More on How Pregnancy Matters (And What That Might Mean)

This piece was in yesterday’s NYT.   I’m in no position to comment on the science so, for the moment, I’m going to assume it is sound, though I do know there is plenty of bad science out there.  The essay (it was on the op-ed page, so I think of it as an essay rather than as news) is about diet in the very early stages of a child’s life and how it has lifelong effects–at least according to the study the essay is considering.

But the studies aren’t only about the effects of diet after the child is born.  Here’s the part that leads me to write here:

 Mothers who were fed foods like Froot Loops, Cheetos and Nutella during pregnancy had offspring that showed increased expression of the gene for an opioid receptor, which resulted in a desensitization to sweet and fatty foods. “The best way to think about how having a desensitized reward pathway would affect you is to use the analogy of somebody who is addicted to drugs,” Jessica R. Gugusheff, a Ph.D. candidate at FoodPlus and the lead author of the study, wrote in an email. “When someone is addicted to drugs they become less sensitive to the effects of that drug, so they have to increase the dose to get the same high,” she wrote. “In a similar way, by having a desensitized reward pathway, offspring exposed to junk food before birth have to eat more junk food to get the same good feelings.”

(One thing I think I should clarify first:  that passive voice thing at the very beginning– “mothers who were fed….’– I think read carefully in context it is actually about rats in a lab study.   This makes that formulation tolerable.  My first reading of it lead me to think it was about human mothers and I was fairly unhappy about that for a variety of reasons.   Suffice it to say that the writing could be a bit clearer (the focus switches from lab rats to humans sentence to sentence) but that since I’m taking this out of context I’m making it look even worse.

Anyway, to return to the point:   The idea here is that the pregnant woman’s diet has lasting or even life-long effects on the resulting child when it comes to things like food preferences and such like.   Let’s assume that’s the case.   Why would it matter?

First off, in general this type of finding will lead to more scrutiny of pregnant women and their behavior.  Suddenly they are responsible for the possible obesity of their child.   (I don’t mean that pregnant women should be oblivious to the health effects of their behavior on their child.   I think it’s probably pretty clear that heavy smoking during pregnancy is a bad idea.   But one could also note that the folks who manufacture Cheetos and FrootLoops could bear a little responsibility, even as I think cigarette companies should.)   These are companies that profit from products that are not actually good for anyone.  (And I say this as pa person who loves Cheetos.)

I am not suggesting that all consideration of the pregnant woman’s behavior is necessarily wrong.   The research, if sound, is valuable.  It allows pregnant women to make intelligent choices about their behavior.   But I’m wary of a tendency to take studies like these and use them to impose external controls over pregnant women.

Second, this seems to me a fine place to highlight the special position of pregnant women vis-à-vis the child.   The expectant mother has to watch her diet and make all these other choices about behavior while her partner (who may well be the genetic father of the child) can eat all the Cheetos he wants.    I note this only because it seems to me that, much as we may want to have similar treatment for men and women, pregnancy is a phenomenon that must frustrate that desire.   Men and women–genetic fathers and genetic mothers–are in profoundly different positions during that time.   I’m not saying what conclusions one has to draw from that.  In particular I’m not asserting that this is a reason why birth-mother-custody should be preferred when parents separate.   I’m just saying we have to confront and consider what difference this different positioning makes.

Third, this study provides some further evidence that the impact of the pregnant woman on the child is lasting.   To me this this seems similar to the assertion (which I accept) that the impact of the people who provide the gametes is lasting.  Perhaps neither of these observations tells us who should be recognized as a legal parent.   But there’s a certain parallelism here.

And finally, I cannot help but consider what the ramifications of this sort of finding will be for surrogacy.   Surely at least some people who contract with surrogates will now be (even more?) concerned with regulating the behavior of the surrogate, perhaps adding contractual provisions that the surrogate will not consume junk food.   (And I’m sure some people wouldn’t even consider a surrogate who ate junk food in the first place.)   This makes me uneasy.   I worry about the power dynamic between the IPs and the surrogate.   The more important pregnancy is to the ultimate well-being of the child, the more control the IPs will want to assert.    It reinforces my belief that the best setting in which surrogacy can possibly occur is one in which there is some form of deep mutual respect between the parties—and that the law should be structured to encourage that.

 

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35 responses to “More on How Pregnancy Matters (And What That Might Mean)

  1. There is this junk science called epigenics that has infertile women believing that they can carry and deliver another woman’s pregnancy and magically become that person’s biological mother when of course they are not biologically related to the egg donor’s child at all. They are deeply confused about causing a person to exist vs influencing their existence by virtue of controlling the environment while that person’s brain and body are developing.

    I would be concerned that this story might be interpreted as the pregnant woman having some sort of biological connection to the fetus she’s carrying when really, all she’s doing is feeding it. Obviously feeding a developing mind and body the nutritional equivalent of chicken feed (corn salt sugar) is going to negatively impact the development of the fetus compared to eating nutrient rich foods. The same would be true of a wet nurse’s diet but we would not say that she was biologically related to the child she was nursing just because she was feeding someone else’s baby. She would no doubt impact the physical development of that infant by her own food choices because her food becomes the food of whatever baby she’s feeding.

    When you and I were infants breast feeding was out of vogue and women made baby formula with karo’s corn syrup and some other ingredient I can’t recall but I’m pretty sure that it was not milk. Our generations are likely the fattest in human history so I’m sure there is something to the story but we should be clear that it’s all about nurture when it comes to women….unlike men whose food choices don’t feed their children directly but can foul up their own genes by drinking doing drugs and eating like crap resulting in children with dimmer bulbs. I grabbed some random articles on the subject.
    http://www.nytimes.com/2012/09/09/opinion/sunday/why-fathers-really-matter.html?_r=0
    http://www.abc.net.au/health/talkinghealth/factbuster/stories/2011/03/02/3152992.htm

    • Marilyn,

      Epigenetics is something that is a biological fact. Epigenetics caused those cloned cats to have different markings on their fur.

      It’s fine if you want to dismiss the process as unimportant — that is your opinion.

      But epigenetics itself is a documented biological process and it does effect the resulting kitten, or human baby, ect.

      If you want to use precise, scientific wording — the biological process that produces children requires both pregnancy and a genomic code (which is produced from two different gametes). In a scientific terms a surrogate is a biological mother.

      If we apply reason we can see that a surrogate — or any woman who carries a baby to term — is a biological mother. If half the genomic code comes from a different women, that woman is also a biological mother — specifically, she is the genetic mother.

      Pregnancy is obviously a biological process, and it is a necessary step to turn embryos into people.

      • Wrong. “In a scientific terms a surrogate is a biological mother.” That is of course unless its her child that she’s carrying. Please refer to the American Society for Reproductive Medicine’s website about who the biological mother is

        http://www.asrm.org/topics/detail.aspx?id=418

        Egg Donation. An egg from a fertile woman that is donated to an infertile woman to be used in an assisted reproductive technology procedure such as IVF. The woman receiving the egg will not be biologically related to the child but will be the birth mother on record. The process of fertilizing eggs from a donor and transferring the resulting embryos to the recipient’s uterus. The recipient will not be biologically related to the child, although she will be the birth mother on record.

        • Pregnancy is a biological process.

          I don’t really understand why it’s important to you to deny that, but whatev.

          • Great argument Tess
            Pregnancy is a biological process – sure. But biological motherhood is determined by the biological relationship is not evidenced by pregnancy but by common biology where one person is the offspring of another. The biological parent has to exist for the child to exist. A gestational carrier is interchangeable. Her existence was not essential to the existence of the person delivered, someone else could have gestated and the person born could still exist as themselves, biological child of his or her parents. Whoever had to exist in order for the person to also exist is the biological parents

            • You’re denying the obvious. Gestational carriers are not interchangeable. This is obvious – hello? Miscarriage. Early birth. And uterine environment shapes brain health.

              Anxiety in pregnancy influences brain growth. Folic acid consumption, toxoplasmosis, viruses, ect.

      • Nobody wants to acknowledge the ASRM’s definition of biological motherhood?

        The American Society for Reproductive Medicine – those who profit the most of the misunderstanding that a woman can be the biological mother of an egg donors offspring states clearly and repeatedly – the egg donor is the biological mother of her own offspring. No matter who delivers them. Nobody else can be the mother of a female’s offspring her. Someone else can deliver them, someone else can raise them but she is for all eternity the mother of her own offspring.

        • Marilynn,
          Interesting – but it doesn’t change the biological facts of pregnancy.

        • I know that’s how the ASRM defines “biological mother.” But you didn’t begin this discussion using that term. You said that this women who were pregnant were “not biologically related at all.” I didn’t (and do not) agree with that statement and the ASRM definition isn’t on that point. Beyond that, I think it is more accurate to call the person who provides the gametes as a “genetic mother.”

          Now as I happens I would not call the woman who gives birth a “biolgocial mother” either. I’ve certainly tried not to do that on the blog, and I don’t think I’ve done that in this post. But I do think she has a biological relationship with the child. It is also a relationship that has social and cultural meaning. Otherwise why would we worry about gestational surrogates being unable to give up the children they give birth to?

          I think for some women the experience of being pregnant and giving birth is an important one–one they long for are go to great lengths to experience. It is an experience that is filled with meaning for some (but not all) women. I think it’s important to respect and acknowledge that, just as I think it is important to respect and acknowledge the experiences of those who are adopted and those who are donor conceived. This is why I consider your cavalier treatment of women who might be pregnant with a genetically unrelated embryo to be unacceptable.

          I am not sure how much more is to be gained by arguing this point further. I will continue to use “genetic mother” in an effort to be clear. And I will continue to argue that being pregnant matters–and that it is more than just feeding a child.

    • First off, I object to the general tone of your first paragraph, which it seems to me cavalierly discards the experience of infertile women with an incredibly broad generalization. It’s simply not reasonable to say that all infertile women are “deeply confused.” I try very hard to avoid this sort of broad characterization here because I think it only leads to the degradation of the overall dialog.

      Beyond that, I also reject the underlying premise of your comment. You reject the idea that a pregnant woman has “some biological connection” to the fetus she’s carrying. I think there is some biological connection even when there is no genetic connection. I’ll certainly agree we don’t understand the dimensions of the biological connection. You say all she’s doing is feeding the child. I think this is understating things rather drastically. When a pregnant woman carries a developing embryo to term she is doing more than feeding it.

      I will agree that I don’t know what it all means in the end, but I’m pretty confident I could say that what it means varies. Some of the meaning is scientific and measurable, I suspect. (That’s the junk science of epigenetics you refer to. I don’t think it is junk science, though I don’t doubt it is sometimes misused/misunderstood.) Some of the meaning is cultural. At the very least, I think it undeniable that a woman who has just given birth to a child typically has a different social relationship with that child than a woman who takes the child in her arms just after a different woman gives birth to the child. I strongly suspect that (generally) the woman who gives birth is more likely to feel an immediate stronger connection to the child than the woman who does not give birth–even if neither woman has any genetic relationship to the child. I do think that a great deal of the meaning we assign to pregnancy is socially constructed and hence, it can change over time and across culture. And I think that means that if everyone took your view–that the pregnant woman does nothing terribly special–that would change the social meaning of pregnancy.

      • American Society of Reproductive Medicine http://www.writethenextchapter.org/topics/detail.aspx?id=3634

        Topics:

        The woman from whose ovum a child developed and who is therefore genetically related to that child.

      • Julie it bothers me that someone who has no offspring would attempt to define herself as being the biological mother of someone. She has no biological connection to the person she gave birth to. Motherhood of any sort be it biological or adoptive or social begins when there is a born person to be the mother of. You know that prior to that time we refer to people as expectant or hopeful parents. Birth mother would be semi accurate but slightly deceptive

        • I really don’t get why you are invested in how someone else (who is a stranger to you) defines oneself.

          You can really only control how you define yourself.

          We don’t have control over how strangers define themselves. No one has that sort of control over other people.

          This goes for any issue, really, not just those things involving sex and gender.

      • Is sharing her digested food the same as having common biology

      • If she relates biologically its only durring pregnancy before she becomes a mother of the birth giving sort legally. Even during pregnancy her biology does not intermingle with the biology of the child she’s carrying as in they share no blood her cellular biology is not part of the fetus she allows to share space in her body

        • You’re the one talking about relationships. I’m simply explaining biology.

          Pregnancy is a biological process. It’s obvious that pregnant woman are necessary to produce a child. It’s obvious that pregnancy is a biological process and the woman’s body is necessary to create a child.

          Uterine environment is essentially to several steps. It effects meiosis, the expression of genes and the development of the brain. It has a lot more biological import then providing food.

          Her body will cause some genes to be expressed and repress others. Her body will shape how the child looks and will shape the baby’s brain.

          The DNA of male fetus cells ends up in the pregnant woman’s brain forever. If you want to call that a relationship, fine. If you don’t fine. It’s your business how you construct family.

          • Really which genes does she switch on or off? Because an egg donors daughter shares 3380 cm with a longest block of 267.21 just like the daughter of a woman who was not an egg donor. It’s not like the egg donors child is somehow biologically less related to her because she did not gestate them.

            Changes how they look? I’m so sure yeah maybe if she drinks or smokes crack and damages the fetus during development. If she does no harm then the fetus develops to its full potential as the biological offspring of two other people.

            • Look up the research on cloned cats.

              And, yes, some uterine environments will “turn on” genes that have significant effects on the child’s life — mental illness, for example.

              Julie has linked to evidence that the metabolic balance of the child’s body is affected by uterine environment.

              Now, pregnant women tend to have enough to worry about that I don’t think I’d show them this research. But it doesn’t surprise me. What occurs in the uterine environment is truly a miracle. And it is a elegant dance between the genomic code and environment as the new human is being produced.

          • The dna of the male child ends up in the gestating female’s body forever? Wow. Never heard that. So the only trace of a biological relationship is all in her mind.

            Which is basically what I was saying to begin with.

            • yes, and that is how you see the world! So that is great.

              But don’t worry so much if someone else sees the world in a different way.

      • What is degrading is the way this quasi biological parenthood is being marketed to infertile women so they’ll spend thousands of dollars to deliver the biological child of another woman. Its a sham playing on their hopes and desires for a biological connection to the child they raise. That person won’t have any memory of being gestated by them. If they are told which many won’t be, all they’ll know is that they are not being raised by the mother that is biologically related to them now that they exist – same as any person being raised by a legally adoptive mother. They’ll know that their maternal relatives are out there somewhere separate from them. How they’ll feel about the separation is anyone’s guess but the fact will remain, regardless of what they are told at home about the woman raising them being their biological vs genetic mother the fact remains they’ll know that they are not biologically or genetically related to her. Its a farce its word play and they’ll know it. I’ve talked to many people who have mothers that were egg donors and they go along with the script not to hurt the feelings of the woman that gave birth to them but they hit 8th grade biology and they know she’s just twisting words to make herself feel more related to them than she is. These are genetically pretty sharp people their mothers were all from good colleges pursuing advanced degrees when they agreed to reproduce under contract. They are sharp they generally had it all figured out long before the 8th grade. They also seem to learn early about managing people’s expectations and feelings and understand the roll they were born to play. They don’t have much of a choice they are kind of trapped. Other people are not born with a job to play a roll different than who they really are just to be loved and taken care of but they have to take on an alternate persona as if they were related to whoever gave birth to them. They know that the woman who gave birth to them would prefer if they were not related to anyone but them an wishes to diminish the importance of their maternal relatives and superimpose her own family in place of theirs. Its an incredibly heavy burden to bear. Imagine being told the truth of who you really are but being forbidden to live it

        • They are adults. Adults get to make significant life choices.

          You are assuming people are stupid and cannot grasp simple biological principles. You’re assuming people can’t differentiate between RNA, DNA, and epigenetics.

          Honestly, I don’t think the general public has a good understanding of the above concepts.

          But adults of at least average brain capacity are generally smart enough to “get” a very basic understanding of genetics, the genome, and differences between DNA, RNA, and epigenetics.

          I really don’t get your investment in this. So what if someone understands that the production of the fetus influences and even shapes the outcome? It’s a biologically true statement, after all. And it doesn’t take anything away from you or yours.

          • Oh because I don’t limit my interests and concerns to things that only effect me personally. I care about the greater common good and I believe that people are selling their children in advance of their births so they’ll basically be born to the people that paid to experience parenthood and they’ll be born with a job to do which is to pretend they are someone else’s child. I think that selling and owning human beings is wrong and I think that the various little lies people tell themselves to make themselves feel better about buying and selling human beings are part of the problem because its part of the process of numbing society to what is really going on under our noses. They feel less like they bought another woman’s child if they give birth to that child – even though they bought the pregnancy experience too like a ride at disney land. Even if they did not pay for the experience if it were given to them as a gift it’s still a novelty experience for them rather than a necessity because any healthy female could have delivered the child it did not have to be them. Sure they are able to control the environment where the fetus develops but it does not make them into something they are not and it should concern us that women are being bilked out hundreds of thousands of dollars thinking they are going to get a biological child out of carrying another woman’s fetus when they won’t. It’s deceptive advertising to a very vulnerable segment of society. Its also a massive public health problem that they are being recorded as birth mothers of record because the CDC treats birth mothers as if they are biological mothers an it throws off medical research on heritable disease and birth defects. I pay for that worthless research with my tax dollars so it matters to me that the lying going on is undermining the accuracy of research that is supposed to help reduce the incidence of things like infant mortality and the like. We don’t live in a vacuum. Lies have the potential to impact people beyond the liar and the person being lied to.

            • “Sure they are able to control the environment where the fetus”

              No- people can control very little about uterine environment.

              Don’t misunderstand me to to say pregnant women can consciously shape outcome. Much of this is not controllable.

              But that doesn’t mean it isn’t a critical factor.

              For example — a woman can consume loads of folic acid, but if her digestive system does a bad job of digesting it, the fetus will not get much of it. See what I mean? Much of this stuff is not in the pregnant women’s control. But that doesn’t mean her body doesn’t play a critical role.

              • folic acid- great example tess. folic acid supplementation decreases the risk of neural tube defects. Did I say prevents neural tube defects? No. all it does is decrease the risk somewhat.
                A slight decrease or increase in risk is usually the best we can do when it comes to fetal wellbeing.

                • yeah, humans want to have control over the world. And I get that — especially when things are high stake, like the health of a baby.

                  But control is fleeting and it’s often an illusion.

      • How about this eating Cheetos is a wonderful blissful experience which is not real healthy. I prefer the puffs to the crunch ones because they kind of melt but I won’t turn the crunchy ones down. I’m going to the store to buy them now because my will power gene is turned off. Wash it back with a 7up and I’ll be in heaven.

  2. oh gimme a break. how many more creative ways of mother blaming can we think of? i admit it, as a society we can’t control our obesity, so lets do the old trick, BLAME IT ALL ON MOM. bet all those folks wringing their hands about pregnant women eating cheetos aren’t themselves swearing off cheetos forever. call social services cuz i bet they even take their already born kids to dunkin donuts and mcdonalds from time to time! and believe you me, it is far more established what junk foods do to the actual person who eats them, than some nebulous studies about pregnant rats.
    In my opinion, this isn’t about health at all, its about control. fetal wellbeing is one of the areas that is so far out of our control that we want to imagine we can control it. actually there is precious little we can do.
    I agree with you about those intended parents. bet they’ll be sitting there eating their cheetos while drawing up a list of all the things they forbid the surrogate to do. ART reinforces the illusion of control so naturally they think if they just exert a little more control th ey can control how the baby comes out.

    • mmm dunkin doughnuts better hot krispy kreme
      I take Ruby miles on the bus, to Bob’s doughnuts on Polk in SF at 9pm and wait in a line around the block for the hot doughnuts that sit glistening in the window. I’m screwing up her metabolic clock for sure but I can’t leave her at home when the craving strikes. She likes the hot apple fritters.

  3. To address the post:

    1) It’s inappropriate for intended parents to attempt to exert control over a surrogate. And to try to force her to eat particular things? That would be obnoxious and rude. Intended parents have to let go of a lot of control and trust the other person.

    2) I think people are over-reacting to the lab test. Remember – in lab studies rats aren often fed more of a particular substance then is humanly possible to consume. That’s often how tests are conducted. I don’t know if these rats were injected with glucose into their bloodstream, but in order to test for an outcome, scientists often go far beyond what is normal consumption.

    3) We can’t control uterine environment much anyways. Pregnancy is always a gamble. (ie – one can take loads of folic acid. But certain people will not be able to absorb enough of it to be folic acid replete.)

    4) I suspect we’ll continue to discover that uterine environment interacts with the embryo/fetus in subtle, elegant, and interesting ways.

    But we still won’t be able to control the outcome much. And so it goes.

  4. Anybody who thinks they can truly control the behavior of a surrogate shouldn’t be involved in surrogacy. And anybody who believes that a surrogate has any motivation to do something that would knowingly cause harm to the baby shouldn’t be involved in surrogacy, either. It’s a matter of trust on both ends. And if you don’t trust each other then surrogacy won’t work.

    • I think the problems would be most likely to occur when there is a gray area, such as insisting on the ideal diet (and probably not even all experts agree on what “ideal” is). For example, I’m pregnant and I ate a tuna fish sandwich today because I hadn’t had one in seven months, I wanted one darn it, and my OB’s medical opinion is that it’s fine in moderation, but some doctors/experts disagree and say it should be avoided entirely.

      • Not a surrogate BTW, just mentioned it because it’s something that came to mind instantly (the ideal diet thing).

      • NO NOT YOU REBECCA! TUNA?! I CANT BELIEVE IT! AFTER ALL YOUR TAKE NO CHANCES APPROACH EXQUISITELY PLANNING YOUR WITH THE MOST EXPENSIVE AND INVASIVE TECHNOLOGY YOUD THROW IT ALL AWAY AFTER SEVEN MONTHS ON A TUNA SANDWICH?????
        ok just kidding, i had tuna like every couple of weeks and even sipped the kiddush wine. (since you’re jewish i’m guessing you know what that is,..) and my kid is just fine.

        • (for those not in the know, Kiddush means consecration, and its a jewish custom to consecrate the sabbath by making a blessing over a glass of wine and passing it around the family to take a sip)

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