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A brilliant writer, first-time mother, and respected biologist, Sandra Steingraber tells the month-by-month story of her own pregnancy, weaving in the new knowledge of embryology, the intricate development of organs, the emerging architecture of the brain, and the transformation of the mother’s body to nourish and protect the new life. At the same time, she shows all the hazards that we are now allowing to threaten each precious stage of development, including the breast-feeding relationship between mothers and their newborns. In the eyes of an ecologist, the mother’s body is the first environment, the mediator between the toxins in our food, water, and air and her unborn child.Never before has the metamorphosis of a few cells into a baby seemed so astonishingly vivid, and never before has the threat of environmental pollution to conception, pregnancy, and even to the safety of breast milk been revealed with such clarity and urgency. In Having Faith, poetry and science combine in a passionate call to action.A Merloyd Lawrence Book
for Jeff and Faith
Every woman who becomes pregnant brings to the experience her various identities. I am an ecologist, which means I spend a lot of time thinking about how living things interact with the environments they inhabit. When I became pregnant at age thirty-eight, I realized, with amazement, that I myself had become a habitat. My womb was an inland ocean with a population of one.
So I turned my scientist's eye inward and began to study in earnest the biological drama of new life being knit from the molecules of air, food, and water flowing into a woman's body from the outside environment. I looked also at the environmental threats to the bodies of pregnant and breastfeeding mothers. How do toxic chemicals cross the tough sponge of the placenta? How do they find their way into amniotic fluid? How do they enter the milk-making globes in the back of the breast? What are the effects for the child of these earliest encounters with synthetic chemicals? The answers to these questions seemed essential to my new responsibilities as an expectant mother. And they all pointed to a simple truth: protecting the ecosystem inside my body required protecting the one outside.
This book is the result of that most personal of ecological investigations. Part I describes the unfolding events of fetal development, month by joyful month, the nine chapters named for the traditional names of each month's full moon in the agricultural cycle. Along the way, I explore various mysteries: the puzzling malaise of morning sickness; the historical failure to recognize fetal toxicants; the experience of holding in my hands a tube of my own amniotic fluid; the origins of birth defects; and the ways in which certain chemical contaminants can sabotage fetal brain development. As birth nears, I turn my attention to the ecology of the birth process itself. As I try to plan for a natural childbirth within a large research hospital, another one of my identities—cancer survivor—plays a key role in my decision-making.
Next, Having Faith takes a close look at the symbiosis of breastfeeding. Part II thus begins with the reestablishment of the biological bond between mother and child as the breast takes over from the placenta the task of nurturing the infant. In Part II, I also take a close look at the evolutionary origins of human breast milk, with its disease-fighting properties and unsurpassed ability to guide the brain development of nursing infants. Finally, I examine how the goodness of breast milk—and indeed a mother's very ability to produce it—is now being compromised by the presence of toxic chemicals in the human food chain.
The source notes at the end of the book direct readers to the many hundreds of scientific papers, monographs, reports, and texts that informed my analysis. Those interested in more detailed biological descriptions can seek them here. All this research, however, can really be summed up in a few simple sentences. In the words of Katsi Cook, a Native American midwife, a woman's body is the first environment. If the world's environment is contaminated, so too is the ecosystem of a mother's body. If a mother's body is contaminated, so too is the child who inhabits it. These truths should inspire us all—mothers, fathers, grandparents, doctors, midwives, and everyone concerned about future generations—to action.
January 31, 2001
Ithaca, New York
Ithaca, New York
September 26, 1998, late morning
In the hospital solarium, sunlight pours through the glass like a warm shower. I have brought you here, little one, to show you the sky, blue as cornflowers, and the stone buildings of Boston, city of your birth. But you are sleeping and show no sign of changing your mind about sleeping.
You spent last night nestled in the crook of my arm. I curled around you so that the curves and bumps of your body, familiar to me as my own, pressed against my belly, pressed against me now from the outside instead of from the inside. (I recognize especially the curve of your heel. For many weeks I felt it through my own skin, just under my left rib.) At 3 A.M. you awoke. Your father said he looked over from his cot and saw you staring at a square of light on the wall. While I slept he held you in his arms and made shadow puppets for you. He said that you watched intently. He emphasized "intently"—and that, after he had run through his entire repertoire, you turned your attention to his face, holding him in a calm gaze. He said he knew in that moment what kind of person you would become. He said you have an observant, inquisitive spirit.
Your left hand wriggles out now from the top of your swaddling blanket, but still you do not wake. The pattern your veins make on the back of your hand is identical to my own. I cannot stop staring at you. No wonder mothers claim they cannot remember their labors clearly. You fill all my brain cells. Just the sound of your breathing—which is a miracle—requires my complete attention. The sea smell of your hair. The pulse behind your ear. The butter of your skin. I am so busy memorizing you that I cannot recall anything about my life before today.
In the world outside this glass room, songbirds are feeding and resting in the trees. Some will take off tonight and not land until they reach Venezuela. Sandpipers, plovers, and broad-winged hawks have already left for Patagonia and Panama. Bats are heading for caves in Kentucky and Tennessee. Out in the Atlantic, hump back whales pass by on their way to the Caribbean. Even now, Canada geese are honking toward us from Quebec. It is a good day for the beginnings of journeys.
Every time I look at you, I think, Now I cannot die.
I decide your name is Faith.
In a faculty bathroom on the campus of Illinois Wesleyan University, I am trying to pee on a stick. Outside, the first snowfall of winter is coming down thick and fast, which is a good thing because I have a seminar to teach downstairs in five minutes, and the snow—with all the required stomping of boots and shaking of scarves—should keep the class preoccupied for a while.
When I was a student here myself, twenty years ago, I always wondered what went on in private, professorial chambers like this one. Now that I have returned for a semester as a visiting writer-in-residence, accompanied by my visiting artist–in–residence husband, I've been walking through lots of familiar old buildings and opening doors to rooms I never knew existed. The provost's inner office, for instance. The faculty dining hall. And now this dark-paneled, wide-windowed lavatory with its crooked floor and oversized porcelain fixtures.
I focus on the chortling sounds of the radiator. Urine splashes over my fingers, and I feel the stick bend down like a divining rod.
In my office, a few minutes earlier, I finished an interview with the alumni magazine editor, during which time I was completely absorbed with the question of whether or not I was pregnant. My period is not due for another two days, and yet I have a hunch. So as soon as he left, I walked across the street to the pharmacy where, as a college student, I had bought contraceptive devices. I used to stand in the checkout lane and worry that one of my professors would walk in and see me with a handful of condoms and spermicides. Today, with the same air of fake casualness, I sidled up to that identical counter holding a home pregnancy test kit, hoping that none of my students would walk in before the clerk could slip that too-pink box safely into a bag.
I lay the wet stick on the cool, curved lip of the sink basin. White on white, it seems to vanish.
I hadn't really planned to do this right now. But I was amazed, after reading the directions on the back of the box, how simple and quick the test is. Pee on a stick, and three minutes later you have your question answered. It was too irresistible. In 1986, as a science writer for the Detroit Free Press, I had researched a story about diagnostic home test kits and raised eyebrows in the features department by keeping a stack of pregnancy tests piled on my desk. The idea of women diagnosing their own pregnancies was still disconcerting back then. The kits themselves contained entire miniature laboratories. They required first morning urine, a willingness to follow complicated instructions, and a half hour of waiting. "Am I going to have a baby?" a woman asked the little chemistry set. The appearance of a ghostly brown ring in a mirror mounted under the test tube meant "Yes." It was like reading tea leaves.
Before the advent of home tests, women handed their urine over to medical technicians to foretell their futures. The Aschheim-Zondek method was developed at a charity hospital in Berlin in 1927. It involved injecting a virgin mouse (later a rabbit or a toad) with the urine of a possibly pregnant woman and then dissecting the animal to see whether it had ovulated. If so, the test was positive. This took weeks. Before Aschheim-Zondek, women relied on their own bodies to tell them they were pregnant. For some, this could take months. Now, a positive pregnancy test means that two colored lines appear on a plastic stick in less time than it takes to brush your teeth.
I note the starting time on my watch, and then very deliberately look out the window. Across the parking lot is the dormitory where I lost my virginity. Beyond the dorm is the old science building where I spent most of my waking hours—studying invertebrate zoology, comparative anatomy, organic chemistry. Somewhere in there was the embryology lab where I once successfully transplanted the wing bud of a chick embryo. It was strange really—to have begun one's sexual life in the midst of an intense intellectual immersion into reproductive biology. I had spent my days poring over micrographs of fetal cross sections, completely humbled by the operatic beauty of it all, and my nights in sticky dormitory couplings, actively trying to prevent sperm and egg from finding each other. This all took place in an age that now seems so fleeting on almost doubts it ever really existed: the handful of years between Roe v. Wade in 1973 and the advent of AIDS in the early 1980s, that brief time when sex did not hold between its teeth the red rose of either ruin or death. Now I have returned; married, sexually unprotected, and twice as old as I was when I became semi-skilled at prenatal chicken surgery.
The snow falls harder. Already the quadrangle's sward of brown grass is buried.
Am I pregnant? It is an old, old question. How many women have asked it before me? How many women right now are standing at windows waiting for urine-soaked sticks to turn color? Some are praying not to see lines. Some are trying to will them into existence. Am I pregnant? At this particular moment I'm not sure what answer I'm hoping for. Mostly I'm unnerved by the ease of the experiment I'm conducting, as though such a venerable and terrifying question should demand an animal sacrifice, or at least intricate and difficult operations. I reread the instruction sheet. I notice it refers to the plastic stick as "the wand."
I guess that about a minute has passed. Two more to go. To avoid looking at my watch, I decide to think about the menstrual cycle. Reviewing the inside of the human body is a habit of mine, my own private form of meditation. Once, I stayed in a London hotel that became the unintended site of a terrorist attack. While being assembled, a bomb exploded in a room across the courtyard from my own, killing its makers and a sleeping woman next door. In the days that followed, I traced over and over in my mind's eye the passage of venous and arterial blood through the heart's four chambers. It was a way of slowing down my own heart—and not replaying the image of windows shattering.
So, the menstrual cycle.
At the end of a period, the lining of the uterus is thin and bare—like a layer of silt left behind after flood waters have receded. The ovaries, too, are smooth and quiet. Then, high in the brain, the pituitary gland begins to drizzle into the bloodstream a substance called follicle stimulating hormone. True to its name, the hormone awakens in one or the other ovary a whole choir of follicles. Like bubbles, they rise to the surface in unison. Each one is a sack that holds a single human egg. Typically, only one follicle will ultimately surrender its singular possession, but all participate in the task of turning testosterone into estrogen, and it is this collective effort that makes the next step possible.
The assembled estrogen seeps from the follicle-studded surface of the ovary and swirls around in the bloodstream. Some reaches the brain, and, in a second round of call and response, the pituitary gland replies by releasing back into the blood another substance called luteinizing hormone. Like the initial hormone that set the whole process in motion, this, too, is received by the ovary, and it induces one of the swollen follicles to break through the ovarian surface. An egg is delivered out into the headwaters of the fallopian tube. Ovulation. All this in less than two weeks.
The faucet drips. The radiator hisses and bangs into action. I guess that another minute has passed. If I look down at my watch, I'll see "the wand," so I keep my eyes on the falling snow.
It's easy to think of the egg as a little gondola floating serenely down the Venetian canal of the fallopian tube, but this is not quite right. I remember the textbook case of the young woman who lost an ovary and a fallopian tube to surgery. Unfortunately, her remaining ovary and tube were located on opposite sides from each other. To the amazement of all concerned, she got pregnant anyway. Under the influence of estrogen, fallopian tubes move. They stretch, and they bend, and their mouths are actively attracted to ovulating eggs, a drawing power that apparently extends even across the continent of the pelvis. Moreover, once the egg is captured, a fallopian tube has muscles and cilia that ferry it downstream. This is not to say the tube does all the paddling. A living egg denuded of its outer coating will not move. Fallopian transport is a mutual affair, and something in the egg itself assists in the journey. No one knows exactly what.
I wonder what time it is. Down in the parking lot, the last of my students are negotiating their way through rows of cars. But I am not ready yet to consult the plastic oracle on the sink.
During the next three or four days, the floodplain of the uterus is completely transformed. Its flat endometrial lining rises and thickens. Spiral arteries coil through it like snakes. The deeper layers swell with starch-filled glands, and the surface crawls with immune cells. The elixir responsible for this luxuriant growth is the hormone progesterone, which trickles into the bloodstream from the ovarian follicle that released the ovulated egg. Once its sol performance is over, the emptied-out follicle does not sit down with the rest of the choir. Instead, it balls up, turns yellow, and begins secreting hormones. Called the corpus luteum, it is this new gland that turns the interior landscape of the uterus into a lush marshland.
Now we come to the crossroads, the crux of the matter, the source of my lady-or-the-tiger inquiry. An ovulated, unfertilized human egg has a lifespan of just twelve to twenty-four hours. Forty-eight hours, tops. If it dies a maiden, its journey ends. The yellow moon of the corpus luteum soon wanes. As progesterone levels fall, the root ends of the spiral arteries constrict, and the whole endometrium blanches with the loss of blood flow. The starchy pools evaporate. The curly stalks of the spiral arteries senesce. White blood cells infiltrate. All that is left is the denouement of menstruation: the base of the spiral arteries reopens and a surge of fresh blood carries the dying tissue away. In the last twenty-five years I've already gone through several hundred rounds of flooding and renewal. The almanac of the uterus is steadying.
If, on the other hand, something else has happened during the trip down the tunnel—that subject of seventh-grade film strips and intense theological argument—then our story changes. If a living zygote emerges from the far end of the fallopian tube, then the rest of my life is going to be very different.
When an egg is fertilized by a sperm in the upper reaches of the fallopian tube, the first cell division happens in about twelve hours. Four days later, as it bobs out into the womb's delta, there are fifty-eight cells, arranged in a cluster like a mulberry. At this point, a bubble of fluid begins to fill one side of the ball of multiplying ells, and the outermost cells on the other side fuse together. Between the two is a teard rop of cells destined to become the embryo. The bubble is the amnion, the fused part the placenta. One week after the egg's successful affair with the sperm, the whole unit sinks into the endometrial marsh in a process called implantation. The fused cells push long, amoeba-like fingers deep into the uterine lining while secreting digestive enzymes that facilitate its burial. In response, the tips of the spiral arteries break open and spurt like geysers. Thus, life begins in a pool of blood.
Twelve days after conception—that's about where I would be now, if indeed I am there at all—the uterine lining has already grown over the point of entry, and the embryonic placenta has sent siphoning hoses into the bloody lagoons beneath. Equally important, it has begun the manufacture of a hormone called human chorionic gonadotropin—HCG—which spills into the mother's capillaries and circulates until it reaches the ovaries. HCG stops the menstrual cycle at summer solstice. It does so by commuting the monthly death sentence of the corpus luteum. Estrogen and progesterone there fore keep flowing from the ovary in ever larger quantities. The uterine lining is not shed but becomes ever more overgrown. More and more spiral arteries wind upward and break open to feed the new life buried there. Immune cells surround it and offer their protection.
HCG is the hormone that pregnancy kits attempt to detect. If it is present in blood, it is present in urine. If it is present in urine, it can be poured over plastic sticks embedded with antibodies. If the antibodies have been extracted from mice previously exposed to the hormones of pregnant women, then they will bind to the HCG in the urine. If the antibodies can be made to change color once they are so bound, then pregnancy is made visible. If I am pregnant, then I should be able to see it. Now.
I look at my watch. Five minutes! I look down at the stick. Two lavender lines. Unmistakable. Now there are two of us. And I am late for class.
The season's only snowfall melts and then freezes, cruelly, into pleated sheets of ice that last for weeks. Bundled up, I carry my secret with me, imagining the baby (the baby!) as a lavender thread caught within a plush red carpet. The pregnancy seems unreal. I still look the same, feel the same, eat, sleep, and think the same. Like everyone who is not pregnant, I skate gingerly across the ice, head down, arms out, in my daily circuits to class, library, home, and back. Except that I am overcome with a new sense of urgency. I begin reading embryology texts again. I also collect a few popular guidebooks for pregnant women.
I quickly learn that embryologists and obstetricians speak two different languages and utilize two different calendars for chronicling the passage of unfolding events. One is a fortnight ahead of the other. The embryological timetable uses the moment of fertilization as its starting point. This seems sensible, and it is the system I am used to. By the embryologists' accounting, a human pregnancy is thirty-eight weeks long. More or less.
The obstetricians, however, begin the clock with the first day of the woman's last menstrual period. By their method, gestation is an even forty weeks. Their argument for adding two weeks to the beginning of pregnancy is that the fertilization is an unknowable point in time, whereas the onset of menstruation is subject to data collection—either because it has been dutifully recorded in a woman's week-at-a-glance appointment book or because it can be deduced with a little reflection: "Let's see. I was just stepping onto the subway platform when I realized my period had started. That was the day I had planned to go Christmas shopping, so it must have been Monday, the twenty-first." The assumption is that menstruation, on average, precedes ovulation and therefore conception by fourteen days. This is not an unreasonable system either. In fact, it's very practical. Using the obstetrical calendar, a date of birth can be quickly predicted by subtracting three months from the date of last menstruation and adding seven days.
The problem with the obstetrical method is that it pretends a woman is pregnant two weeks before the egg boat has even left the ovarian dock. This is the fiction the whole system hangs on. The surreal result is that a newly pregnant woman is fast-forwarded in time: one short week after a missed menstrual period she is said to be five weeks pregnant.
For a while, I walk around translating the obstetrical calendar into the embryological one I am familiar with. The obstetrician I choose from the Yellow Pages of the phone book is first interested in seeing me when I am about eight weeks pregnant—by which he means six weeks since I actually became pregnant. The pregnancy advice books note that morning sickness often sets in at six weeks, by which they mean four weeks. Finally, I give in and adopt the new, accelerated way of marking time. In some ways, it more closely mirrors the experience of pregnancy discovery. Learning I am pregnant is like crossing the International Date Line. All of a sudden, time skips forward.
Jeff feels the new time sense, too—ever since the afternoon two weeks ago when I handed him the tiny wand, tattooed with its pair of colored lines. Standing in his sculpture studio, he took it and turned it over slowly.
"Is it a thermometer?"
I shook my head.
"Is it. . . a clock?"
This was a response I hadn't expected.
"Yes, in a way." I laughed, sure I had misled him. But objects are his medium. He wasn't thrown off by my words. He looked again.
"Are you pregnant? Does this say you're pregnant?"
I nodded furiously, and then we were hugging and laughing. And then I cried, and Jeff held his head in his hands. And then we walked home in the snow with the cars crunching slowly by us, and began to make dinner in an already darkening kitchen, and by the time we had finished, it was truly dark and we sat together quietly like that for a long time, feeling the hours of the short winter days flying by us and pressing behind us at the same time.
Two weeks later, we are flipping pages in our date books and comparing our various plans for art shows, book projects, travel, teaching commitments. My due date is October 2. We pencil it in our calendars as though it were some kind of deadline for a grant application.
"You know, it's only a guess. It could be four weeks early. It could be two weeks late."
"Only twelve percent of women actually give birth on their due dates."
Let's just take things one step at a time. That's what you always say, right?"
"Do you think I should cancel my trip to Toronto?"
"Why? It's only a few weeks from now."
Future time increasingly seems like some kind of finite resource, like coal or aluminum ore, that must be inventoried, processed, allocated, bankrolled. This kind of stocktaking is new for us. I wonder if all adults who are parents think this way.
I start paying attention to the silver maples outside the windows of the faculty guest house where we are living. Acer saccharinum. It's a fast-growing tree. Homeowners plant them when they want shade in a hurry, but their crowns are brittle and come down quickly in windstorms. Against a gray February sky, their bare, pointy branches are pencil sketches of themselves. In early spring, pom-poms of tiny flowers will open from lateral buds and shower sidewalks and car windshields with chartreuse confetti. Soon after, deeply cut, silvery white leaves will unfurl. Then the helicopters of winged seeds will whirl down and lie topsy turvy in the summer grass. Finally, the leaves will roll up into dry, papery tubes and these too will float down so they can be raked into heaps of ashy lace. But before these leaves fall—if all goes well—I will have a baby. October 2.
I peer more closely at the hunched-up leaf buds paired along the twigs, barely visible, barely there at all. In February, October does not seem possible. Nothing except February seems possible in February—not the wind travels of pollen, not the making of seed helicopters from flower tassels, not the appearance of fancy leaves from the sides of cold twigs, not the formation of babies from menstrual blood.
Organogenesis is the formation of body parts. It takes place in the month between weeks six and ten, as the obstetricians date it. By the time it is over, the embryo is the length of a paper clip, and, by definition, all the organs and structures of the body are present in "a grossly recognizable form." At week eleven of pregnancy, no further assembly is required: the embryo is knighted a fetus and simply grows bigger until it is ready for birth, when it weighs about the same as a gallon of milk.
- On Sale
- May 15, 2012
- Page Count
- 352 pages
- Da Capo Press