Is ‘who we are’ really determined in the womb?

I remember the first time I saw my son’s face. It wasn’t at his birth but a few months before. When other mothers-to-be were fussing over birth plans, midwives and natural birth, I was most at ease surrounded by technology. I lived for my fortnightly visits to the ‘high-risk’ clinic where a state-of-the-art Doppler ultrasound machine measured blood flow and the development of the placenta, and, best of all, allowed me to catch a glimpse of a hand, a leg or the profile of a face: our son.

By my seventh month, I was an old hand at reading the white-on-black pictures the ultrasound tech printed off for me at each visit. 4D ultrasound images, those haunting pictures with solidity and depth, were only just becoming available, but my doctor dismissed them as having no diagnostic value. After a difficult first and second trimester, when things were truly touch and go, we – my doctor, the clinic staff and I – had finally begun to relax; this time we would make it. It was during one of these light-hearted visits that my doctor, on a whim, flipped a switch. Suddenly a solid face rendered on the viewing screen: our son. I saw the curve of his cheek, his little nose and the joints of his tiny fingers slipping in and out of focus as he shifted in my belly.

An ultrasound image of
Nancy McDermott’s first child.

I do not remember anything else about that visit, only sitting in a nearby coffee shop afterwards, unfolding the flimsy printout bearing the image of our son’s face, crying tears of joy.

To be pregnant is to feel the actuality of the future personified, both familiar and strange. It almost defies the imagination, that leap from the two-dimensional baby of the imagination to the complex flesh-and-blood child. It’s a moment that repeats itself in a thousand little ways over the years as we experience firsthand the infinite capacity of human beings to turn our expectations on their heads and surprise us in ways we never imagined.

Reading Annie Murphy Paul’s new book, Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, in which she explores the emerging scientific field of fetal origins, I can’t help but think how the same advances in science that brought me so much reassurance during my own pregnancy have become a source of anxiety for so many women – even for Paul, who was herself pregnant while writing the book.

Paul, a science writer, who experienced the seemingly endless list of pregnancy prohibitions firsthand before the birth of her young son, began to notice the increasing prominence of research in the new field of fetal origins. This new view of the prenatal period, emerging within different disciplines and through many varied types of investigations, seemed to hold out the promise of a more positive approach to pregnancy. There was ‘a dawning sense that intrauterine conditions can make a lot of things go right, that the prenatal period is where many of the springs of health and strength and wellbeing are found’. Pregnant once again, she decided to investigate the new science for herself.

It’s become a cliché for authors, especially women, to declare their personal interest in their topic – the jilted twentysomething who decides to write about commitment, the infertile writer who writes about infertility. It doesn’t always work, but in Paul’s case it does, brilliantly. Paul’s progressing pregnancy is a constant reminder of our peculiar relationship to science today. There is a certain expectation that scientific research can act as a guide for individual behaviour and that a good parent will be aware of how their decisions about their children’s environment will affect their lives. For Paul, the overall message of fetal-origins research is good news, but even she is forced to admit that the discoveries about fetal origins ‘have been cast as one long ringing alarm bell, one long line of doctors in white lab coats pointing their fingers at pregnant women: No. Don’t. Stop!’

In virtually every area she investigates, from nutrition to maternal health, the positive news carries with it the potential for angst-filled rumination. For instance, research showing that babies whose mothers are a little stressed during pregnancy seem to be slightly more intelligent than babies whose mothers are either very stressed or not stressed at all begs the question: ‘How stressed am I? Should I be more stressed?’ Paul herself veers between reassurance and alarm as she investigates the effects of food, environmental chemicals, alcohol and even the pain of birth itself on the baby’s life and fortunes.

Why has pregnant women’s relationship to science become so fraught? Paul believes that fetal-origins research represents a return to a more ancient notion of the relationship between a mother and her unborn child, one that fell out of favour with the rise of modern medicine and the medicalisation of birth itself.

Superstitions, such as the idea that a pregnant woman’s experience of being frightened by an animal would cause her child to take on the characteristics of that animal, could be easily dismissed as backward and primitive. Notions of the heritability of behaviour were also discredited as the science of genetics advanced. The idea that a mother’s experience and behaviour really can have an impact on the child in her womb flies in the face of our understanding of human nature. And while it is undoubtedly true at some level that the environment of the womb makes some impact on the individual inside it, it doesn’t really explain why we look to this particular science, not just as a way to explain what makes us what we are, but as a way to influence the potential of our children.

One of the great advances of the Enlightenment was to take human potential for granted and to insist that man could, through the exercise of reason, make his own fate. The notion of the primacy of the mother’s experience in shaping the child in her womb is not simply a new and interesting discovery that has happened spontaneously in many divergent disciplines; rather it is part of a trend to see the potential of any individual, not in terms of their relationship with the world at large, but in terms of their relationship with their parents. Fetal-origins research takes the determinism that we see so often in discussions of parenting today and projects it backwards into the womb. It carries with it a huge burden of responsibility for mothers, where a child’s very potential is intimately tied up with its mother to the extent that she must regulate her own feelings lest her emotions have some sort of toxic effect on her baby. No wonder all this research makes mothers nervous!

Perhaps more disturbingly, by focusing on the environment of the womb and its impact on the fetus/future person, human potential is increasingly reduced to the issue of health. I was particularly struck by Paul’s interview with Douglas Almond, an economist form Columbia University in New York. Though it might seem odd to find an economist interested in fetal origins, Almond told Paul that ‘estimating the cost of adverse early experience is the kind of thing economists are good at’. Almond has used census data to examine the fate of children born at various periods of adversity in history. His ‘natural experiments’ are based on census data about children whose mothers had the flu in the 1919 pandemic, or who suffered through the famine that accompanied China’s Great Leap Forward.

In every instance, Almond is able to demonstrate that children gestated during these periods do worse than others. Children of the 1919 flu pandemic were shorter than children born before and after it. They were also 15 per cent less likely to graduate from high school, were less educated, earned less money and were 20 per cent more likely to have heart disease or to be disabled at adults. Being in the womb during that time of adversity apparently rendered them ‘less able citizens and less productive workers’. For Almond, this is a great demonstration of why society benefits from prenatal care.

And yet, it seems to me to be perverse to draw a line from the womb to the citizen, especially for those who, born in 1919, would have been 22 in 1941. Whatever strikes the children of the pandemic may have had against them in terms of health, they and others of their generation were swept up in the tumult of war and mostly rose to the occasion, enduring unimaginable hardships. They went on to become the architects, artists and engineers who created our postwar world. Would they have done more if their mothers didn’t have flu when they were in the womb? Perhaps, but what they did do and what they were part of should tell us that there’s far more to the story of humanity than those nine months gestating.

Just as our individual attitudes to pregnancy tell us something about our personal hopes and fears for the future, so the way we regard pregnancy as a society tells us something about our collective view of human potential. The research Paul reviews in Origins is fascinating, but, unwittingly perhaps, it reveals how our diminished view of human subjectivity shapes our relationship to children and to science today.

Paul really wants to be optimistic about fetal-origins research but seems to struggle with it throughout her book. It is difficult, and maybe impossible, to reconcile scientific research with everyday life, and even harder to look at one’s own child through the prism of pregnancy. The book ends with the birth of Paul’s second son. After nine chapters and nine months, she simply accepts that our babies do not emerge ‘clean and unmarked by life’. In the end, the arrival of her son seems to melt away the worry and the fear. Whatever we’re told about how our actions will affect our children’s destinies, the actuality of human potential becomes real when we hold our infants for the first of many times. There is, she writes, ‘nothing more real than a baby’ – and I agree.

Nancy McDermott is a writer and mother based in New York.