Researching all the scary things that can happen to a fetus may not seem like the best idea for a pregnant woman. But when New York science writer Annie Murphy Paul was pregnant with her second son, she had a personal stake in the emerging field of "fetal origins."
Her new book, Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, explores the effects of factors such as a mother's diet as well as major events such as war and famine - even 9/11.
Case in point: It appears that the children of Manhattan women who experienced post-traumatic stress disorder after the Twin Towers fell were vulnerable to suffering from PTSD themselves. It didn't matter whether their fathers did or did not have PTSD. It was all about the womb.
How did you balance knowing too much with having to live your life while you worked on this book?
I would just rather know - that's how I deal with anxiety. ... The hardest part was when I was doing research for the chapter about chemical and drug exposures and I had to read about thalidomide and DES babies and look at pictures. There is this dread and this fear. Until you see your baby and you know it's fine, there's just so much that you don't know.
What were some of your most surprising findings?
I was surprised that there was solid evidence that really traumatic stress or life-threatening stress can have an effect in all different kinds of contexts: natural disasters and wars and political violence. There was a lot of evidence this was harmful to the fetus. And then I was surprised and relieved to come across the evidence about how moderate stress can be beneficial to the fetus. I just love that research, the idea that fetuses need a little bit of pressure to do their best. It tones the nervous system of the fetus.
So many of the substances we assume to be villains are moving targets. New research this week suggests "light drinking" is okay for pregnant women.
So many things are moving targets. No one really has an overview of the whole field. I had a Google alert set up and I came to dread that little ping. More Google alerts ... I can't keep up!
You portrayed the findings on eating fish to be pretty solid: eating lower down on the fish food chain is good.
But it's still confusing to women. You hear about mercury and then women get scared to eat fish at all. But then you're depriving the fetus of the beneficial Omega-3 fatty acids.
How new is the idea of fetal origins?
The idea that we're shaped by experiences before birth is old and deeply entrenched. It was the scientific and medical culture of the 20th century that rejected that idea. ... [We're]rediscovering it and putting it a scientific footing that it wasn't on before.
The placenta was assumed to be super-strong and keep toxins out in the 1950s?
Mid-century doctors and scientists used the phrase "perfect parasite," the idea that the fetus takes whatever it needs from the mother and isn't really affected by what she eats.
But the new findings can mean that everything a pregnant woman does is under a microscope, can't they?
I'm not saying don't pay attention to this research and do whatever you want. ... Another trend I saw that disturbed me is whenever there's new evidence that what a woman does during pregnancy affects her fetus, one reaction inevitably seems to be, let's take control of what women do, let's punish them for doing something bad.
You found that being poor increases your chances of drinking, smoking, having an inadequate diet, being exposed to toxins and suffering from depression.
One striking finding is that fetuses may vary in their susceptibility to alcohol. Children of alcoholic pregnant women don't develop fetal alcohol syndrome at the same rate than the offspring of poor alcoholic pregnant women. Probably because they're also subject to stress and poor nutrition. All of these things work together. We tend to see things in isolation. Take this vitamin or eat this fish. I didn't want to make this a What to Expect When You're Expecting how-to pregnancy book, which are often for affluent women who are already probably doing most things right anyway.
When you write about the negative effects of societal events, you include our Canadian ice storm of 1998. The more stressful events pregnant women encountered during the ice storm, the lower their babies' birth weights - and they had continued cognitive and language delays. Are you suggesting a new "women-and-unborn-children-first" approach to disaster relief?
Pregnant women need to be added to our list. In emergency situations, we think of children, the elderly, the disabled. And it's not just women who are heavily pregnant, but women who are newly pregnant that are most vulnerable to traumatic stress or chemical exposure.
Did you find across these fields there is a period during which the fetus is most vulnerable?
In general, the first trimester. The organs, limbs and the brain are being formed and everything is elaborated from there. It can be frighteningly specific. With thalidomide, which limb or which particular deformity the baby had depended on the day that the woman took the pill.
Is our fate sealed at birth?
We talk about DNA and genes as if that DNA was contributed at the moment of conception and nothing happens after that. But we know now, through the burgeoning science of epigenetics, that the expression of those genes continues to be tweaked and tuned and that happens especially consequentially in utero. It's a new chapter in the debate.
So, is this the perfect baby shower gift? Or the worst?
Well, I've got to say that it is, right? I would say that for the thoughtful pregnant woman it would make a great gift. I did have a woman on an e-mail list and someone said, "Can you please take me off your list, I'm pregnant and even just hearing about your book increases my anxiety."
This interview has been condensed and edited.