Pregnancy book births a movie

The recently released movie What To Expect When You're Expecting has plenty of stars (Cameron Diaz, Jennifer Lopez, Chace Crawford, Elizabeth Banks) and a storyline chockablock with pregnancy and, eventually, birth.

Critics hated it but viewers gave it a somewhat warmer reception.

What to expect movie 2

Elizabeth Banks and Brooklyn Decker in What To Expect: The Movie

The mere fact a movie called What to Expect...  got made reflects the strength of the brand of the 28-year-old self-help book that inspired it, What to Expect When You're Expecting.

And it is an awesome brand. WTE is in its fourth edition, with more than 15 million books in print.

The author of What to Expect When You're Expecting, Heidi Murkoff, wrote the first edition of the book with her late mother, Arlene Eisenberg, and her sister Sandee Hathaway, who is no longer involved with the series. Sharon Mazel co-authored the fourth edition.

The WTE franchise also includes books on babies and toddlers, plus a baby-sitter's handbook.

The WTE website now has a page about the movie, including the stars' thoughts about the book. It has all come full circle, which gets to be a little dizzying, if you ask me.

London flashmob for safety in childbirth

Don't try this at home.

From the producers (2008):

If you think this is dangerous, try giving birth in poor countries without a midwife, hospital or medicine. This flashmob is one of a series happening in Paris, Berlin, Utrecht and across Canada to highlight the scandal that millions of women in poor countries and around the world aren't getting the healthcare they need for a safe and healthy pregnancy.

(And just to put your minds a rest - the dancing expectant mums in this video aren't pregnant, they were professional dancers wearing pregnancy suits!)

Carla Bruni-Sarkozy is reportedly pregnant

Carla Bruni-Sarkozy, the first lady of France, reportedly is pregnant.

Carla Bruni-Sarkozy
Carla Bruni-Sarkozy

The Sarkozys have not confirmed the story, but it moved beyond rumor this week when the president's 82-year-old father, Pal, told the German newspaper Bild, "I'm glad to be having a grandchild."

The Italian-born Bruni-Sarkozy, 43, a former model and entertainer, has one child from a previous relationship. Her husband, French President Nicolas Sarkozy, 56, has three children from two previous marriages. The couple married in 2008.

The baby boom doesn't stop in the Elysee Palace. With an average of 2.01 children, the French have one of the highest fertility rates in Europe. The population hit 65 million last year, when 828,000 babies were born in France.

Tina Fey is pregnant, choosing to juggle more

Tina Fey, Emmy-winning creator/writer/producer/star of the television comedy 30 Rock, has kicked the ambivalence she was wrestling about having another baby.

Fey, a former standout member of the Saturday Night Live ensemble, will announce on The Oprah Winfrey Show on April 12 that she is five months pregnant with her second child, People magazine reported on its website this week.

Celebrities are often reticent about the details of their pregnancies, but Fey has let her anxieties hang out on the topic in her new book, Bossypants, and in a recent, related New Yorker article, "Confessions of a Juggler."

Tina Fey

Tina Fey

It is unsettling to be a woman of 40, in her "last five minutes" both of fertility and decent movie offers, Fey writes, and she weaves wacky scenarios as she considers having another baby vs. concentrating on her career.

"Why not do both, like everybody else in the history of the earth?" she asks.

The math is impossible, Fey writes.

"No matter how you add up the months, it means derailing the TV show where 200 people depend on me for their income, and I take that stuff seriously. Like everyone from Tom Shales to Jeff Zucker, I thought 30 Rock would be canceled by now."

But 30 Rock is still going, and now Fey is pregnant. It's going to be interesting to see what happens.

In my opinion, Fey has made the right decision, because it is the decision she has made. (Her husband, she writes, just wanted her to get off the dime.) And that goes for any woman. She who controls her own fertility has at least a shot at controlling her life.

(Or, Fey may have gone through years of hand-wringing and then just discovered she was pregnant. That whole control thing is hard to pull off.)

In any event, the gynecologist who tells Fey during her paroxysms of indecision, "Either way, everything will be fine," was probably right.

Fey is in for a wild ride, balancing a hugely demanding job and two children. She is sure to get a lot of the question she says is the rudest you can ask a woman: "How do you juggle it all?"

Image courtesy of David Shankbone/Wikimedia Commons

Booties on the ground

In his excellent review of Annie Murphy Paul's new book, Origins: How the Nine Months Before Birth Shape the Rest of Our Lives in the New York Times Book Review on Sunday, physician/author Dr. Jerome Groopman wrote:

Of necessity, research on fetal development involves observing pregnant women in their daily lives; no one would purposefully have one group eat in a possibly risky way or be exposed to a potentially dangerous substance, and compare outcomes with an unperturbed control group. We have, at best, only correlations between a mother’s lifestyle and her child’s future health, not clear causation.

And, in "The Case Against Breast-Feeding," Hanna Rosin's 2009 article in The Atlantic, she wrote, "An ideal study would randomly divide a group of mothers, tell one half to breast-feed and the other not to, and then measure the outcomes. But researchers cannot ethically tell mothers what to feed their babies."

Really? Why not? Both Groopman and Rosin are writing about how vulnerable observational studies are to being tainted by hidden variables. Controlled trials are a better system for testing what works and what doesn't.

But if I am reading their statements correctly, Groopman and Rosin are saying that we cannot even think about practicing actual, rigorous science if babies and fetuses are involved.

Building up a body of "evidence-based medicine" around a segment of the population that is exempted from clinical trials — depending entirely on observational research, that is — seems unwise to me. We don't need to wonder what a worst-case scenario involving babies would look like;  we have the 50-year-old thalidomide catastrophe as a demonstration. Thousands of children around the world were born with deformed limbs after their mothers took the drug.

Subjecting drugs and behaviors that can affect unborn children to standard scientific trials that include pregnant women might save the population from potentially massive damage from those behaviors, and from the drugs once they are put on the market. This is especially true now that we suspect the experience in the womb has a huge influence on the course of an individual's life — the subject of Paul's book, Origins.

Now I understand why the medical ethicist Ruth Macklin, writing in The Lancet last winter, called for the inclusion of pregnant women in drug trials, and retaining women who get pregnant in such trials. Conventional wisdom seems to have rendered the concept so unthinkable that a call for change is necessary.

What do you think about including pregnant women in clinical trials? I would love to read your comments.