On Sunday, October 3rd, the New York Times of October 3rd printed two articles on the same subject-the effect of the intrauterine environment on the health and growth of infants and children. The first was a review of a new book by Annie Murphy Paul entitled "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives." The second was an editorial by Nicolas Kristof-"At Risk From The Womb." Both the book and the editorial are thoughtful and intelligent pieces of writing on a subject that clearly is going to be more important in terms of public health than we previously would have imagined.
We have tended to believe that the uterus and amniotic fluid shelter the fetus from stresses and toxins to which the mother is exposed. It turns out that studies of fetal environment show that children with low birth weight are more likely to develop heart disease in later life, that children born to women who were pregnant during the influenza pandemic of 1918 did worse on every socioeconomic outcome recorded, that there was a greater incidence of schizophrenia in children born after the Arab-Israeli Six Day War of 1967 and the famine in China in from 1959 to 1961. And these studies are just the beginning of a new set of worries. We already know about bad genes and now will have to worry about all the toxins, chemicals, stresses and emotional crises to which pregnant women are exposed.
You may ask why this is problematic and why a discussion of it appears in a blog about maternal ambivalence. After all, the more we know about producing healthy babies, the better off the human race will be. The problem, as I see it, is not the scientists who are doing these important studies, but today's mothers, who are already so burdened with their need to do mothering perfectly and so ready to blame themselves for all outcomes. This is one more thing they can torture themselves with. And the irony will be that middle and upper class mothers, who already take good care of their health, will be the ones most concerned. Working class mothers are so besieged about how to make ends meet and take basic care of their children that the finer points of environmental health will drop by the wayside.
In connection with this "new" problem for mothers, I am generally concerned about the issue of changing fashions in childcare. When my children were babies, in the early sixties, we put them to sleep on their tummies so they wouldn't aspirate if they spit up during their sleep. Now, babies are put to sleep on their backs to reduce the incidence of SIDS. Both these disasters are infrequent. Remembering my own children and observing my grandchildren I am convinced that children sleep better on their tummies. So, what to do? Better sleep is important for both the child and the mother, but what if.......?
Another example, among many, of changing fashions has to do with weight gain in pregnancy. In the early sixties pregnant women were "allowed" by our obstetricians to gain 20 pounds per pregnancy and 30 pounds for twins. These days doctor's orders allow women to gain at least twice as much weight. Good maternal and fetal nourishment, but bigger babies and difficult, longer labors. My children weighed six and a half to seven and a half pounds and these days babies are weighing eight to ten pounds, sometimes more. Today's mothers don't go through pregnancy feeling they are starving, as I did, but then have difficult childbirths. Which children grow better? As I experience it, my children and my grandchildren are growing equally well, making me wonder why I so dutifully starved during my pregnancies. I don't know of another area of human behavior that so religiously follows the advice of experts, no matter what it is, or how often it changes. The connection to maternal ambivalence is that contemporary mothers are so hard on themselves about feeling any resentment towards their children, that they feel compelled to "do it right." Let's hope that these new contributions to fetal health don't drive mothers even crazier than they already are!
