No pressure, Mom!

Annie Murphy Paul's new book, Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, is getting the star treatment. It is the subject of a Time magazine cover story (written by Paul), and an article by the New York Times' Motherlode blogger, Lisa Belkin.

And why not? Paul has written what looks to be a fascinating exploration of the explosion of research on the effects of the environment human beings encounter while developing in their mothers' wombs.Origins by Annie Murphy Paul

In a guest post for Motherlode (the link is above), Paul writes, "Startling as it may seem, qualities ranging from our intelligence to our temperament to our health, and our susceptibility to diseases as varied as cancer, asthma, obesity, diabetes and mental illness, are affected by our experiences as fetuses decades ago."

We have already considered one aspect of this research here at Birth Story, how a mother's weight gain during pregnancy can influence her infant's lifetime chances of being able to maintain a healthy weight. But Paul covers the waterfront in this "new chapter in the long-running nature-nurture debate," as she calls it.

In her Motherlode guest post, Paul raises and then downplays the likelihood that mothers will be blamed for anything that goes awry with their children, given the new understandings of the importance of what goes on in the womb.

Love Paul's optimism! And, I'm impressed she researched this book while she was pregnant. I'm looking forward to reading it.

The latest edition of doctors’ book on birth

Often, the annual meeting of a medical group produces a flurry of scientific papers, but the meeting of the American College of Obstetricians and Gynecologists seems more like, say, a bunch of writers  getting together. (I attended the 2009 meeting in Chicago.) As a cohort, OB-GYNs seem to want to find out about the newest approaches, tools and techniques they might put to use in their practices, and perhaps exchange some stories from the trenches as well.

Happy babyBut here's something new for consumers from ACOG, which held its annual meeting in San Francisco this week. The fifth edition of Your Pregnancy and Childbirth: Month to Month was unveiled, along with a new companion website,  www.yourpregnancyandchildbirth.com.

While there are many pregnancy books, this one is "unique in the extent of the medical detail that it covers about all aspects of pregnancy, yet it is designed as an easy-to-read, helpful reference for all of those questions that inevitably pop up," said Hal Lawrence, MD, The College's vice president of practice activities in a press release on the ACOG website.

The latest edition of the book has a new chapter that addresses obesity and eating disorders, another devoted to diabetes during pregnancy, and a third covering other chronic diseases like hypertension, heart disease, celiac disease, lupus, and physical and mental disabilities.

"The majority of women do not experience severe complications, but we felt it was important to give a thorough overview so women will know if something's wrong and when to call a doctor," Dr. Lawrence said.

Another new chapter covers feeding the baby, and includes advice on both breastfeeding and the use of formula.

All aboard!

Remember, dear reader, I said there would be tangents. Now we are embarking on a trip to Baltimore, Md., and childbirth will barely be mentioned for a while.

Locomotion

In his groundbreaking 1982 book, The Social Transformation of American Medicine, Paul Starr plumbs the source of mainstream medicine's authority. Simply put, it comes from the public's dependence on the doctor's superior competence, real or perceived.

As the title of Starr's book suggests, doctors were not always able to lay claim to that authority. Indeed, before the germ theory was proved and methods of administering anesthesia devised, making possible the development of effective surgery, physicians had very little to offer. (That didn't keep them from practicing, though.)

But in Baltimore, late in the 19th century, with new technologies and understandings developing rapidly on all sides, events were unfolding that would help solidify the medical profession's authority.

Image by permission  http://creativecommons.org

To the Lighthouse

My favorite book about a mother is To the Lighthouse, by Virginia Woolf. I read it for the first time only recently. I couldn’t believe how powerful it was.

I have had friends who loved To the Lighthouse. They usually admired the character of Lily Briscoe, an artist and independent woman who seems to stand in for Woolf herself in some ways. In the book, Briscoe visits a British family, the Ramsays, at their vacation home on a Scottish island before World War I.

To the Lighthouse

Incredibly, to me now, anyway, my friends never talked about Mrs. Ramsay. I guess I can understand why they didn’t. Lily Briscoe was what we wanted to be at the time, serious women devoted to our art. Or at least that’s what we thought.

Mrs. Ramsay. Woolf doesn’t even give her a first name. Mrs. Ramsay is married to a celebrated intellectual who has come to Scotland with his favorite students. While he marches up and down the beach spouting great thoughts and obsessing about whether his work will live on after him, she is thinking about all the people in her home, her children and guests, and how she might make them happy.

Using the stuff of ordinary life, Mrs. Ramsay pulls off one magical evening in particular, even in spite of a number of glitches, that will stay with all of them for the rest of their lives, tying them with emotion and memories to that time and place.

I don’t want to trivialize a literary masterpiece, but that is what mothers do. Woolf is making that point, of course, that this woman who is almost part of the furniture to the people around her creates the moments that make their lives worth living.

I’m starting to think about Mother’s Day, and I hope you are, too, especially if your mother is still alive. Make that dinner reservation. Plan to give your mother something that will make her happy — flowers, a card, a phone call, a big kiss, or maybe a copy of To the Lighthouse.

Whatever your relationship with your mother, she is the only one you have.

A Midwife’s Tale

Only one American midwife of the Revolutionary War era left a diary that has been recovered, Martha Ballard of Hallowell, Maine. It is a fairly basic document. Some entries are just a few words. Still, between 1785 and 1812, a time of incredible change in New England, Martha tended her diary regularly.

A Midwife's Tale

A Midwife's Tale

In 1990, the historian Laurel Thatcher Ulrich used her own considerable knowledge of the period to connect the dots in Ballard's diary. The result was A Midwife's Tale, which won the Pulitzer Prize and other awards. It is a terrific book, and it was made into a film for PBS's "American Experience."

One of the best things about A Midwife's Tale is the fact that Ulrich has given us a fully fleshed-out picture of Martha Ballard, and has at the same time retained her distinctive voice. Ballard was a religious, hard-working wife and mother who trained her daughters and other young women to assist her, understood the medicinal uses of the plants she grew in her kitchen garden, and in her prime delivered two-thirds of the children in Hallowell.

The town had more than one doctor, but in 816 births over the course of 27 years, Martha called a doctor in to help her with a birth just twice. In all those years, Martha saw 19 babies and five mothers die just before, during or just after birth.

While childbirth rested on a community of women when Ballard began her career, one of the tensions of the book comes out of the inroads male doctors were already making into midwifery by the time Martha died in 1812.