived in Fresno, California, where the ambient air quality tends to have high levels of pollution. This study found changes to several genes that are associated with the immune system.

While more studies are needed, an increasing body of research is building that shows air pollution can have negative impacts on unborn children and this is particularly noticeable in communities of color that are disproportionately impacted by air pollution.

Bechard highlighted some of this research in her response to NM Political Report.  She said research has tied particulate matter pollution, also known as soot, and ground-level ozone, which is a major component of smog, to adverse birth outcomes such as preterm birth, low birth weight and “heartbreakingly, even stillbirth.”

She said being born too small or too early can have long-lasting effects on the child.  

Bechard’s twins were born prematurely and one of them has sensory processing disorder as well as ADHD. She said both those conditions have been linked to preterm birth.

“I can share from personal experience that these kinds of issues can affect daily quality of life for children and families for years,” she said. 

Preterm birth and low birth weights also increase the risk of developmental issues including cerebral palsy, vision and hearing impairments, mental health challenges and developmental delays, she said.

And those are not the only impacts that air pollution may have on unborn children. Researchers have also found some evidence that pregnant people exposed to particulate matter may be more likely to give birth to a child with cleft palate or cleft lip.

Berchard said living near oil and gas facilities may also lead to an increased risk of congenital heart and neural tube defects.

“Expectant parents are carrying so much concern even without the added burden of air pollution to worry about, so I have deep compassion for any parent who is rightfully concerned about how pollution might be affecting their child on top of everything else they’re likely worried about,” she said.

Inequitable exposure

Where a person lives can impact their exposure to air pollution. Bechard said that exposure to air pollution is not distributed evenly. Because of this, she said, “the burden of air pollution on pregnant people and their babies is also unevenly distributed.”

That means communities of color are more likely to be exposed to higher levels of air pollution. Bechard highlighted a 2020 systematic review that looked at research conducted between 2009 and 2017. She said this review found that Black and Latina/Hispanic people as well as individuals with asthma had higher risks of their children experiencing adverse birth outcomes due to exposure to soot and smog.

“We know that communities of color and low wealth communities are disproportionately exposed to air pollution from sources like heavily-trafficked roads and fossil fuel power plants, because of historically racist practices like redlining and other policies,” Bechard said, adding that non-white people are also disproportionately more likely to have asthma. 

She said this is a form of environmental injustice and “the ability to reduce prenatal exposure to air pollution is, in many ways, a privilege.” 

Bechard said that breathing unhealthy air while pregnant does not guarantee the baby will face adverse birth outcomes.

“Many people who breathe unhealthy air will have healthy babies,” she said. “But breathing unhealthy air does increase the risk of outcomes that no family wants for their child.” 

Reducing exposure

She said there is little that pregnant people who are exposed to air pollution because of where they live or work can reasonably do to reduce exposure.

There are steps that people can take to reduce exposure, Prunicki said.

“First, know your air quality,” Prunicki said.

Air quality monitoring and alerts are an important tool that agencies can provide people to help them manage their risk.

During the wildfires of 2022, the New Mexico Environment Department Air Quality Bureau worked along with the U.S. Forest Service to monitor air quality issues, including increased particulate matter. The two agencies set up special EPA-approved monitors that are known as Environmental Beta Attenuation Monitors at various locations. These helped monitor the particulate matter and ensured up to date information.

The data from those monitors can be distributed through AirNow.gov and on social media. 

Additionally, the Air Quality Bureau uses a Smoke Management System webpage to track wildfires and prescribed burns and provide information to the public.

“You can download apps on your phone that can give you fairly rough ideas of outdoor air quality,” Prunicki said, adding that it is also good to know indoor air quality.

She said indoor air quality can be improved using air purifiers or filtration systems.

Pregnant people can reduce their exposure by remaining inside on days when there is poor air quality.

Prunicki said masks are a good idea for people who have to go outside during poor air quality. Those masks should be designed to filter out pollutants. N95 masks, which became popular during the COVID-19 pandemic, are an example of a mask that can reduce exposure to pollutants.

“These things may help, but it’s important to acknowledge that these kinds of steps may not be accessible to everyone,” Bechard said. “For example, pregnant people who work outdoors may not be able to avoid being outside on days when the air quality is bad. The environmental injustice of air pollution is really a call to action to do everything we can to reduce the sources of pollution in the first place, as much as possible.”

Prunicki said she thinks pregnant people should be given air purifiers or filters to help protect them and their children from air pollution.

Sources of air pollution

According to the New Mexico Environment Department, the largest source of air pollution in the state is the oil and gas sector.  

NMED told NM Political Report that this includes tank batteries, compressor stations, gas processing facilities and refiners. Any facility with a combustion engine or turbine or flares or enclosed combustion devices can contribute to air pollution, the department states. Those emissions include volatile organic compounds, nitrogen oxides, carbon monoxide, sulfur dioxide and hydrogen sulfide.

“In recognition of the amount of air pollution from the oil and gas sector, the Air Quality Bureau proposed some of the most stringent rules for ozone precursor pollutants in the country,” NMED wrote in its response to questions from NM Political Report. 

These rules have since been adopted and implemented statewide.

This is one area where pollution can be addressed through changing regulations and lifestyles. Increasing adoption of electric vehicles eliminates pollutants like nitrogen oxides. As more and more people switch to electric vehicles, air quality is expected to improve. However, electric vehicles currently come with inequities. Charging stations are not always available in lower income areas and the price of electric vehicles places them out of reach for many households. 

In 2021, President Joe Biden issued an executive order that instructs the U.S. Environmental Protection Agency to set pollution standards for cars and trucks and set a goal of half of the new vehicles sold in 2030 being electric.

The EPA announced new proposed vehicle emission standards in April that will impact vehicles starting with those manufactured for model year 2027. 

At the state level, NMED’s Climate Change Bureau is working to develop a Clean Transportation Fuel Program, which will set a maximum threshold for carbon intensity of fuels. This does not necessarily mean a move away from fossil fuels. These rules could allow for electric vehicles, but also may mean more hydrogen fuel cells or renewable natural gas, such as methane captured from animal waste.

The state has also adopted regulations that require at least 7 percent of new passenger vehicles sold in New Mexico beginning in 2026 to have zero tailpipe emissions.

Another pollution source that the EPA has proposed more stringent emission guidelines is power plants. 

Bechard said the EPA’s recent proposal to limit greenhouse gas emissions and other pollutants from power plants could also reduce the levels of air pollution pregnant people breathe.

“Setting strong emissions reductions standards for power plants, and advocating for the necessary transition to clean sources of energy, is key to reducing health-harming air pollution,” she said. “Any regulatory action we take to address climate change will also impact air pollution, because climate change is making air pollution worse in a number of ways—for example, climate change exacerbates wildfires, which generate health harming smoke; hotter days also increase the formation of ground-level ozone, which is bad for our health and especially unhealthy for people who are pregnant.”

The EPA has also proposed updating the National Ambient Air Quality Standards for particulate matter and is expected to consider updating the NAAQS for ozone next year.

Those are areas where policy makers have some control. But not all pollutants can be controlled through new or updated regulations.

According to NMED, the state also experiences air pollution from “significant windblown dust due to the nature of our environment” which can increase concentrations of particulate matter in the air.

This can impact people with respiratory conditions such as asthma, chronic obstructive pulmonary disease and COVID-19.

“Dust is an often-overlooked pollutant despite its prevalence in New Mexico and potential impacts to our most vulnerable residents,” NMED states. 

The Air Quality Bureau has established a dust mitigation plan for southern Doña Ana and Luna counties, which works to increase awareness about the impacts of exposure to dust.  

dust in the atmosphere. The Air Quality Bureau and the National Weather Service release dust storm advisories to help people prepare.

Bechard said wildfires are one source of air pollution that cannot be controlled.

“Because we know that climate change is increasing the conditions that make wildfires worse and wildfire season longer, this is a growing cause for concern,” she said. “We can’t control pollution in the air that comes from wildfire smoke, which makes it more important than ever to control the sources of pollution that we can address with regulatory changes. Children and infants are especially vulnerable to the impacts of wildfire smoke for a host of physiological (and developmental) reasons.”