Lessons From the Womb
I detect a shade of distaste in your most recent posting, a wrinkled-nose dismay at the messiness of this emerging discipline. In an earlier entry you twice referred to fetal origins research as "alluring," as if you were fortifying yourself against its disreputable charms. I'll admit that to me, the wild, wide-open nature of the field of fetal origins is part of its appeal. You ask why I haven't excluded some of the more raffish guests from the party I've thrown in my book, Origins, suggesting it's because I'm too polite to show them the door. Actually, it's just the opposite: I purposely want to provoke a noisy, animated conversation on this subject I find so fascinating and compelling. I want an alternative to the grim, guilt-laden, anxiety-laced lecture that currently passes for our culture's discussion of pregnancy, an exchange that does full justice to the gestation of a child as a physical, emotional, and intellectual adventure.
You ask how I chose which research to write about in my book, puzzling over my inclusion of studies that "might not make women feel so good." The answer is that I want to treat women as thoughtful adults, capable of looking at pregnancy from every angle. There exists now a particular lack of positive, optimistic perspectives on pregnancy, so that's a gap I tried to fill. But I included all research that struck me as interesting and important, that seemed to shed light on the experience of being pregnant today.
Of course, it's imperative that this work adheres to rigorous scientific standards. In my book, for example, I don't recount experiments about enriching the fetus (by playing music to a pregnant belly and so on), because there's no evidence such activity is beneficial or even safe. But Daniel Fessler, the UCLA anthropologist who reported that women hold more ethnocentric attitudes earlier in their pregnancies, is doing sound science. So as not to bog down this entry, I'll address your specific concerns about his research in this this sidebar. The short version is that I find Fessler's results intriguing, if preliminary, and worthy of a mention.
In remaining open to new theories and unorthodox ideas about pregnancy, I'm conscious of the history of fetal origins, which has itself moved from the fringes to the almost-mainstream. A couple of decades ago, David Barker would have been the oddball on the fire escape, ranting about how a pregnant woman's diet affects her fetus. When he first presented his evidence that low birth-weight babies were more likely to develop heart disease in middle age, he was roundly jeered by his colleagues. Now he holds court at the center of the crowd, listened to with respectful attention.
His audience of august scientists would have done well to begin listening much earlier to Barker and others outside their cozy circle. Most societies, in most times and places, have believed in the impressionability of the fetus. There may be only one culture, in fact, in which this idea was rejected out of hand: the scientific and medical establishment of the modern West. For much of the 20th century, many researchers and doctors in this part of the world held that the human fetus was largely impervious to external influence—"a perfect parasite," to use their casually contemptuous term—satisfying its needs by skimming nutrients from its mother. "No, smoking and alcoholic drinks have no effect on an unborn baby," chided a news bulletin distributed by a medical society in 1954. Calling such ideas "superstitions" and "old wives' tales," it concluded with a wag of the finger, "Listen to your doctor instead of sewing circle fantasy."
Such attitudes were not without consequence. They led directly to two of the greatest medical disasters in history: the tragedies caused by thalidomide and by diethylstilbestrol. Pregnant women took these two drugs in the belief that their fetuses would be unaffected, when in fact thousands of offspring developed severe malformations or aggressive cancers as a result of prenatal exposure. The attitudes that made this terrible mistake possible linger on—for example, in the sluggish response of health authorities to the hazard posed to fetuses by the class of chemicals known as endocrine disruptors, found in plastics and other household products.
So while I agree that there are costs to credulousness when it comes to fetal-origins research, I'm also acutely aware of the human costs of waiting too long and being too cautious in applying what we know by now to be true: Taking good care of pregnant women produces healthier infants, children, and adults. This care is a collective obligation we owe to pregnant women, much as we owe it to children and the elderly (and to ourselves, since the offspring of these women are our society's future). Yet the crazy-making way we now approach pregnancy treats individual women as responsible for conditions they can't possibly rectify on their own. As the ecologist and author Sandra Steingraber has pithily observed, "The question isn't 'How many tuna sandwiches is it safe for a pregnant woman to eat?' but rather 'How do we get that mercury out of the food chain entirely?' "
Our narrow, crabbed understanding of pregnancy and its significance is what I set out to explode in Origins. I want to acknowledge, and, yes, celebrate, the revolution in thinking that the science of fetal origins is bringing about. A profound idea about human nature—that events and experiences before birth can shape the individual, for good or ill—is being reclaimed, explored, and advanced as we watch. A scrupulous but also spirited account of this revolution: that is what I want to give readers.
It's been my pleasure to correspond with you, dear Amanda, and I know we'll be talking about all this for a long time to come.
Annie Murphy Paul is the author of Origins: How the Nine Months Before Birth Shape the Rest of Our Lives and the forthcoming Brilliant: The Science of How We Get Smarter.