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.

A perfect baby every time

Every pregnancy begins with a 3 percent chance that the resulting baby will have birth defects, and that is before individual genetic and environmental histories come into play. Some birth defects cannot be prevented or fixed. Medicine cannot work miracles.

That's the message in "The perils of the imperfect expectation of the perfect baby," an article in this month's American Journal of Obstetrics and Gynecology. Prospective parents need to understand that "perfection in pregnancy is not attainable now or even in the foreseeable future," according to the article's authors.

Doctors too can get drawn into "expecting more from medicine than its limited diagnostic and therapeutic capacities justify," say the article's authors, led by Frank A. Chervenak MD. Not only that, but "many pregnant patients are optimistic about the advances in medicine and are confident that their physicians will solve all problems that could occur with their pregnancy."

In fact, everyone needs to get in touch with "the inherent errors of human reproduction, the highly variable clinical outcomes of these errors, the limited capacity of medicine to detect these errors, and the even more limited capacity to correct them," the article states.

The expectation that a perfect baby can eventually be taken away from every pregnancy "assumes powers of medicine to control human reproduction that medicine does not possess," the article states.

Planning to head off childhood obesity

September is Be Kind to Writers and Editors Month, and as both writer and editor here at Birth Story, I intend to take advantage of this important event. I've been writing some long posts, but I'm hoping to keep them a bit shorter this month.Red typewriter

September is also Baby Safety Month, as well as National Preparedness Month, two interrelated observances, you could say, as planning ahead could help keep that baby safe.

Jane E. Brody's Personal Health column in the New York Times Science section today, for example, suggests that moms should adopt a healthy regimen, and maintain a lean frame, even before they get pregnant, if they want to help their children avoid becoming overweight themselves.

Brody's piece is a survey of the present understandings of how a mother's weight while pregnant affects the health of her fetus.

Her chief reference is a recent Lancet article that sought to tease apart the influence of genetics from the effects of more-than-adequate weight gain during pregnancy.

A separate study in Circulation "found that a woman’s weight before pregnancy was even more important than excessive weight gain during pregnancy in predicting a number of risks for the baby" that included childhood obesity," Brody writes.

"The new findings suggest that Americans are now caught in a vicious cycle of increasing fatness, with prospective mothers starting out fatter, gaining more weight during pregnancy and giving birth to babies who are destined to become overweight adults," Brody writes.

The latest recommendations from the Institute of Medicine, a subsidiary of the National Academy of Sciences, call for these weight gains during pregnancy:

¶28 to 40 pounds for thin women, with a B.M.I. of 18.5 or lower.

¶25 to 35 pounds for normal-weight women, with a body mass index of 18.6 to 24.9.

¶15 to 25 pounds for overweight women, with a body mass index of 25 to 29.9.

¶11 to 20 pounds for obese women, with a body mass index of 30 or higher.

Image courtesy of Wikimedia Commons