Making Babies

Watching my kids go through the journey that is pregnancy, I wonder to myself - How did I not see this before?

In previous eras pregnant women had protected status as a result of their delicate condition, and were coddled through their miseries (unless of course you were a peasant and spent sun-up to sun-down in the field) by a flock of women who hovered over and cared for you.  By the time I was pregnant in the 80's women had recently won many victories in equality and pregnancy was the last frontier.  The prevailing attitude to pregnancy was to suck it up and not whine.  Instead of demanding consideration of what we were living through over and above what men live through, we set about proving our equal worth. In retrospect I think we were wrong in this.

Actually, it is an illness

About the same time, some brighto decided that pregnancy needed to be de-medicalized because it was natural. No longer having the excuse of being ‘ill’, women were expected to step up, suck it up, and carry on. What absolute nonsense. If a man walked into emergency with even half of the symptoms of pregnancy he’d be hospitalized for a serious disease.  And so, pregnancy lost its special status and became just another unsupported ring of fire for women to jump through along with menstruation, child birth, and menopause.

Until recently.  Lately I’ve run across a number of posts and essays suggesting in bold print that pregnancy is not all it’s cracked up to be.  And that it frankly sucks. Certainly this isn’t news but up to now dogma regarding how women are supposed to feel about being pregnant has constrained any blasphemy suggesting that many young women today do not feel thrilled/blessed/radiant/wonder-struck about taking on the job. And while logically pregnancy is the result of a conscious decision to embrace the trials of pregnancy in the spirit of self-sacrifice, it rarely is.

 It may be that there are two issues. Dealing with pregnancy is hard enough, but being expected to go to work, run large homes in which they continue to do the majority of cooking and cleaning, often in the absence of family and neighborhood support systems, while raising other children WHILE PREGNANT is perhaps beyond reasonable expectation.  And yes, modern man should/would/could be a partner in pregnancy, but in reality his contribution ranges from Superman to No Man.

It’s Not About You

 In this modern day we’re used to being in control of our lives, so it is a bit of a shock to realize that our much anticipated little embryo is a parasite.   While we’d like to think of pregnancy as a cooperative venture between mother and fetus, it’s actually more of a hostile take-over.   Without our permission or knowledge the embryo directs a massive renovation and revamping of the mother’s body.   Every morsel of food, vitamin, and mineral ingested will be primarily directed to the cause: the construction of a food/waste/gas transfer station (placenta), the assembly of the fetus, laying down of fuel stores, preparation and implementation of the exit strategy, and the development of glands and ducts for mammary take-out. If mom can’t get the nutrients, her own blood, bones, organs, and muscles undergo redistribution to supply the fetus with what it needs.  Need calcium? Take my teeth.  The good news is that like any successful parasite, it rarely harms a healthy host enough that its own survival is threatened.

Most of pregnancy’s symptoms/signs/annoyances stem from the fact that though the code is perfectly orchestrated, there are unintended consequences.  For example, massive amounts of progesterone are secreted by the placenta in order to keep the smooth muscle of the uterus relaxed, thus preventing premature contraction and miscarriage.  Unfortunately, all the smooth muscle in mom’s body has the same progesterone receptors, and responds too.  Smooth muscle in mom’s leg veins relaxes causing blood to pool in the legs resulting in kankles and varicose veins.  Smooth muscle in mom’s gut relaxes and food sits around, leading to heartburn, indigestion, nausea, and constipation. 

Great Expectations

The following is a list of maternal changes in pregnancy - what a woman can be expected to endure during her 280 days of pregnancy. Some women say they never felt better than when pregnant, but most will have some combination of the following.

If you’re a man, consider carefully what it would mean for you to go through this, and decide whether you’d make this sacrifice to have a child.   Act accordingly.

(Note, the following is basic biology.  If you missed it in Grade 12, here’s your chance.)

·        Heart workload increases by 40-50%, heart rate by 15% and cardiac output rises from 4 to 7 L/a minute.  Even when she’s resting she’s jogging.   

·        Unspeakable fatigue.  Early pregnancy hormones lead to an exhausted stupor and the tendency to nod off in mid-sentence.  As pregnancy develops, and the 25-35 lbs of assorted tissues, fluids, and fetus accumulates, weariness is constant. Add the rigors of normal life and getting up with other children in the night and you get the idea.  If you don’t, try strapping 2 or 3 ten pound bags of flour to your abdomen for a full day and night and see how perky you are.

·        Legs and ankles swell (kankles) and painful varicose veins can develop. Smooth muscle in mom’s veins relax causing blood and fluid to pool in the legs by gravity.  Pooling can pop valves in leg veins leading to ropy, painful varicose veins. All effects courtesy of progesterone. (Note: the ‘glow of pregnancy’ is just blood vessels in the face dilating. It doesn’t mean she’s radiating happiness.  She’s just radiating.)

·        Breathing rate increases by 40% while the pressure of the uterus against the lungs and diaphragm can make for breathless nights. (Not that kind.)

·        Nausea and vomiting or the circus trick known as The Reversible Gut. For some, there’s minor gagging on the toothbrush or queeziness looking at meat.  Others endure 9 months of incapacitating wretching hell and the despair that goes with it.

·        Indigestion, heartburn, constipation.  Again, because trusty progesterone relaxes smooth muscle and the gut is made of smooth muscle, food sits and sits instead of being pooped out. As the growing uterus squishes the stomach and intestines into a rapidly disappearing space, heartburn and indigestion are a problem.

·        Hemorrhoids:  Constipation and ‘straining at the stool’ pop out blood vessels in the butt into little grapes. Nasty and painful.

·        An overwhelming desire to eat and lay down fat (when not throwing up). This is natural selection at it’s finest. In days past the ability to find food and accumulate fat in a world where food was scarce ensured that the pregnant woman and her child would survive.  While the average pregnant woman needs only 300 cal more/day, code is strongly suggesting you eat like your life depends on it.  While average weight gain is 25-35 pounds of fetus, fluid, tissue, and blood, those hassling a pregnant woman about her weight should probably expect a right hook and a compulsory viewing of Aliens.

·        Weird changes in taste and smell leading to simultaneous revulsion and craving.

·        Breasts grow ridiculously and may be painful as glands and ductwork develop, indicating greater than ornamental value. Added features include stretch marks, spreading areolas, dark nipples, and possible oozing.  Which may or may not be a turn on.

·        No alcohol and one cup of coffee/day for 9 months.  Gents, this alone might be a deal breaker, right?

·        Dizziness and Fainting:  When standing up suddenly, dilated veins allow blood to pool rapidly in her legs and blood pressure drops.  While lying on her back, the uterus compresses large blood vessels decreasing blood flow to and from the heart and blood pressure drops.  Maybe stay seated?

·        A brain at the mercy of hormones: As estrogen and progesterone make mincemeat of cognitive skills (baby brain) and emotional range, mood may waver between elation, rage, giddiness and despair. Neither logical or reasonable, these emotions may garner little empathy from observers. Interestingly, I read a book for pregnant women from the 1800’s that described hysteria and despair as an expected aspect of pregnancy.  Either this aspect of pregnancy evolved out in the last 100 years or somebody forgot to tell us this is ‘normal’.

·        Peeing All the Time: Initially, because the kidney’s working overtime to process all that extra blood.  Eventually, because Junior’s squishing her bladder. What little sleep she’s getting is interrupted by trips to the can possibly several times a night. A good case for catheterization and a leg bag.

·        Back pain: As the uterus grows abdominal muscles get stretched, pulling her abdomen forward, creating a sway back and causing pain from spinal shearing.

·        Waddle: Changes in center of gravity, posture, and balance change the gait to a side to side waddle.  Foot size increases and foot arch flattens.

·        Falling: Pregnant women fall as much as women of 70+ years of age.  Balance is so altered that caution is needed, particularly during exercise.

·        Proneness to Injury: Relaxin hormone softens and relaxes the symphysis pubis ligaments for delivery but has the same effect on all ligaments and tendons making joints loose and prone to injury and dislocation.  Muscle strains and pulls are more likely. I had a physiology prof whose hip kept dislocating during lectures. Amusing. For us.

·        Risk of clots and embolisms rise as more clotting factors are released to prevent the uterus from hemorrhaging.

·        Risk of diabetes: Pregnancy converts more fat to glucose (sugar) so Junior has all she needs and more. However, blood sugar is useless without insulin present to open the sugar gates into the waiting cells.  Extra blood sugar means more insulin is needed.  If she doesn’t make enough, she gets to be diabetic and shoot up insulin for the duration of her pregnancy. It usually goes away after birth.

·        Vaginal and urinary tract infections: Itching, pain, discharge result from changing vaginal pH; courtesy of estrogen.

·        Stretch marks: Hormones make the skin elastic and Junior stretches it out from the inside as she grows.  Lovely pinks and purple streaks decorate breasts and abdomen.

·        Mask of pregnancy: Dark blotches on the face and darkening of the genitals and mid-abdominal line along with dark nipples/areolas.  Evolutionarily, this was to tell other members of the tribe that she was pregnant.  Hopefully that won’t be necessary.

·        Hair loss: Potentially like your dog in spring. 

·        Being scared:  Scared of what pregnancy is doing to her body and mind; scared of child birth, of breast feeding, of being a good enough mom.  That’s a lot of scared. 

·        Looking and feeling obese.  The big round belly and swollen body of pregnancy can look coincidentally like obesity.  So it’s easy to feel that way. Feeling and looking nothing like her self, she may feel out of control and very alone in this work.  It’s easy for her to forget that underneath all this hormonal havoc, she is still the person she was.

·        Fetal Gymnastics: Having sacrificed her dignity and health, the sweet little fetus she’s devoted 9 months to building, is kicking the crap out of her.

So, what do you want? A medal?

Actually, yes.  For every woman on the planet that has endured pregnancy or even attempted to.  In this day and age we use the word self-sacrifice when referring to fire-fighters and NGO workers overseas.  Yet the every-day sacrifices of pregnancy are not acknowledged simply because pregnancy is natural.

While we don’t have an option on how we make the dear, sweet babies we love, we can expect recognition and appreciation.  One thing we can do is raise our sons to step up.  To cook, clean, launder, and do far more than his share of work in return for his wife’s agreement to endure pregnancy so that he might have a child with his name on it rather than the manufacturer’s.  We can lobby for inclusion of pregnancy and childbirth education in school curricula so that kids are prepared for the reality of what’s to come and the responsibilities they’ll have.  We can change the dynamic of how we view pregnancy  - not as a super-mom competition where she who suffers is not as tough as she who doesn’t, and where moms are advised to suck it up and not seek the support they need.  We can encourage the use of doulas, midwives, support groups and all other sources of strength and care to make pregnancy easier.  We can lobby employers and government to allow husbands to use pat-leave hours to help their wives through pregnancy, not just after the baby comes. We can use the model of European countries and demand that pregnant women be allowed rest time during the work day and be given modified tasks.

I watch my own kids traverse this ground. And it's only when I watch them that I realize what hard work this is – a biological imperative that no technology can expedite.  They, like all pregnant women sacrifice their bodies, minds, and health in the same way women did a million years ago.  I wish I could make it better for them.