Wednesday, November 03, 2010

Book Review: "Origins" by Annie Murphy Paul

Origins
How the Nine Months Before Birth Shape the Rest of Our Lives

By Annie Murphy Paul
Free Press (September 28, 2010)

I thought the acronym FOAD stands for fuck off and die, but Annie Paul taught me it stands for "Fetal Origins of Adult Disease." Maybe I wasn't the only one with that association, because from her book "Origins, How the Nine Month Before Birth Shape the Rest of Our Lives" I also learned that this research field was later renamed into DOHaD - "Developmental Origins of Health and Disease." And that's what her book is about: The increasing amount of scientific evidence that besides our genetic inheritance and individual experience, who we are and what we will be is influenced by a third, and long neglected, factor - the nine months spent inside our mother's womb.

As the renaming of this flourishing research area indicates, these are interesting studies not only to understand the origins of diseases, but also as guides to the health of coming generations. Unlike our genetic information, the conditions in utero are to some extend accessible for prevention and intervention. It has long been known for example that the same genetic information (genotype) might come in different appearances (phenotype), but exactly how this mechanism works and how the phenotype is affected in particular during gestation has only recently become accessible to scientific investigation.

Annie Paul is a science journalist, and her book is a survey of recent and not-so recent studies on DOHaD, together with historical anecdotes and reports of interviews with scientists, all woven together with the story of her own pregnancy. The book's chapters are (guess) month one to nine, and the reference list is extensive. It is a well-written, classical and flawless piece of a good science journalism. It also comes with the typical weaknesses of the genre. While Paul has thoroughly scanned the literature, she reports rather than explains, and if she has an own opinion on a particular controversial issue, she does not offer it. Since in addition a book on such a popular level cannot explain in much detail the studies it reports on, the reader who doesn't go and check the literature himself has little chances to form an informed opinion. While Annie Paul cleans up with a few decade old myths (for example the advise that showering with baking soda increases the chances of conceiving a boy) most of her book is a collection of topics and studies presently under discussion, and also an outlook on studies planned and consequences of what we have learned or may learn.

She covers the influence of traumatic experiences and stress on the developing fetus, environmental toxins, drugs and medication, and preexisting conditions of the mother (such as overweight or diabetes). The reader learns that there are studies that claim to have shown eating a bowl of cereal in the morning increases a mothers' chance of having a boy - and others that claim the result is nonsense, that a mother's experience of high stress or periods of hunger affects more strongly the survival chances of male than female fetuses, and that daily chocolate consumption of a pregnant woman results in happier babies. Paul also briefly touches on economical factors, citing studies that have shown people born in periods of hunger or wide-spread disease do on the average have a lesser income as adults than those who were born before or conceived after the tough times.

Annie Paul does mostly just document the research, but a few paragraphs here and there she takes on the question what the impact of this research may be on our societies in the future and what the benefit of this area of science may be. She hopes that babies born in difficult social situations - often correlated with malnutrition, drug abuse, stress or trauma - will have chances of doing better than their parents if special care is taken of pregnant woman, or children at risk for problems can be identified in advance and offered targeted help. She also hopes that in cases of natural disasters or war, mothers-to-be will receive psychological support to prevent their babies from being affected.

This all sounds very sensible, but on several instances Paul comes close to arguing for this additional care by an improved economic output: Healthy and happy children grow up to be more productive adults, so our societies should have an interest in this investment. I have encountered similar arguments repeatedly when it comes to health care, and I am wary of the implications. It is a quite slippery slope. If you step on it, you easily slide down to where you'll find that investments that will not pay off should not be made. It is however very likely that understanding the origins of adult's diseases and problems will in some cases lead to a better understanding, but a treatment may not pay off in economic terms. To me, it is more a matter of empathy and solidarity, than one of productivity, to offer such support.

Taken together, Annie Paul's book has provided me with a bulk of interesting and entertaining study results, yet with little insight as to their scientific credibility. It has given me an excuse to munch down Stefan's chocolate, reminded me of the weakness of the male part of our species, and caused me a bad consciousness for not clearing my household of plastics containing Bisphenol A, whether or not scientists will eventually find them reason for concern. Paul's book is an easy read, yet I would have appreciated a somewhat deeper coverage of the underlying science. I'd give this book 3 out of 5 stars if I'd have stars to give - in other words, it's not a must-read, you can wait for the paperback version.

39 comments:

Steven Colyer said...
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Steven Colyer said...

This is what I loved most about my Mrs.' first pregnancy.

Before the birth, the three most important things to each of us were a) her pregnancy b) her pregnancy, and c) will this baby just get it over with and be born already!

Within days (and for the next 21 yrs, so far), your three biggest thoughts will be child-raising, child-raising, and when oh God will I ever get a full night's sleep again? (Answer: 2 months).

Steven Colyer said...

Wow if you only give 3 out of 5 stars to books you think are very well-written, what do you give books you don't like? ;-)

Had to remind us how weak men are, eh? Who needs a reminder? Basic zoology: Mammals are dual-gendered, and nature chose the stronger of the two to be the one that gets pregnant.

Bee said...

That a book is well-written just isn't the only thing I'm looking for. Books I really don't like, I typically never finish reading and then I wouldn't write a review (which is one of the reasons why I very much mistrust amazon rankings).

Christine said...

Hi Sabine!

Good to know that you are in Germany and well.

It's somewhat curious and even funny to see your theoretical approach/interest to pregnancy and upcoming babies.

Forget that all!

Your life *will* change completely soon. There are many, many things that you have never *thought* or *felt* in your life that will appear unexpectedly and progressively. This is what it means to become a mother.

In the beginning, it's all instinct, too much work and lack of sleep. (Steven says it's two months? It's because he is a *father*. For me, I had to wait 2 *years* to know what is was to sleep again 6 hours straight).

You will see. But it's all marvelous, I guarantee. To see they grow and develop. Your love will increase as years go by. It's a kind of love that you have never experienced before.

Leave theory and research on that completely away. Just experience it. You will be naturally forced to, when time comes.

All the best,
Christine

Nicola said...

The nine months in the womb are indeed important and so are the first months and years after the birth, of course! For practical advice on pregnancy and the first two years after birth I warmly recommend The Baby Book by Dr. Sears, which promotes an approach called attachement parenting.

How to raise a child is largely a matter of personal preference, anyway. So the best advice I can give is: listen to your heart!
(and to Christine above ;-)

Peter said...

While I see and agree with Christine's POV, I also think that one way to avoid overthinking it too much is to read more books. I'm not sure that twins will seem marvelous quite as soon as having one at a time, but the parents of twins that I've seen seem to be entirely over the shock by the time the kids are 3. Then, having undertaken something that the rest of us can barely guess at, they are in a marvelous world that we can never enter. You've already seen some of it. Good luck! Good luck! Good luck!

The answer to the economic output slippery slope is to change the tax landscape. One can make almost anything come out as uphill or downhill in a cost-benefit analysis if one gives it enough tax benefits, or if one taxes the opposite behavior. Heck, who would have thought that Texas would ever build windmills.

Christine said...

Yes, I agree, to have twins surely must be a different experience from having just one (at a time), I can only imagine...

Let us know, Sabine, although I suppose you will be too busy to report us on your experiences, at least in the beginning.

Best,
Christine

Arun said...

I'm guessing, given that Bee has to take lots of bed rest, that she's simply flying through a pile of books, and will report on the occasional one or two on her blog. I can't infer or even intuit the "theoretical approach" to parenting from a book review (or the choice of book reviewed).

Bee said...

Hi Christine,

I don't think practical doing and theoretical interest exclude each other. I find it an interesting topic not only because I'm pregnant, but also because I, like everybody else, spent 9 months as a fetus. Don't you wonder sometimes how much of your character, preferences, tastes, good or bad health, is due to nature, what is nurture, and how much is due to the amount of chocolate your mom ate when she was pregnant? Only semi-serious on the last one of course ;-) Best,

B.

Bee said...

Hi Arun,

Yeah, that's about correct, just that so far I've been reading piles of articles I marked "read me" over the last year rather than books. If you scroll down the recent posts, you'll notice that's what I've been writing about (rather than "Yesterday, I went to this interesting seminar...") In any case, there's some more books next to my bed :-) Best,

B.

Uncle Al said...

Healthy and happy children grow up to be more productive adults

A decade of Brooklyn public education Gifted programs (IGC, SPE) suggests "happy" is not in there. "Angry" is in there. Pressure makes diamonds. (We only had one attempted suicide, 5th grade. Glen was weak.)

http://www.mazepath.com/uncleal/ritalin3.htm

Contemporary Big Pharma runs a rich social experiment with disruptive (intelligent aggressive male) children and xenobiotics. Prophylactic treatment in the womb celebrates jackbooted State compassion. "A gramme is better than a damn." A modest daily aliquot of delicious dark chocolate sounds better.

Christine said...

Hi Sabine

I don't think practical doing and theoretical interest exclude each other.

No, they don't, and of course I am curious about the matter in question (your present review post). Specially because my mother took an x-ray while pregnant of me, without knowing it, of course. I wonder the consequences to my lifetime health.

In any case, my comment was intended as a more general remark that no book will prepare you for what is to come. Sure, you will have more information, this is helpful, no doubt. But the most important that is to come is not in the books nor in the internet.

Best,
Christine

Christine said...

BTW, it would be interesting if we get back to this in, say 5 years... You will be ~40 and your girls will no longer be babies.

It would be interesting that you read back your posts and recall the way your thinking was at this time... Maybe you will see things differently, maybe not so much. Every one is different, but becoming a mother does imply a big change.

Change is the essence of life. It's good to experience that. I wish you and Stefan good luck for this new phase of your lives! (and be sure to find extra helping hands in the first year).

Best
Christine

Steven Colyer said...
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Steven Colyer said...
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Steven Colyer said...

Dear Christine,

The first 3 of our four kids slept thru the night around 2 months. The 4th took 6 months.

OK, so there's one in every crowd and one in every family and David is ours, and damned what that does to the average. Clan is clan.

BTW Christine, I very much like your advice to Bee re motherhood, and hope you two are sharing tons of private e-mail back and forth re Bee's pregnancy, because that's basically where her head is at right now as if this post subject wasn't a clue.

Also props on choosing the Comp Sci side of Astronomy for your future career. Seems to me that's the immediate future. Just think of the tons of unexplored data to mine on known servers, and not enough miners to dig. Kinda makes your mouth water, huh?

Robert L. Oldershaw said...

I like Einstein's dictum:

'Look to nature. It is there that you will find all the answers.'

Phil Warnell said...
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Phil Warnell said...

Hi Bee,

Just as they say that though a boy is to grow to become a man, that’s not to have it believed this has had the boy lost to the man. So here I find it similarly being true, that having a baby(s) may have a scientist to become a mother, yet not be able to prevent them from being a scientist. Then again it’s probably just as well the book wasn’t as enlightening as you might have wished, as at this stage of the game it would have formed to be of little use, other than perhaps have it to rebuke yourself; which is what Christine was reminding .

I can remember back when my children came into the world, there wasn’t much about the dos and don’ts, that is other than to advise the mothers to be of the importance of maintaining a healthy diet and not strain themselves in the latter part of their pregnancy. Now we have all these tests, dire warnings about the avoidance of this, that and suggestions as to what it is one might do to have things to be better.

Now don’t take me wrong, as I more than most am all for having things improved with the aid of science and yet am dead set against when it’s presented as mostly serving to scare people or to have them to feel inadequate as having it be believed we just can’t manage without it. That’s simply to say I share your criticism of the book, if it mostly stands as being something that presents a lot of notions, without also offering the reasons why they should be taken seriously; as after all one of the primary goals of science is to relieve our doubts, rather than to have them increased.

“The first was never to accept anything for true which I did not clearly know to be such; that is to say, carefully to avoid precipitancy and prejudice, and to comprise nothing more in my judgement than what was presented to my mind so clearly and distinctly as to exclude all ground of doubt.”

-René Descartes-Discourse on The Method: of Rightly Conducting The Reason, and Seeking Truth in the Sciences (1637)

Best,

Phil

Bee said...

Hi Christine,

"Specially because my mother took an x-ray while pregnant of me, without knowing it, of course. I wonder the consequences to my lifetime health."

She must have been worried sick before your birth. Is it likely there's consequences that might only show up decades later? Which makes me notice that Annie Paul didn't discuss electromagnetic radiation at all.

I didn't read the book to prepare for motherhood. My preparation so far consists of a single baby seat, which is pretty much the total of baby equipment we have. Best,

B.

Bee said...

Hi Robert,

I totally agree with Einstein there... After all, what is *not* nature? however, I think he uses the term "nature" in a different meaning than it is used in the nuture vs nature discussion. Best,

B.

Robert L. Oldershaw said...

Hi Bee,

I think he was saying something like:

Study nature, not books.

Physical reality (i.e., nature)contains a wealth of answers, clues, hints. And all one has to do is observe and think about what one has observed.

Obviously books can be an excellent source of knowledge too, but sometimes we get led into cul-de-sacs due to abstract thinking that strays too far from nature's correction and redirection.

:)
RLO

Steven Colyer said...

My preparation so far consists of a single baby seat, which is pretty much the total of baby equipment we have.

Perfectly understandable given the current importance of the pregnancy. I'm sure you're shopping for cribs. A diaper pail is a must, and in your future is the glorious day you can throw it out. Unless you go green with cloth diapers. A high chair, two in your caae, will be a constant kitchen companion. Baby wipes, towels and blankets, pacifiers, sippy cups, a mobile of the nine planets. Baby spoons, back harness, stroller, baby sunglasses, dolls, stuffed animals, and that greatest of tools:

The bib.

Bee said...

Hi Robert,

There's certainly truth to what you say, but I think my own observations are quite limited both in objects as well as methods, so I find it useful to read what others have examined and found. Best,

B.

Christine said...

Hi Sabine,

She had a problem with her gallbladder. She had to wait until I was born to remove it. Her pictures of when she was pregnant showed clearly that she was suffering. When I was born, she went into surgery. Not the current techniques which only small apertures are needed. A huge vertical cut throughout the belly. When she came home I was already some 15 days old. So it was not only the x-rays, but certainly a not very healthy pregnancy. But she endured it all. My life owes to her, twice at least.

Best,
Christine

Christine said...

Hi again,

I would say that talking to experienced mothers is very, very helpful, even though each pregnancy is different, each baby is different, each mother is different. Even taking into account these differences, experience is always good.

Books about babies/pregnancy are a good source of information, I'm not saying that they have no value, but you will notice when the time comes that, in this area, theoretical knowledge is not as useful as having a couple of helping hands, or someone to talk to, with experience to share. Like your own mother, for instance. At least in the beginning. Afterwards, they become full-powered grandmothers/grandfathers, and do all those "wrong", spoiling things that you will happen to understand when time comes.

It is also important to have access to a very good doctor for the babies. Nurse them for the longer you can, it's good for you (long term protection against breast cancer, etc) and for them.

Since you are expecting twins, you certainly should have more apparatus than you mention. It seems silly or a waste of money, but it is not. It is not funny to have to go out in the middle of the night to purchase things you should already have at home. I mean it!

Best,
Christine

Christine said...

BTW, I only have *one* book about babies. It's been a best seller in Brazil, for decades. It's a good book. But it was not indispensable. If I lived in a very remote area, I would say the book would have been more worthy. I have no other books, did not read much about pregnancy (but talked to my sister, who had a baby 3 years before), and the internet (around 1999) was not like today. I just had regular visits to the doctor, have eaten very healthy food, exercised very softly, and all was well.

Having twins is surely a different story, you might need more info than usual. If you know other mothers of twins, that would be great.

Best,
Christine

Christine said...

Ah, and listen to Steven, he is absolutely right.

Shawn Halayka said...

re: Steven:

Playtex has a "Diaper Genie II" model that uses a plastic bag to seal the diapers from the outside world. The cats sleep in the baby's room, sometimes right by the diaper genie. That shows how effective the diaper genie is at keeping the room "olfactorily tolerable".

Steven Colyer said...

Thanks, Shawn, I didn't know that, but I'm not surprised that "poopie tech" has matched onward since last I handled said material. That will come in handy if I become a grandfather and babysit someday.

Thanks Christine, but as you know, that's just the tip of the iceberg. Gasoline, or lots of mass transits, are also in the cards for pediatrician visits, playground visits, and millions of trips to the supermarket to get whatever supplies you run out of.

And crying. Before language, that's how we communicate, and at first it's frustrating because you don't always know what they want. When in doubt, sling em' up on the shoulder and pat their backs till they burp. Works like a charm most of the time.

Also, post-partum depression is quite normal, for the father as well as the mother, so be prepared to fight that bugger before it raises its ugly head. Forewarned is fore-armed.

Also, as you'll see, everything they touch goes right in the mouth (experimentalism begins quite young), so don't hand them a cell phone unless it's saliva-proof.

Christine said...

Steven wrote:

that's just the tip of the iceberg.

Yeah, Sabine and Stefan will find out in their time. It's all part of that "big change" in life that I mentioned before. A brave new world.

Best,
Christine

Steven Colyer said...

Life is a trip, ain't it? I submit that not only are Bee and Stefan about to go though a big change, but the single biggest experience of their lives. Much more so than getting their PhD's, getting married, losing one's virginity. going through puberty, or shaving for the first time, etc.

On our deathbeds (which Schrodinger said was a pain in the ass because dying takes too long), when we reflect back on our life and ask where we split it in two, I think we'll split it such that becoming a parent for the first time is THE dividing line of our lives.

I mean, we look at life ... SO differently after that, right up until the end, we ... gain in wisdom so much, at an exponential rate.

IMO, as always.

Christine said...

I think we'll split it such that becoming a parent for the first time is THE dividing line of our lives.

Your are right, at least up to now in my life. It's THE dividing line.

Steven Colyer said...

Your are right, at least up to now in my life. It's THE dividing line.

Not "just up to now", but forever. Consider the three worst things that could ever happen to you other than multiple limbs-loss in war or accident, which in order are ...

1) The death of a child (parents should go first)
2) The death of a spouse/lifemate you've had a great run with ...
3) Divorce (SO unnecessary in the USA in 80% of the marriages that end so) ...

... these do NOT compare, in terms of intensity, with the joy of becoming a parent for the first time.

And so, once again, the good out-trumps the bad.

Christine said...

Hi Steven,

Well, you're right. Shame on me for using "up to now". Opened the door for you to list pretty bad things that could happen... Please, do not remind us of those possibilities... On the other hand, even if we think instead about good things that could happen... well, again you end up right, there are none which could compare with becoming a parent for the first time. Since I have only one child, I cannot tell what it is like to have more children, like you do. And Bee will have two, all will happen at one time, every time!


Christine

Steven Colyer said...

No shame on me for taking advantage of an "open door." I get a bit impish at times and a bit excited about the start of a nuclear family; frankly it brings back many wonderful memories of the start of 2 families: the one in which I was a child and the one in which I was and still am a father. They are really sweet days, with a thousand details, help from unexpected places, and a low level fear we weren't raising the kids perfectly. Worry, worry, worry, yet ...don't worry! People worry too much. Give time, time, like 13 years, especially 15. THEN they're teenagers, THEN you can worry. But that time is far away.

Sorry about the "bad" things I mentioned but like the Quakers say, how can you appreciate the good without the bad in the world?

In any event, I'm glad Bee read this book, and she's intelligent enough to see its failings. If Physicists can't agree on things, it's mind-blowing what psychologists and medical doctors disagree on. Every last book on human relationships carries with it a secret agenda by the author, sometimes subconsciously and often not. So its important to read critically, as Bee does. We really love your book reviews, Bee, keep em coming.

Mark said...

Best of luck with the twins Bee! May they inspire your to new revelations in quantum gravity. I'm thinking early some morning when they are both teething and you are 20 hours without sleep - bam! Cosmic inspiration!

joel rice said...

Bee. sorry
tt = time squared
xx = distance squared
The usual equation for the light cone.