Motherhood, war, and attachment: what does it all mean?


The antebellum tales
Scene 1: Two fathers encounter each other at a Boy Scout meeting. After a little conversation, one reveals that his son won’t be playing football because of concerns about head injuries. The other father reveals that he and his son love football, that they spoke with their pediatrician about it, and that their son will continue with football at least into middle school. There’s a bit of wary nodding, and then, back to the Pinewood Derby.

Scene 2: Two mothers meet on a playground. After a little conversation about their toddlers, one mother mentions that she still breastfeeds and practices “attachment parenting,” which is why she has a sling sitting next to her. The other mother mentions that she practiced “cry it out” with her children but that they seem to be doing well and are good sleepers. Then one of the toddlers begins to cry, obviously hurt in some way, and both mothers rush over together to offer assistance.

Scene 3: In the evening, one of these parents might say to a partner, “Can you believe that they’re going to let him play football?” or “I can’t believe they’re still breastfeeding when she’s three!” Sure. They might “judge” or think that’s something that they, as parents, would never do.

But which ones are actually involved in a war?

War. What is it good for?

I can’t answer that question, but I can tell you the definition of ‘war’: “a state of armed conflict between different nations or states or different groups within a nation or state.” Based on this definition and persistent headlines about “Mommy Wars,” you might conclude that a visit to your local playground or a mom’s group outing might require decking yourself out cap-á-pie in Kevlar. But the reality on the ground is different. There is no war. Calling disputes and criticisms and judgments about how other people live “war” is like calling a rowboat on a pond the Titanic. One involves lots of energy release just to navigate relatively placid waters while the other involved a tremendous loss of life in a rough and frigid sea. Big difference.

I’m sure many mothers can attest to the following: You have friends who also are mothers. I bet that for most of us, those friends represent a spectrum of attitudes about parenting, education, religion, Fifty Shades of Grey, recycling, diet, discipline, Oprah, and more. They also probably don’t all dress just like you, talk just like you, have the same level of education as you, same employment, same ambitions, same hair, or same toothpaste. And I bet that for many of us, in our interactions with our friends, we have found ourselves judging everything from why she insists on wearing those shoes to why she lets little Timmy eat Pop Tarts. Yet, despite all of this mental observation and, yes, judging, we still manage to get along, go out to dinner together, meet at one another’s homes, and gab our heads off during play dates.

That’s not a war. That’s life. It’s using our brains as shaped by our cultural understanding and education and rejection or acceptance of things from our own upbringing and talks with medical practitioners and books we’ve read and television shows we’ve watched and, for some of us, Oprah. Not one single friend I have is a cookie cutter representation of me or how I parent. Yet, we are not at war. We are friends. Just because people go online and lay out in black and white the critiques that are in their heads doesn’t mean “war” is afoot. It means expressing the natural human instinct to criticize others in a way that we think argues for Our Way of Doing Things. Online fighting is keeping up with the virtual Joneses. In real life, we are friends with the Joneses, and everyone tacitly understands what’s off limits within the boundaries of that friendship. That’s not war. It’s friendly détente.

The reality doesn’t stop the news media from trying to foment wars, rebellions, and full-on revolutions with provocative online “debates” and, lately, magazine covers. The most recent, from Time, features a slender mother, hand on cocked hip, challenging you with her eyes as she nurses her almost-four-year-old son while he stands on a chair. As Time likely intended, the cover caused an uproar. We’ve lampooned it ourselves (see above).

But the question the cover asks in all caps, “Are you mom enough?” is even more manipulative than the cover because it strikes at the heart of all those unspoken criticisms we think–we know–other women have in their heads about our parenting. What we may not consider is that we, too, are doing the same, and still… we are not actually at war. We’re just women, judging ourselves and other women, just like we’ve done since the dawn of time. It’s called “using your brain.” Inflating our interactions and fairly easily achieved parental philosophy détentes to “war” caricatures us all as shrieking harpies, incapable of backing off and being reasonable.

The real question to ask isn’t “Are you mom enough?” In fact, it’s an empty question because there is no answer. Your parenting may be the most perfect replica of motherhood since the Madonna (the first one), yet you have no idea how that will manifest down the road in terms of who your child is or what your child does. Whether you’re a Grizzly or a Tiger or a Kangaroo or a Panda mother, there is no “enough.”

So, instead of asking you “Are you mom enough?”, in keeping with our goal of bringing women evidence-based science, we’ve looked at some of the research describing what might make a successful parent–child relationship. Yes, the answer is about attachment, but not necessarily of the physical kind. So drop your guilt. Read this when you have time. Meanwhile, do your best to connect with your child, understand your child, and respond appropriately to your child.  

Why? Because that is what attachment is–the basic biological response to a child’s needs. If you’re not a nomad or someone constantly on the move, research suggests that the whole “physically attached to me” thing isn’t really a necessary manifestation of attachment. If you harken to it and your child enjoys it (mine did not) and it works for you without seeming like, well, an albatross around your neck, go for it.

What is attachment?

While attachment as a biological norm among primates has been around as long as primates themselves, humans are more complicated than most primates. We have theories. Attachment theory arose from the observations of a couple of human behaviorists or psychologists (depending on whom you ask), John Bowlby and Mary Ainsworth. Bowlby derived the concept of attachment theory, in which an infant homes in on an attachment figure as a “safe place.” The attachment figure, usually a parent, is the person who responds and is sensitive to the infant’s needs and social overtures. That parent is typically the mother, and disruption of this relationship can have, as most of us probably instinctively know, negative effects.

Bowlby’s early approach involved the mother’s having an understanding of the formational experiences of her own childhood and then translating that to an understanding of her child. He even found that when he talked with parents about their own childhoods in front of their children, the result would be clinical breakthroughs for his patients. As he wrote,

Having once been helped to recognize and recapture the feelings which she herself had as a child and to find that they are accepted tolerantly and understandingly, a mother will become increasingly sympathetic and tolerant toward the same things in her child.

Later studies seem to bear out this observation of a connection to one’s childhood experiences and more connected parenting. For example, mothers who are “insightful” about their children, who seek to understand the motivations of their children’s behavior, positively influence both their own sensitivity and the security of their infant’s attachment to them.  

While Bowlby’s research focused initially on the effects of absolute separation between mother and child, Mary Ainsworth, an eventual colleague of Bowlby, took these ideas of the need for maternal input a step further. Her work suggested to her that young children live in a world of dual and competing urges: to feel safe and to be independent. An attachment figure, a safe person, is for children an anchor that keeps them from become unmoored even as they explore the unknown waters of life. Without that security backing them up, a child can feel always unmoored and directionless, with no one to trust for security.

Although he was considered an anti-Freudian rebel, Bowlby had a penchant for Freudian language like “superego” and referred to the mother as the “psychic organizer.” Yet his conclusions about the mother–child bond resonate with their plain language:

The infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment.

You know, normal biological stuff. As a side note, he was intrigued by the fact that social bonds between mother and offspring in some species weren’t necessarily tied to feeding, an observation worth keeping in mind if you have concerns about not being able to breastfeed.

The big shift here in talking about the mother–child relationship was that Bowlby was proposing that this connection wasn’t some Freudian libidinous communion between mother and child but instead a healthy foundation of a trust relationship that could healthily continue into the child’s adulthood.

Ainsworth carried these ideas to specifics, noting in the course of her observations of various groups how valuable a mother’s sensitivity to her child’s behaviors were in establishing attachment. In her most famous study, the “Baltimore study” [PDF], she monitored 26 families with new babies. She found that “maternal responsiveness” in the context of crying, feeding, playing, and reciprocating seemed to have a powerful influence on how much a baby cried in later months, although some later studies dispute specific influences on crying frequencies.

Ainsworth also introduced the “Strange Situation” lab test, which seems to have freaked people out when it first entered the research scene. In this test, over the course of 20 minutes, a one-year-old baby is in a room full toys, first with its mother, then with mother and a strange woman, then with the stranger only (briefly), then with the mother, and then alone before the stranger and then the mother return. The most interesting findings of the study came from when the mother returned after her first absence, having left the baby alone in the room with a stranger. Some babies seemed quite angry, wanting to be with their mothers but expressing unhappiness with her at the same time and physically rejecting her.

From her observations during the Strange Situation, Ainsworth identified three types of attachment. The first was “Secure,” which, as its name implies, suggested an infant secure and comfortable with an attachment figure, a person with whom the infant actively seeks to interact. Then there’s the insecure–avoidant attachment type, in which an infant clearly is not interested in being near or interacting with the attachment figure. Most complex seems to be the insecure–resistant type, and the ambivalence of the term reflects the disconnected behavior the infant shows, seeming to want to be near the attachment figure but also resisting, as some of the unhappy infants described above behaved in the Strange Situation.

Within these types are now embedded various subtypes, including a disorganized–disoriented type in which the infant shows “odd” and chaotic behavior that seems to have no distinct pattern related to the attachment figure.

As you read this, you may be wondering, “What kind of attachment do my child and I have?” If you’re sciencey, you may fleetingly even have pondered conducting your own Strange Situation en famille to see what your child does. I understand the impulse. But let’s read on.

What are the benefits of attachment?

Mothers who are sensitive to their children’s cues and respond in ways that are mutually satisfactory to both parties may be doing their children a lifetime of favors, in addition to the parental benefit of a possibly less-likely-to-cry child. For example, a study of almost 1300 families looked at levels of cortisol, the “stress” hormone, in six-month-old infants and its association with maternal sensitivity to cues and found lower levels in infants who had “more sensitive” mothers.

Our understanding of attachment and its importance to infant development can help in other contexts. We can apply this understanding to, for example, help adolescent mothers establish the “secure” level of attachment with their infants. It’s also possibly useful in helping women who are battling substance abuse to still establish a secure attachment with their children.

On a more individual level, it might help in other ways. For example, if you want your child to show less resistance during “clean-up” activities, establishing “secure attachment” may be your ticket to a better-looking playroom.

More seriously, another study has found that even the way a mother applies sensitivity can be relevant. Using the beautiful-if-technical term ‘dyads’ to refer to the mother–child pair, this study included maternal reports of infant temperament and observations of maternal sensitivity to both infant distress and “non-distress.” Further, the authors assessed the children behaviorally at ages 24 and 36 months for social competence, behavioral problems, and typicality of emotional expression. They found that a mother’s sensitivity to an infant’s distress behaviors was linked to fewer behavioral problems and greater social competence in toddlerhood. Even more intriguing, the child’s temperament played a role: for “temperamentally reactive” infants, a mother’s sensitivity to distress was linked to less dysregulation of the child’s emotional expression in toddlerhood. 


And that takes me to the child, the partner in the “dyad”

You’re not the only person involved in attachment. As these studies frequently note, you are involved in a “dyad.” The other member of that dyad is the child. As much as we’d like to think that we can lock down various aspects of temperament or expression simply by forcing it with our totally excellent attachment skills, the child in your dyad is a person, too, who arrived with a bit of baggage of her own.

And like the study described above, the child’s temperament is a key player in the outcome of the attachment tango. Another study noted that multiple factors influence “attachment quality.” Yes, maternal sensitivity is one, but a child’s native coping behaviors and temperament also seem to be involved. So, there you have it. If you’re feeling like a parental failure, science suggests you can quietly lay at least some of the blame on the Other in your dyad–your child. Or, you could acknowledge that we’re all human and this is just part of our learning experience together.

What does attachment look like, anyway?

Dr. William Sears took the concept of attachment and its association with maternal sensitivity to a child’s cues and security and… wrote a book that literally translated attachment as a physical as well as emotional connection. This extension of attachment–which Sears appends to every aspect of parenting, from pregnancy to feeding to sleeping–has become in the minds of some parents a prescriptive way of doing things with benefits that exclude all other parenting approaches or “philosophies.” It also involves the concept of “baby wearing,” which always brings up strange images in my mind and certainly takes outré fashion to a whole new level. In reality, it’s just a way people have carried babies for a long time in the absence of other easy modes of transport.

When I was pregnant with our first child and still blissfully ignorant about how little control parents have over anything, I read Sears’ book about attachment parenting. Some of it is common-sense, broadly applicable parenting advice: respond to your child’s needs. Some of it is simply downright impossible for some parent–child dyads, and much of it is based on the presumption that human infants in general will benefit from a one-size-fits-all sling of attachment parenting, although interpretations of the starry-eyed faithful emphasize that more than Sears does.

Because much of what Sears wrote resonated with me, we did some chimeric version of attachment parenting–or, we tried. The thing is, as I noted above, the infant has some say in these things as well. Our oldest child, who is autistic, was highly resistant to being physically attached much of the time. He didn’t want to sleep with us past age four months, and he showed little interest in aspects of attachment parenting like “nurturing touch,” which to him was seemingly more akin to “taser touch.” We ultimately had three sons, and in the end, they all preferred to sleep alone, each at an earlier and earlier age. The first two self-weaned before age one because apparently, the distractions of the sensory world around them were far more interesting than the same boring old boob they kept seeing immediately in front of their faces. Our third was unable to breastfeed at all.

So, like all parents do, we punted, in spite of our best laid plans and intentions. Our hybrid of “attachment parenting” could better be translated into “sensitivity parenting,” because our primary focus, as we punted and punted and punted our way through the years, was shifting our responses based on what our children seemed to need and what motivated their behaviors. Thus, while our oldest declined to sleep with us according to the attachment parenting commandment, he got to sleep with a boiled egg because that’s what he wanted. Try to beat that, folks, and sure, bring on the judging.

The Double X Science
Sensitivity Parenting (TM) cheat sheet.

What does “sensitive” mean?

And finally, the nitty-gritty bullet list you’ve been waiting for. If attachment doesn’t mean slinging your child to your body until you’re lumbar gives out or the child receives a high-school diploma, and parenting is, indeed, one compromise after another based on the exigencies of the moment, what consistent tenets can you practice that meet the now 60-year-old concept of “secure” attachment between mother and child, father and child, or mother or father figure and child? We are Double X Science, here to bring you evidence-based information, and that means lists. The below list is an aggregate of various research findings we’ve identified that seem reasonable and reasonably supported. We’ve also provided our usual handy quick guide for parents in a hurry.
  • Plan ahead. We know that life is what happens while you’re planning things, but… life does happen, and plans can at least serve as a loose guide to navigation. So, plan that you will be a parent who is sensitive to your child’s needs and will work to recognize them.
  • Practice emotion detection. Work on that. It doesn’t come easily to everyone because the past is prologue to what we’re capable of in the present. Ask yourself deliberately what your child’s emotion is communicating because behavior is communication. Be the grownup, even if sometimes, the wailing makes you want your mommy. As one study I found notes, “Crying is an aversive behavior.” Yes, maybe it makes you want to cover your ears and run away screaming. But you’re the grownup with the analytical tools at hand to ask “Why” and seek the answer.
  • Have infant-oriented goals. If you tend to orient your goals in your parent–child dyad toward a child-related benefit (relieve distress) rather than toward a parent-oriented goal (fitting your schedule in some way), research suggests that your dyad will be a much calmer and better mutually adapted dyad.
  • Trust yourself and keep trying. If your efforts to read your child’s feelings or respond to your child’s needs don’t work right away, don’t give up, don’t read Time magazine covers, and don’t listen to that little voice in your head saying you’re a bad parent or the voice in other people’s heads screaming that at you. Just keep trying. It’s all any of us can do, and we’re all going to screw this up here and there.
  • Practice behaviors that are supportive of an infant’s sensory needs. For example, positive inputs like a warm voice and smiling are considered more effective than a harsh voice or being physically intrusive. Put yourself in your child’s place and ask, How would that feel? That’s called empathy. 
  • Engage in reciprocation. Imitating back your infant’s voice or faces, or showing joint attention–all forms of joint engagement–are ways of telling an infant or young child that yes, you are the anchor here, the one to trust, and really good time, to boot. Allowing this type of attention to persist as long as the infant chooses rather than shifting away from it quickly is associated with making the child comfortable with independence and learning to regulate behaviors.  
  • Talk to your child. We are generally a chatty species, but we also need to learn to chat. “Rich language input” is important in early child development beginning with that early imitation of your infant’s vocalizations.
Lather, rinse, repeat, adjusting dosage as necessary based on age, weight, developmental status, nanosecond-rate changes in family dynamics and emotional conditions, the teen years, and whether or not you have access to chocolate. See? This stuff is easy.

                                                          

Finally

As you read these lists and about research on attachment, you’ll see words like “secure” and “warm” and “intimate” and “safe.” Are you doing this for your child or doing your best to do it? Then you are, indeed, mom enough, whether you wear your baby or those shoes or both. That doesn’t mean that when you tell other women the specifics of your parenting tactics, they won’t secretly be criticizing you. Sure, we’ll all do that. And then a toddler will cry, we’ll drop it, and move on to mutually compatible things.

Yes, if we’re being honest, it makes most of us feel better to think that somehow, in some way, we’re kicking someone else’s ass in the parenting department. Unfortunately for that lowly human instinct, we’re all parenting unique individuals, and while we may indeed kick ass uniquely for them, our techniques simply won’t extend to all other children. It’s not a war. It’s human… humans raising other humans. Not one thing we do, one philosophy we follow, will guarantee the outcome we intend. We don’t even need science, for once, to tell us that.


By Emily Willingham, DXS managing editor

These views are the opinion of the author and do not necessarily either reflect or disagree with those of the
DXS editorial team. 

The Only Mother’s Day Gift Guide You Will Ever Need

Our mothers were nothing like either of these people. (Source)

(Warning: We are having some fun, so what you are about to read does not explicitly contain science but does reference soy, onanism, tubed meats, and vacuums. In keeping with the DXS mission, however, we have embedded a little science here and there in the links. )

While the celebration of mothers is not a new concept, the modern version of Mother’s Day is a far cry from the ancient festivals that honored Cybele.  However, in 1907, when Anna Jarvis invented the modern Mother’s Day as a means to pay homage to her own mother, it was not her intention to use moms for profit.

But, alas, by the 1920s, this well-intended national holiday quickly morphed into the cash cow we see today.  Sure, it is nice to receive a gift, but perhaps capitalism has since stripped Mother’s Day of its original meaning, and for the first week or two in May, we are bombarded with advertisements that claim to know what item every mother must have.  


From this, many sites have done us all the great favor of curating these cannot-live-without gifts into a single, easy to navigate list (financial kickbacks notwithstanding), often broken down into natural June Cleaveresque categories like “kitchen” and “for the home” (read: how to cook for everyone and keep shit clean). Besides the fact that these lists can be generalized to every gift-giving holiday for the lovely lady in your life, even Don Draper himself would scoff at many of these suggestions.  

Because we at DXS wish to ensure that your Mother’s Day experience is the best it can possibly be, we present you with a different kind of list – one that provides the most valuable unsolicited advice you will ever receive when it comes to choosing for dear old mom.  Here, you will be schooled on what not to get for the woman that gave you life.   

  1. Flowers. One of the most suggested gifts for Mother’s Day is flowers. What woman doesn’t love flowers? Well, one who does not need one more thing to water, or sees her own mortality in each dried up petal aimlessly floating down onto the floor that had just been cleaned. Oh, and those tears you see building up in our eyes? Not tears of joy. You better back up or you might get caught in a sneezing fit of fury because, frankly, the last thing we want to do on “our” day is pretend that we like feeling like our heads will explode. And let us not forget how those flowers came to be available in your local flower shop or supermarket in the first place… from Colombia?

  1. Soy Candles.  Soy. For the last decade or two, we have seen the magical benefits of this plant product popping up in pseudoscientific “reports” in quality magazines like First for Women. And now, soy-pushers all over the intertubes will willingly exclaim that soy is the superior material for the production of candles, allegedly “soot free” (they aren’t really). Sure, anything soy-based will help the American Soy Farmer keep up with the Joneses, but a candle is a candle and unless you are also giving me a golden ticket to enjoy its inherent ambience whilst I soak in my imaginary claw-footed tub, full of bubbles and rose petals and the sultry sounds of Barry White, save it. Plus, I’d rather not burn my house down (again).

  1. Gift Baskets! What says “I admire you like a work colleague” more than a gift basket?  Sure, smoked cheeses and tubed meats taste fine after a few martinis, but when enjoying such delicacies, I prefer to do it while watching my co-workers photocopy their ass cheeks. Some things just don’t have the same effect in the home.  

  1. Teething Necklace. One website was flashing necklaces all over the place – but these weren’t just any old necklaces – they doubled as teething necklaces for the baby.  Anyone who knows anything about a teething baby knows that, despite the alleged pain babies feel (hey, I don’t remember it, do you??), moms suffer the most. So instead of the necklace, why don’t you go ahead and take the dang baby for a few hours and give me a much deserved break? I’ll even sweeten the deal and throw some Tylenol in the diaper bag. And, in the strange and rare event that I might want rope burn on my neck, I’d rather get it from some fantasy role-playing in the boudoir. Take that as you will.

  1. Vacuum Cleaner. If you really think that I want another reminder of how much I have to pick up after you and all of your friends – who regularly come over and wipe out all of the food I just deposited into my refrigerator – then yes, go ahead and buy me a vacuum. I mean, it is not like I don’t already spend all of my “free” time vacuuming the floors, so why not give me the gift that embodies what you really think of me (your maid)? Plus, Dyson has been showing commercials non-stop for a sale that runs until Mother’s Day, with the clear implication to get your mother (or if you are a mother to get yourself) a vacuum for Mother’s Day. So if you do decide to get a vacuum, make sure you have $500 for it. Remember, though, that a vacuum is really empty space, so you might want to consider getting me something more tangible–and fun.

  1. 50 Shades of Gray. Well, maybe I am not too opposed to this, but let it be known that I will probably need about ten minutes (give or take) of “alone” time after each time I pick up this series. As long as you are OK with this, I am OK with this. By the way, did you know that there are really more than 50 shades of grey?
We hope you will seriously consider this advice. After all, we really don’t need more shit to take care of, water, clean with, or… actually, we can always use some more good reads. Happy Mother’s Day!

Motherhood Defined: It is in the heart of the beholder

“Motherhood”: Sculpture at the Catacumba Park, Rio de Janeiro, Brazil
Motherhood.  It can mean many things, and our own definition of it is largely defined by our individual experiences.  To one person, motherhood might simply mean the act of raising children; to another, motherhood might be what defines them.  

It is not uncommon to generalize the concept of “motherhood” and lump everyone who upholds a single criterion – being a mom – into one group.   But, really, motherhood affects us all in one way or another, and that way is as unique as the pattern of curves and ridges on a fingertip.

Despite the recent outbreak of (heated) discussion surrounding the Time cover story depicting a beautiful and young woman nursing a toddler, and the questioning if following a certain philosophy makes one more or less of a mother, humans, as a whole, are truly bound by a common goal: to raise the next generation to the best of our abilities under the circumstances at hand.   
But, there is no one answer.
Every mom will have her own definition of motherhood.  But, being a mom is by no means a prerequisite for understanding motherhood as it relates to an individual.  For this special Mother’s Day post, we would like to pay homage to motherhood in its many forms.  Here you will not find a singular description of motherhood.  What you will find, however, is what it means on a more personal level, which is to say that the definition can only come from the heart. 

Thank you to all of the wonderful people who participated in this project (and with short notice!) – we have answers in paragraph, tweet, and prose forms.    

Ilina Ewen, Blogger at Dirt and Noise@IlinaP

What does motherhood mean to me?

Motherhood means feeling a kaleidoscope of emotions simultaneously – fear, glee, worry, angst, pride. And it means being an advocate and a revolutionary who empowers her children to engage in society in a meaningful, fun, vibrant way. And lastly, motherhood means always giving up the biggest piece of cake and the last popsicle and being okay with that.

Momma, PhD, Scientist/Wife/Mother

Motherhood means accepting responsibility. If you read the news or listen to the hype, you know what I mean.  Every choice you make, from before a child is conceived, until long after you’re dead, there is someone out there that will tell you how it impacted your kid. As my nana always said, “It’s always the mother’s fault.”  I just hope that as the time passes I get more credit than blame for how my kids turn out.

Motherhood is how you stretch your heart in ways you never thought possible. It’s how you love through the ups & down, the challenges that life brings. And, it lasts a lifetime from that first tiny cry. 

Chris Gunter, Director of Research Affairs, HudsonAlpha Institute for Biotechnology, @Girlscientist

I’m a human geneticist by training, so I’ve been told having a child is the ultimate version of participating in my research. But the science analogy that best summarizes it for me is maternal-fetal microchimerism. Data demonstrating that my son and I each likely have some of each other’s intact cells inside us forever — as I have with my mother, and she with hers, and so on — beautifully represent to me the meaning of motherhood. As the quote from Elizabeth Stone goes, having a child “is to decide forever to have your heart go walking around outside your body.” To me, that includes half my DNA, some of my cells, and so many of my hopes and dreams, all in one sweet, kissable package.

Dr. Cheryl G. Murphy, Optometrist and Science Writer, @MurphyOD

Motherhood: As a mom of triplets, some would say I have triple the work but I like to think of it as triple the hugs, triple the joy, triple the fun! And when people ask me what it’s like to become a mom I tell them “it’s the toughest job you’ll ever love.” Happy Mother’s Day to all of you amazing, do-it-all moms out there! 

Matt Shipman, Science writer, and founder of the First Step Project@Shiplives

I’m a man, so I obviously have no first-hand experience as a mother. That said, I was raised by a (wonderful) single mother, and have had the pleasure of watching my wife be an awesome mom to our three daughters. Those experiences have shaped my impressions of motherhood. To me, motherhood means being kind, but honest. Being gentle, but strong. Being nurturing, but encouraging independence. Motherhood is letting your kids think you are ten feet tall and bulletproof, so they feel you can keep them safe — even though there’s stuff out there that scares the hell out of you. It’s encouraging your kids to learn new things and to work their butts off in school, without making them feel stupid. Motherhood is leading by example when it comes to telling right from wrong, and showing your kids which battles are worth fighting. And, when the time comes, motherhood is letting go of the reins to see where the kids go on their own. Motherhood is not for wimps.

Julie Marsh, VP of Operations, Cool Mom Picks + Cool Mom Tech@coolmompicks@coolmomtech 

To me, motherhood means leading by example in the most pivotal role I’ve ever accepted.

Emily Willingham, PhD, managing editor, Double X Science, science writer and editor, biologist, autism parent, mother, @ejwillingham

The greatest realization of motherhood for me was that the children we have are people of their own, not “our” children or some kind of nutty, messy, screaming, demanding “other” invading our space, disrupting our lives, and taking our precious time. They are people I love to have around me because they make me laugh, they bring out the teacher in me (not hard to do), they are cool and interesting and imaginative and fun, and each of them (I have three) is a complete individual with a unique personality, outlook, potential, talent, and beautiful, beautiful face that I love to see every day. Just as I choose to spend time with others whom I love, respect, admire, and laugh with, I choose to do the same with my children. That said, I also still have what I had before my children arrived–a happy, full busy life with a partner to whom I seem to grow closer every day, and work that I love. Thanks to my children, I’ve got something even more–three more wonderful people added to my life whom I am deeply delighted and, frankly, honored to know. As Bill Murray’s character in Lost in Translation observes, “They learn how to walk and they learn how to talk… and you want to be with them. And they turn out to be the most delightful people you will ever meet in your life.”

Alice Callahan, Science of Mom@Scienceofmom

What does motherhood mean to me?

Motherhood is humbling. Of all the endeavors I have tackled in my life, never have I wanted so badly to get everything right and yet known that I would not. Never have I been so emotionally invested in the results, so exhausted by the labor of it, and also, so strangely confident that it will turn out OK. It is the most human thing I have ever done.

David Wescott, It’s not a Lecture@dwescott1

For men whose ideas of fatherhood were shaped in large part by its absence in our own lives, motherhood may mean something a bit different.  I’m by no means a scholar, but I’ve had the opportunity to speak often and at length with women across the globe on this topic, and to curate their thoughts a bit. These women talk about the feeling of connection to their children they know no one else has.  They describe the magic of watching their little ones narrate the moments of discovery in their lives. They talk about how their children “complete the circle” and teach them the other side of unconditional love. They help you understand why people invoke the lioness or the grizzly when describing the protective instinct.  

My perspective of motherhood is a lot like that last sentiment – it’s the unyielding power that rises up in you when you realize a little person depends on you for everything.  I know that many men step up when left in that situation – I’ve seen it first-hand – but I suspect the feeling is different for women because this little person actually came from you, is an extension of you, is connected to you in ways no man will ever fully understand. 

When I think of motherhood, I think of unconditional love. It’s what my mother gave to me, and it’s what I expect I would feel for the children I don’t intend to have. My mother made countless sacrifices for me, but she was independent and did not allow motherhood to define her. She has always encouraged me to be my own person and chase my own dreams. She didn’t want me to feel constrained by gender roles. I feel fortunate to live in a time when motherhood is a choice, not an obligation. I admire my peers who have chosen to have kids, but I’m content to enjoy the rich mother-daughter relationship I have with my mom without feeling obliged to replicate it. 

Editors note: Christie has recently written a wonderful piece on motherhood at Last Word On Nothing.  Go read it!

Carin Bondar, Blogger and Filmmaker for Scientific American, the David Suzuki Foundation and Huffington Post, @drbondar

As a working mother of 4 very young children, I don’t have much time to reflect on much – this stage of my life is pretty much dedicated to surviving.  I do know that once I decided that I really wanted to start having children (when I was almost finished my PhD) – my life seemed oddly empty.  It was as though I realized that something tremendous was missing and I became completely obsessed with wanting them.  Now that I have them (yes all 4 of them!) there are many times when I feel completely overwhelmed and exhausted, but  I will always remember the feelings of desire to have a family.  I know that my life would be empty and incomplete without my lovely babies.

Jeanne Garbarino, Biology Editor at Double X Science and Rockefeller University Postdoc, @JeanneGarb

For five years, I have been a mother.  I have learned – and am still learning – some very difficult lessons on time management and prioritization, on choosing my battles wisely, and on being ok when things aren’t exactly perfect (or even decent).  But, to be honest, these are all lessons I really needed to have in my life.  Though it might seem a bit counterintuitive, the mostly delightful chaos associated with rearing my girls has given me more focus.  For me, motherhood is more of a state of being, and it has helped me learn how to not sweat the small stuff (for the most part), to be more mindful of the present, and to think more about the future.  Oh, and motherhood also gives me that special golden ticket to buy really cool games and toys (because who isn’t interested in seeing what Doggie Doo is all about), as well as provides a dependable companion for roller coaster rides.

Motherhood had made me stand in my living room as my kids run around me and think how odd it is that I protect these three little persons. Motherhood has made me weep at the sight of children hurt or hungry; has made me rageful at a world where monsters are free; has made me face my own capacity for anger; and it has graced me with random gifts like hysterical laughter over blueberry waffles at the breakfast table. 

Rebecca Guenard, PhD, Atomic-o-licious@BGuenard

Motherhood

Listening to stories,

admiring all they know.

Hugging, kissing,

holding Cheeto-covered hands.

Tightening hockey skates,

washing baseball uniforms.

He stands on the mound alone.

From Twitter

@Scientistmother: motherhood means joyous bittersweet scary make a better person love no matter what

@Cbardmayes: mh=if my heart was as the universe, still would not be big enough to hold all the love for my son & his smiles #happymunkimama

@Labroides:motherhood is seeing my wife find reserves of strength patience and love that we didn’t know she had

@Babyattachmode:to me motherhood means realizing that I have this enormous amount of love for such a little person!

@Jtothehizzoe:The “motherhood” is that end of town where all the moms hang out, actin’ all hard, right?

Pregnancy 101: My placenta looked like meatloaf, but I wasn’t about to eat it.

By Jeanne Garbarino, Biology Editor
An historic view interpretation of the placenta (source). 

She gave me a few minutes to meet my daughter before she reeled me back into a state that was my new reality.  “You’re not finished Jeanne.  You still need to birth your placenta.”  What?!?! More pushing? But I was lucky and the efforts required to bring my placenta ex vivo were minimal. 

This is the second placenta my body helped make.  OK,
so it doesn’t EXACTLY look like meatloaf…  

The idea of a placenta, which is the only human organ to completely and temporarily develop after birth, was fascinating.  That thing sitting in a rectangular periwinkle bucket was what allowed me to grow another human.. inside of my body!  There was no way I was not going to check it out, as well as create a permanent record of its relatively short-lived existence. 

My first impression was that it looked like “meatloaf.”  Not necessarily a well made meatloaf, but perhaps one that is made by my mother (sorry mom).  But, alas, chaos reigned and I wasn’t able to really take a good look.  However, for my second birth and hence second placenta, my midwife indulged me with a more detailed look and a mini-lesson.   

Baby’s eye view:
Where geekling deux spent 39 weeks and 4 days. 

Her gloved hands, still wet with my blood and amniotic fluid, slid into the opening that was artificially created with a tool resembling a crocheting needle.  She opened the amniotic sac wide so I could get a baby’s eye view of the crimson organ that served as a nutritional trading post between me and my new bundle of joy. 

She explained that the word “placenta” comes from from the Greek word plakoeis, which translates to “flat cake” (however, I’m sure if my mom’s meatloaf was more common in ancient Greece, the placenta would be named differently).   “It’s one of the defining features of being a mammal,” she explained as I was working on another mammalian trait – getting my baby to nurse for the first time.

That was about all I could mentally digest at the time, but still, more than three years later, the placenta continues to fascinate me, mostly due to the fact that it is responsible for growing new life.  It’s a natural topic for this long overdue Pregnancy101post, so let’s dive in!
Development of the placenta
It all starts when a fertilized egg implants itself into the wall of the uterus.  But, in order to fully understand how it works, we should start with an overview of the newly formed embryo. 

The very early stages of us (and many other things that are alive).
The trophoblast invades the uterus,
leading to implantation of the blastocyst.

As soon as a male sperm cell fuses with a female egg cell, fertilization occurs and the cells begin to multiply.  But, they remain contained within a tiny sphere.  As the cells continue to divide, they are given precise instructions depending on their location within that sphere, and begin to transform into specific cell types.  This process, which is called cellular differentiation, actually seals the fate every cell in our body, sort of like how we all have different jobs – some of us are transport things, some of us are involved in policing the neighborhoods, some of us build structures, some of us communicate information, some of us deal with food, some of us get rid of waste, etc.  Every cell gets a job (it’s the only example of 100% employment rates!).

Now back to the cells in the fertilized egg.  As they start to learn what their specific job will be, the cells within the sphere will start to organize themselves.  After about 5 days after fertilization, the sphere of cells becomes something called a blastocyst, which readies itself for implantationinto the wall of the uterus. 

The act of implantation is largely due to the cells found on the perimeter of the blastocyst sphere.  These cells, collectively known as the trophoblast, release a very important hormone – human chorionic gonadotropin (hCG) – that tells the uterus to prepare for it’s new tenant.  (If you recall, hCG is the hormone picked up by pregnancy tests.)  Around day 7, the trophoblast cells start to invade the lining of the uterus, and begin to form the placenta.  It is at this point that pregnancy officially begins.  (Here is a cool video, created by the UNSW Embryology Department, showing the process of implantation.)

Structure of the placenta

Eventually the trophoblast becomes the recognizable organ that is the placenta.  Consider the “flat cake” analogy, with the top of the cake being the fetal side (the side that is in contact with the baby), and the bottom of the cake being the maternal side (the side that is in contact with the mother).     

Cross section of the placenta: Blood vessels originating from the fetus sit in a pool
of maternal blood, which is constantly replenished my maternal arteries and veins.
The red represents oxygenated blood, and the blue represents de-oxygenated blood.

Projecting from the center of the fetal side of the placenta are two arteries and one vein, coiled together in a long, rubbery rope, often bluish-grey in color.   This umbilical cord serves as the tunnel through which nutrients and waste are shuttled, and essentially serves to plug the baby into the mother’s metabolic processes.  At the umbilical cord-placenta nexus, the umbilical cord arteries and vein branch out into a network of blood vessels, which further divide into a tree-like mass of vessels within the placenta. 

These tree-like masses originating from the umbilical cord (and thus fetus) sit in a cavity called the intervillous space, and are bathed in nutrient-rich maternal blood.  This maternal blood, which provides the fetus with a means for both nutrient delivery and waste elimination, is continually replenished via a network of maternal arteries and veins that feed into the intervillous space.  Furthermore, these arteries and veins help to anchor the placenta into the uterine wall.  One of the most interesting aspects about the mother-feus relationship is that the blood vessel connection is indirect.  This helps to prevent a detrimental immune response, which could lead to immunological rejection of the fetus (sort of like how a transplanted organ can become rejected by the recipient).  
Functions of the placenta

Just like a plant needs sunlight, oxygen, and water to grow, a baby needs all sorts of nutrients to develop.  And since a baby also produces waste, by nature of it being alive and all, there is an absolute requirement for waste removal.  However, because we can’t just give a developing fetus food or a bottle, nor are we able to change diapers in utero, the onus lies completely on the biological mother. 

This is where the placenta comes in. Because the fetus is plugged into the circulatory system of the mother via the umbilical cord and placenta, the fetus is provided with necessary nutrients and a mechanism to get rid of all the byproducts of metabolism.  Essentially, the placenta acts as a waitress of sorts – providing the food, and cleaning it all up when the fetus is done eating. 

But it’s not just about nutrition and waste.  The placenta also serves as a hormone factory, making and secreting biological chemicals to help sustain the pregnancy.  I mentioned above that the placenta produces hCG, which pretty much serves as a master regulator for pregnancy in that it helps control the production of maternally produced hormones, estrogen and progesterone.  It also helps to suppress the mother’s immunological response to the placenta (along with other factors), which cloaks the growing baby, thereby hiding it from being viewed as a “foreign” invader (like a virus or bacteria). 

Another hormone produced by the placenta is human placental lactogen (hPL), which tells the mother to increase her mammary tissue.  This helps mom prepare for nursing her baby once it’s born, and is the primary reason why our boobs tend to get bigger when we are pregnant.  (Yay for big boobies, but my question is, what the hell transforms our rear ends into giant double cheeseburgers, and what biological purpose does that serve??  But I digress…)

Despite the fact that the mother’s circulatory system remains separate from the baby’s circulatory system, there are a clear mixing of metabolic products (nutrients, waste, hormones, etc).  In essence, if it is in mom’s blood stream, it will very likely pass into baby’s blood stream.  This is the very reason that pregnant mothers are strongly advised to stay away from cigarettes, drugs, alcohol, and other toxic chemicals, all of which can easily pass through the placental barrier lying between mother and fetus.  When moms do not heed this warning, the consequences can be devastating to the developing fetus, potentially leading to birth defects or even miscarriage.        

There are also situations that could compromise the functions of the placenta – restriction of blood supply, loss of placental tissue, muted placental growth, just to name a few – reducing the chances of getting and/or staying pregnant.  This placental insufficiency is generally accompanied by slow growth of the uterus, low rate of weight gain, and most importantly, reduced fetal growth.     

And it’s not just the growth of the placenta that is important – where the placenta attaches to the uterus is also very important.  When the placenta grows on top of the opening of the birth canal, the chances for a normal, vaginal birth are obliterated.  This condition, known as placenta previa, is actually quite dangerous and can cuase severe bleeding in the third trimester.  0.5% of all women experience this, and it is one of the true medical conditions that absolutely requires a C-section. 

Then, there is the issue of attachment.  If the placenta doesn’t attach well to the uterus, it could end up peeling away from the uterine wall, which can cause vaginal bleeding, as well as deprive the baby from nutrient delivery and waste disposal.  This abruption of the placenta  is complicated by the use of drugs, smoking, blood clotting disorders, high blood pressure, or if the mother has diabetes or a history of placental abruption. 

Conversely, there are times when the blood vessels originating from the placenta implant too deeply into the uterus, which can lead to a placenta accreta.  If this occurs, the mother generally delivers via C-section, followed by a complete hysterectomy. 

Cultural norms and the placenta

There are many instances where the placenta plays a huge role in the culture of a society.  For instance, both the Maori people of New Zealand and the Navajopeople of Southwestern US will bury the placenta.  There is also some folklore associated with the placenta, and several societies believe that it is alive, pehaps serving as a friend for the baby.   But the tradition that seems to be making it’s way into the granola culture of the US is one that can be traced back to traditional Chinese practices: eating the placenta. 

Placentophagy, or eating one’s own placenta, is very common among a variety of mammalian species.  Biologically speaking, it is thought that animals that eat their own placenta do so to hide fresh births from predators, thereby increasing the chances of their babies’ survival.  Others have suggested that eating the nutrient-rich placenta helps mothers to recover after giving birth.

However, these days, a growing number of new mothers are opting to ingest that which left their own body (likely) through their own vaginas.  And they are doing so though a very expensive process involving dehydrating and encapsulating placental tissue.  

Why would one go through this process?  The claims are that placentophagy will help ward of post partum depression, increase the supply of milk in a lactating mother, and even slow down the ageing process.  But, alas, these are some pretty bold claims that are substantiated only by anecdata, and not actual science (see this).

So, even though my placentas looked like meatloaf, there was no way I was eating them.  If you are considering this, I’d approach the issue with great skepticism.  There are many a people who will take advantage of maternal vulnerabilities in the name of cold hard cash.  And, always remember, if the claims sound to good to be true, they probably are!   


Thanks for tuning into this issue of Pregnancy101, and enjoy this hat, and a video!

Source


Childbirth and C-sections in pre-modern times

[Today's post first appeared at Dr. Kristina Killgrove's blog, Powered by Osteons. Kristina is a bioarchaeologist who studies the skeletons of ancient Romans to learn more about how they lived. Her biography at her blog begins, "When your life's passion is to study dead Romans, you often get asked for your 'origin story,' something that explains a long, abiding and, frankly, slightly creepy love for skeletons." Now that you undoubtedly want to know more, read the rest of her bio here, and then read below to learn why childbirth is so difficult and what the archaeological record has to tell us about outcomes for mother and child in the ancient world. For more about Kristina and her work, you can see her academic Website at Killgrove.org  and find out about her latest research project at RomanDNAProject.org. You can also find her at her G+ page and on Twitter as @BoneGirlPhD.]

Basically since we started walking upright, childbirth has been difficult for women.  Evolution selected for larger and larger brains in our hominin ancestors such that today our newborns have heads roughly 102% the size of the mother’s pelvic inlet width (Rosenberg 1992).

Yes, you read that right. Our babies’ heads are actually two percent larger than our skeletal anatomy


Fetal head and mother’s pelvic inlet width
Photo credit: Evolution-of-man.info

Obviously, we’ve also evolved ways to get those babies out.  Biologically, towards the end of pregnancy, a hormone is released that weakens the cartilage of the pelvic joints, allowing the bones to spread; and the fetus itself goes through a complicated movement to make its way down the pelvic canal, with its skull bones eventually sliding around and overlapping to get through the pelvis.  Culturally, we have another way to deliver these large babies: the so-calledcaesarean section.

Up until the 20th century, childbirth was dangerous.  Even today, in some less developed countries, roughly 1 maternal death occurs for every 100 live births, most of those related to obstructed labor or hemorrhage (WHO Fact Sheet 2010).  If we project these figures back into the past, millions of women must have died during or just after childbirth over the last several millennia.  You would think, then, that the discovery of childbirth-related burial – that is, of a woman with a fetal skeleton within her pelvis – would be common in the archaeological record.  It’s not.

Archaeological Evidence of Death in Childbirth

Two recent articles in the International Journal of Osteoarchaeology start the exact same way, by explaining that “despite this general acceptance of the vulnerability of young females in the past, there are very few cases of pregnant woman (sic) reported from archaeological contexts” (Willis & Oxenham, In Press) and ”archaeological evidence for such causes of death is scarce and therefore unlikely to reflect the high incidence of mortality during and after labour” (Cruz & Codinha 2010:491).

The examples of burials of pregnant women that tend to get cited include two from Britain (both published in the 1970s), four from Scandinavia (published in the 1970s and 1980s), three from North America (published in the 1980s), one from Australia (1980s), one from Israel (1990s), six from Spain (1990s and 2000s), one from Portugal (2010), and one from Vietnam (2011) (most of these are cited in Willis & Oxenham).  Additionally, I found some unpublished reports: a skeleton from Egypt, a body from the Yorkshire Wolds in England, and a skeleton from England.

The images of these burials are impressive: even more than child skeletons, these tableaux are pathos-triggering, they’re snapshots of two lives cut short because of an evolutionary trade-off.


The wide range of dates and geographical areas illustrated in the slideshow demonstrates quite clearly that death of the mother-fetus dyad is a biological consequence of being human.  But what we have from archaeological excavations is still fewer than two dozen examples of possible childbirth-related deaths from all of human history.

Where are all the mother-fetus burials?


As with any bioarchaeological question, there are a number of reasons that we may or may not find evidence of practices we know to have existed in the past.  Some key issues at play in recovering evidence of death in childbirth include:
  • Archaeological Theory and Methodology.  From the dates of discovery of maternal-fetal death cited above, it’s obvious that these examples weren’t discovered until the 1970s.  Why the 70s?  It could be that the rise of feminist archaeology focused new attention on the graves of females, with archaeologists realizing the possibility that they would find maternal-fetal burials.  Or it could be that the methods employed got better around this time: archaeologists began to sift dirt with smaller mesh screens and float it for small particles like seeds and fetal bones.
  • Death at Different Times.  Although some women surely perished in the middle of childbirth, along with a fetus that was obstructed, in many cases delivery likely occurred, after which the mother, fetus, or both died.  In modern medical literature, there are direct maternal deaths (complications of pregnancy, delivery, or recovery) and indirect maternal deaths (pregnancy-related death of a woman with preexisting or newly arisen health problems) recorded up to about 42 days postpartum.  An infection related to delivery or severe postpartum hemorraging could easily have killed a woman in antiquity, leaving a viable newborn.  Similarly, newborns can develop infections and other conditions once outside the womb, and infant mortality was high in preindustrial societies.  With a difference between the time of death of the mother and child, a bioarchaeologist can’t say for sure that these deaths were related to childbirth.  Even finding a female skeleton with a fetal skeleton inside it is not always a clear example, as there are forensic cases of coffin birth or postmortem fetal extrusion, when the non-viable fetus is spontaneously delivered after the death of the mother.
  • Cultural Practices.  Another condition of being human is the ability to modify and mediate our biology through culture.  So the final possibility for the lack of mother-fetus burials is a specific society’s cultural practices in terms of childbirth and burial.  In the case of complicated childbirth (called dystocia in the medical literature), this is done through caesarean section (or C-section), a surgical procedure that dates back at least to the origins of ancient Rome.

Cultural Interventions in Childbirth


It’s often assumed that the term caesarean/cesarean section comes from the manner of birth ofJulius Caesar, but it seems that the Roman author Pliny may have just made this up. The written record of the surgical practice originated as the Lex Regia (royal law) with the second king of Rome, Numa Pompilius (c. 700 BC), and was renamed the Lex Caesarea (imperial law) during the Empire.  The law is passed down through Justinian’s Digest (11.8.2) and reads:

Negat lex regia mulierem, quae praegnas mortua sit, humari, antequam partus ei excidatur: qui contra fecerit, spem animantis cum gravida peremisse videtur.

The royal law forbids burying a woman who died pregnant until her offspring has been excised from her; anyone who does otherwise is seen to have killed the hope of the offspring with the pregnant woman. [Translation mine]
Example of Roman gynaecological equipment: speculum
From the House of the Surgeon, Pompeii (1st c AD)
Photo credit: UVa Health Sciences Library

There’s discussion as to whether this law was instituted for religious reasons or for the more practical reason of increasing the population of tax-paying citizens.  In spite of this law, though, there isn’t much historical evidence of people being born by C-section.  Many articles claim the earliest attested C-section as having produced Gorgias, an orator from Sicily, in 508 BC (e.g., Boley 1991), but Gorgias wasn’t actually born until 485 BC and I couldn’t find a confirmatory source for this claim.  Pliny, however, noted that Scipio Africanus, a celebrated Roman general in the Second Punic War, was born by C-section (Historia Naturalis VII.7); if this fact is correct, the earliest confirmation that the surgery could produce viable offspring dates to 236 BC.


This practice in the Roman world is not the same as our contemporary idea of C-section.  That is, the mother was not expected to survive and, in fact, most of the C-sections in Roman times were likely carried out following the death of the mother.  Until about the 1500s, when the French physician François Rousset broke with tradition and advocated performing C-sections on living women, the procedure was performed only as a last-ditch effort to save the neonate.  Some women definitely survived C-sections from the 16th to 19th centuries, but it was still a risky procedure that could easily lead to complications like endometritis or other infection.  Following advances in antibiotics around 1940, though, C-sections became more common because, most importantly, they were much more survivable.


Caesarean Sections and Roman Burials


Roman relief showing a birthing scene
Tomb of a Midwife (Tomb 100), Isola Sacra
Photo credit: magistrahf on Flickr

In spite of the Romans’ passion for recordkeeping, there’s very little evidence of C-sections.  It’s unclear how religiously the Lex Regia/Caesarea was followed in Roman times, which means it’s unclear how often the practice of C-section occurred.  Would all women have been subject to these laws?  Just the elite or just citizens?  How often did the section result in a viable newborn?  Who performed the surgery?  It probably wasn’t a physician (since men didn’t generally attend births), but a midwife wouldn’t have been trained to do it either (Turfa 1994).


Whereas we can supplement the historical record with bioarchaeological evidence to understand Romans’ knowledge of anatomy, their consumption of lead sugar, or the practice of crucifixion, this isn’t possible with C-sections – the surgery is done in soft tissue only, meaning we’d have to find a mummy to get conclusive evidence of an ancient C-section.

We can make the hypothesis, though, that because of the Lex Regia/Caesarea, we should findno evidence in the Roman world of a woman buried with a fetus still inside her.  This hypothesis, though, is quickly negated by two reported cases – one from Kent in the Romano-British period and one from Jerusalem in the 4th century AD. The burial from Kent hasn’t been published, although there is a photograph in the slide show above.

Interestingly, the Jerusalem find was studied and reported by Joe Zias, who also analyzed theonly known case of crucifixion to date.  Zias and colleagues report on the find in Nature(1993) and in an edited volume (1995), but their primary goal was to disseminate information about the presence of cannabis in the tomb (and its supposed role in facilitating childbirth), so there’s no picture and the information about the skeletons is severely lacking:

We found the skeletal remains of a girl (sic) aged about 14 at death in an undisturbed family burial tomb in Beit Shemesh, near Jerusalem.  Three bronze coins found in the tomb dating to AD 315-392 indicate that the tomb was in use during the fourth century AD.  We found the skeletal remains of a full-term (40-week) fetus in the pelvic area of the girl, who was lying on her back in an extended position, apparently in the last stages of pregnancy or giving birth at the time of her death… It seems likely that the immature pelvic structure through which the full-term fetus was required to pass was the cause of death in this case, due to rupture of the cervix and eventual haemorrhage (Zias et al. 1993:215).

Both Roman-era examples involve young women, and it is quite interesting that they were already fertile.  Age at menarche in the Roman world depended on health, which in turn depended on status, but it’s generally accepted that menarche happened around 14-15 years old and that fertility lagged behind until 16-17, meaning for the majority of the Roman female population, first birth would not occur until at least 17-19 years of age (Hopkins 1965, Amundsen & Diers 1969).  These numbers have led demographers like Tim Parkin (1992:104-5) to note that pregnancy was likely not a major contributor to premature death among Roman women.  But the female pelvis doesn’t reach skeletal maturity until the late teens or early 20s, so complications from the incompatibility in pelvis size versus fetal head size are not uncommon in teen pregnancies, even today (Gilbert et al. 2004).

More interesting than the young age at parturition is the fact that both of these young women were likely buried with their fetuses still inside them, in direct violation of the Lex Caesarea.  So it remains unclear whether this law was ever prosecuted, or if the application of the law varied based on location (these young women were both from the provinces), social status (both young women were likely higher status), or time period.  Why wasn’t medical intervention, namely C-section, attempted on these young women?  It’s possible that further context clues from the cemeteries and associated settlements could give us more information about medical practices in these specific locales, but neither the Zias articles nor the Kent report make this information available.

Childbirth – Biological or Cultural?

Childbirth is both a biological and a cultural process.  While biological variation is consistent across all human populations, the cultural processes that can facilitate childbirth are quite varied.  The evidence that bioarchaeologists use to reconstruct childbirth in the past includes skeletons of mothers and their fetuses; historical records of births, deaths, and interventions; artifacts that facilitate delivery; and context clues from burials.  The brief case study of death in childbirth in the Roman world further shows that history alone is insufficient to understand the process of childbirth, the complications inherent in it, and the form of burial that results.  In order to develop a better understanding of childbirth through time, it’s imperative that archaeologists pay close attention when excavating graves, meticulously document their findings, and publish any evidence of death in childbirth.



Further Reading:
ResearchBlogging.orgReferences:

This post was chosen as an Editor's Selection for ResearchBlogging.orgD.W. Amundsen, & C.J. Diers (1969). The age of menarche in Classical Greece and Rome. Human Biology, 41 (1), 125-132. PMID: 4891546.


J.P. Boley (1991). The history of caesarean section. Canadian Medical Association Journal, 145 (4), 319-322. [PDF]


S. Crawford (2007). Companions, co-incidences or chattels? Children in the early Anglo-Saxon multiple burial ritual.  In Children, Childhood & Society, S. Crawford and G. Shepherd, eds.  BAR International Series 1696, Chapter 8. [PDF]

C. Cruz, & S. Codinha (2010). Death of mother and child due to dystocia in 19th century Portugal. International Journal of Osteoarchaeology, 20, 491-496. DOI: 10.1002/oa.1069.

W. Gilbert, D. Jandial, N. Field, P. Bigelow, & B. Danielsen (2004). Birth outcomes in teenage pregnancies. Journal of Maternal-Fetal and Neonatal Medicine, 16 (5), 265-270. DOI:10.1080/14767050400018064.

K. Hopkins (1965). The age of Roman girls at marriage. Population Studies, 18 (3), 309-327. DOI: 10.2307/2173291.


E. Lasso, M. Santos, A. Rico, J.V. Pachar, & J. Lucena (2009). Postmortem fetal extrusion. Cuadernos de Medicina Forense, 15 (55), 77-81. [HTML - Warning: Graphic images!]

T. Parkin (1992).  Demography and Roman society.  Baltimore: Johns Hopkins University Press.

K. Rosenberg (1992). The evolution of modern human childbirth. American Journal of Physical Anthropology, 35 (S15), 89-124. DOI: 10.1002/ajpa.1330350605
J.M. Turfa (1994). Anatomical votives and Italian medical traditions. In: Murlo and the Etruscans, edited by R.D. DePuma and J.P. Small. University of Wisconsin Press.


C. Wells (1975). Ancient obstetric hazards and female mortality. Bulletin of the New York Academy of Medicine, 51 (11), 1235-49. PMID: 1101997.

A. Willis, & M. Oxenham (In press). A Case of Maternal and Perinatal Death in Neolithic Southern Vietnam, c. 2100-1050 BCE. International Journal of Osteoarchaeology, 1-9. DOI:10.1002/oa.1296.


J. Zias, H. Stark, J. Seligman, R. Levy, E. Werker, A. Breuer & R. Mechoulam (1993). Early medical use of cannabis. Nature, 363 (6426), 215-215. DOI: 10.1038/363215a0.

J. Zias (1995). Cannabis sativa (hashish) as an effective medication in antiquity: the anthropological evidence. In: S. Campbell & A. Green, eds., The Archaeology of Death in the Ancient Near East, pp. 232-234.

Note: Thanks to Marta Sobur for helping me gain access to the Zias 1995 article, and thanks toSarah Bond for helping me track down the Justinian reference.

Mother’s Day: Part of me forever

Always a part of each other. (Source)

Double X Science’s Chris Gunter, science education and outreach editor, wrote this wonderful post for the Last Word on Nothing. We are featuring it here for Mother’s Day because, as she writes, if you’re a mother, you and your child are part of each other forever–and this time, we mean in a scientific sense.
Source.
This summer I put my Lilkid, as I call him online, on the school bus for the first time ever. Evidently I have “socialized” him enough with other lilkids, because he got on without a backwards glance, ignoring his mother getting all teary and father waving goodbye. He chose a seat and then mouthed through the window with a huge grin, “MOM! I am ON THE SCHOOL BUS! And IT HAS NO SEAT BELTS!!!”
When you have a kid, people tell you various clichés about how your child will be part of you forever. Ladies, in your case, it’s true, and it’s supported by science.
Thanks to a phenomenon called fetal microchimerism, a mother can carry cells from her fetus in her own body for many years after the pregnancy ends. Particularly in the last two decades, microchimerism has been recognized as the norm rather than the exception. We now know that, instead of being separate systems, the mother and fetus leave a number of permanent marks on each other through the trafficking of cells back and forth over the placenta. Fetal stem cells make their way into the mother’s bloodstream and even into her bone marrow, sometimes contributing to her blood supply for the rest of her life.
Source.
Like many parts of having a kid, the consequences of this microchimerism are both good and bad. Fetal cells have been found at sites of injury in the mother while she’s pregnant, or even years later in liver injuries or appendicitis cases, apparently drawn by damage and participating in repair or regeneration. Good news! Fetal cells have also been found in breast cancers much later, again seeming to try and repair the tissue. Thanks, kid!
But the presence of fetal cells is also invoked as the reason why women have more autoimmune disorders, including lupus and thyroiditis, during and years after pregnancy. Immunologists think that this happens essentially because Mom’s immune system eventually realizes that these fetal cells don’t belong to her own body, and attacks them as a result. Hmmm, not great. [However, at least you have some more scientific basis if you hear yourself telling your child, “You are KILLING me!”]
Source.
In fact, testing women’s cells for the presence of the Y chromosome — the “male” chromosome, which females shouldn’t carry — uncovers it in about 30% of the bone marrow of grown women and 47% of cardiac aortas. Even among women who have truly never had a reportable pregnancy, 7% or more would test positive for XY cells. Doubling those numbers to account for fetuses of both sexes further supports the idea that many pregnancies go undetected. It’s not just the mothers standing with me at the bus stop who are microchimeric; these problems and benefits apply to more women than we think.
So as I watched Lilkid pull away into a new stage of independence, this geeky scientist thought about how his cells would literally be part of my body forever, for both good and more challenging times. Then the straight Mom kicked in with a host of more mundane worries: “Great — now I have to go look into this ‘no seat belt on the bus’ thing. Did I pack enough snacks for him to eat?” And so on as the school bus drove off for the first of many mornings.
_____________
Chris Gunter is a geneticist and the Director of Research Affairs at the HudsonAlpha Institute for Biotechnology in Huntsville, Alabama, and a DXS editor. 

Captivating and matriarchical: the meerkat.

Dominants, alphas, and queens: Happy Mother’s Day!

Mothers who rule in the animal kingdom.

by Jacquelyn Gill     

On the second Sunday in May in the United States, mothers reign supreme, receiving tributes of breakfast in bed, hand-made cards, flowers, and obligatory long-distance phone calls. Meanwhile, for the rest of the animal kingdom, it’s just another day: eat, hunt, mate, birth, nest, migrate, defend, and rest.

Some go it alone, but others—like spotted hyenas and bison—live in groups with complex social structures, and moms are at the top, year-round. In a matriarchy, females hold central roles of leadership and power. This might sound like a nice change of pace for some of us, but most anthropologists now agree that there have likely been no true matriarchal human societies (in spite of popular books like The Chalice and the Blade). Instead, matriarchies are more likely to be found in the rest of the animal kingdom, from meerkats to mammoths. Here are a few examples:

The Queen, surrounded by her supportive workers.

The Queen, surrounded by her supportive workers.

Honey bees: Bee colonies are giant matriarchal societies ruled by a single queen—quite literally the “queen mum.” Her offspring (as many as 25,000 at a time) make up the entire clan of female workers and male drones. The queen spends her life tended to by her worker daughters. These workers have underdeveloped reproductive systems, so the queen is the only female in the hive who gets to mate. The females do the work of the hive and tend to the queen while the male drones laze about until it’s time to mate with the queen. This setup might sound appealing at first, but it comes with a couple of important caveats. The Queen only mates once in her lifetime with a select handful of drones who were bred for that sole purpose (assuming they weren’t pushed out or killed by their worker sisters during tough times, when freeloading is less tolerated). During a series of nuptial flights, the queen gets all the sperm she’ll ever need for an entire lifetime—as many as five million individuals. She uses this sperm for to around 2500 eggs a day, which are tended to by her sterile daughters while she dines on royal jelly. The males get no reward for their service, but instead perish shortly after depositing their sperm, the unfortunate victims of an acute case of exploded abdomen.

Positives: Waited on hand-and-foot, low risk, low stress.  Negatives: Once-in-a-lifetime mating, copious egg-laying.

Captivating and matriarchical: the meerkat.

Captivating and matriarchical: the meerkat.

Meerkats: Meerkat societies are highly structured, with a complex ranking system based on dominance. If you want to get ahead in the meerkat world, perfect the art of chin swiping and hip checking, practiced on those lower down the totem pole while someone more powerful than you is looking the other way. Being on top has its rewards; alpha female meerkats are the only ones who get to mate in meerkat town. A matriarch chooses her partner, who becomes the dominant (and only mating) male. Males initiate copulation by ritually grooming the female until she submits. If the matriarch tires of her partner, he’s quickly deposed by beta males who are more than eager to earn a chance at mating. Alpha females make all the decisions in the group: where to sleep, where to burrow, when to go outside, when to forage. Like bees, meerkat females are typically mother to all the pups in the group (females typically kill pups born of unsanctioned unions). In addition to being free to engage in mating, being a matriarchal meerkat comes with free baby-sitting and nursemaid service from the subordinate females (who also will lactate to feed her pups). The downside is that all the other females want your job; as they get older, the young females start hip-checking, stealing food, and even picking fights. Often, the alpha kicks young competitors out of the group before they get old enough to pose a threat.

Positives: Your clan, your rules; mate selection; ritual grooming; cooperative breeding. Negatives: High risk.

Cooperative and matriarchical.

Cooperative and matriarchical.

Killer whales (orcas): Killer whales have some of the most complex social structures known in nature and are found in large resident groups (mostly fish eaters), smaller transient groups (seal hunters), or offshore groups (of which relatively little is known). Killer whale societies are entirely structured around the maternal line, in a hierarchy of groups. The smallest of these is the matriline, which contains the oldest female and her direct descendents—as many as four generations in one (great grand-whale, grand-whales, mama whales, and baby whales). Several matrilines together make a pod, and groups of pods with the same dialect and shared maternal lineage form a clan. For killer whales in resident groups, the young live with their mothers for the their entire lives, while in the smaller, transient groups, females tend to depart once they become mothers of their own. Meanwhile, male killer whales are mama’s boys, maintaining a strong relationship with their mothers for life. Even siblings remain close after their mother dies. Unlike bees or meerkats, all females can mate as they wish, although almost always only with males from other pods. These close-knit groups are important for successful hunting, as well as for rearing young that require a lot of parental investment (like humans do!). A killer whale’s female relatives assist her during labor, and even help guide her 400 lb calf to the surface to take its first breath. This cooperative behavior is a key part of teaching calves important life skills like the complex group hunting strategies similar to those that wolf packs use.

Positives: Strong family structure, cooperative breeding, matrilineal. Negatives: The kids never leave home.

Don't let the tusks fool you: It's a she, and she's the boss.

Don’t let the tusks fool you: It’s a she, and she’s the boss.

Elephants: Female elephants live together in small family groups, typically consisting of a matriarch and her young or closest relatives. The oldest female elephant in each family group gets the job, and the position is passed down to her oldest daughter when she dies. Matriarchs have a lot of social power but are also the source of important lore in the herd, like where the water is, how to avoid predators, and even how to use various tools like makeshift fly-swatters. Meanwhile, males live bachelor lifestyles, fending for themselves alone or in small groups after getting kicked out at puberty. Male and female elephants occasionally come together to socialize or mate, but otherwise live separately. Unlike bees, meerkats, and killer whales, female elephants have a lot less control in the mating process. Fertile females are followed around by aggressive bulls who rumble, produce a musky scent that they disperse by flapping their ears, and fight off other interested parties. For young female elephants, this mating behavior can be a bit intimidating, and so her female relatives will often stay by her side to provide moral support. After a two-year pregnancy, a female will give birth to a calf, which quickly becomes the center of herd life, as female relatives caress and welcome the newborn. The perks of elephant motherhood include free babysitting and protection from predators; females will circle the young when they sense danger. In some Asian elephant populations, multiple families have even been observed coming together to form specialized groups for nursing or juvenile care, like a cooperative preschool.

Positives: Strong family ties, cooperative parenting. Negatives: Lack of mate control, two-year pregnancy (!).

Many different kinds of matriarchy exist in the animal kingdom, as do many kinds of moms. Whether you’re a queen or a worker, an alpha or a beta, a subdominant or a matriarch, Happy Mother’s Day to moms everywhere.

References 

The Living Elephants: Evolutionary Ecology, Behavior, and Conservation, Raman Sukumar. Oxford University Press, Oxford, UK. Kalahari Meerkat Project, Cambridge University

Killer Whales: The Natural History and Genealogy of Orcinus Orca in British Columbia and Washington, Kenneth C. Ford, Graeme M. Ellis, & Kenneth C. Balcomb. University of British Comumbia Press, Vancouver.

WebBeePop, Carl Hayden Bee Research Center, USDA Agricultural Research Service

[Photo credits: all photos are from Wikipedia with Creative Commons with Attribution liceneses except for #3, which is Public Domain: (1) A queen bee surrounded by her worker daughters. Photo by Waugsberg. (2)  A meerkat in the Kalahari. Photo by Muriel Gottrop. (3) A mother-calf killer whale pair. Photo by Robert Pitman. (4) A matriarchal elephant and her family. Photo by Amoghavarsha.] Continue reading