Just-So Babies

If you've ever watched a baby eat solid foods, that's DuckFace.

If you've ever seen a shirtless baby, that's DadBod.

Why are we so into these things, whatever they are, right now?

Because whether we realize it or not, they're babylike, which means they're adorable. And all things #adorbs are so #totes #squee right now for the millions (billions?) of social media users in our species. And if they're babylike, they're especially adorable to women and women are more frequently duckfaces than men. And women are increasingly open to embracing, maritally, the non-chiseled men of the world...who knew?

Well, anyone and everyone who's spent a damn second raising a baby, that's who. Especially those with mom genes.

Understanding babies, how they develop, and our connections to them while they do so is key to explaining just about everything, and perhaps literally eh-vuh-ray-thing, about humanity. How can I be so sure? Well aren't you?

We all know that the most attractive women are the ones that look like babies. 

source

And to help Nature out, makeup, lasers, and plastic surgery neotenize us temporarily or permanently, making our skin smooth, our eyes big, our lips pouty, our cheeks pinchable and rosy, and our noses button-y.

That stuff about beauty is common knowledge isn't it? We do these things to ourselves because of our evolved preferences for babies. We find them to be so extremely cute that this adaptive bias for babies affects much of the rest of our lives. Beauty is just the tip of the iceberg because, like I said, babies explain everything: DuckFace, DadBod, ...

And, yes, I do have more examples up my sleeve.

All that weight we gain while pregnant? You think it's to stockpile fat for growing a superhuge, supercharged baby brain both before and then after it barely escapes our bipedal pelvis?

Me and Abe, with hardly an inkling that there's still a whopping five more weeks ahead of us... suckers.

Or maybe I gained 20 pounds above and beyond the actual weight of the pregnancy so that I could protect my baby from calorie lulls from disease or food shortage, especially when those things happened more frequently to my ancestors.

Nope. And nope.

Pregnant women gain all that weight so that its lightning fast loss while lactating leaves behind a nice saggy suit of skin for the baby to grab and hold onto--not just on our bellies, but our arms and legs too. Our ancestors were dependent on this adaptation for quite a while, but over time mothers and infants became less dependent on it when they started crafting and wearing slings. Slings reduced selection on a baby's ability to grasp, you know.

Before slings, selection would have been pretty intent on favoring baby-carrying traits in both mothers and babies. For example, the way that our shoulder joints are oriented laterally, to the side, is unlike all the apes' shoulders which are oriented more cranially, so they're always kind of shrugging. You think we have these nice broad shoulders for swinging alongside us while running, for seriously enhancing our throwing ability, and, of course, for making stone tools? 

No. No. No.

All that's great for later in our lives, but our lateral facing shoulder joints are for being picked up and carried around while we're helpless babies. Our sturdy armpits are necessary for our early survival. And, biomechanically, those shoulder joints are oriented in the optimal way for carrying babies too. It's a win win. Combine that with the shorter hominin forearm, oh, and that itty-bitty thing called hands-free locomotion and it's obvious that we're designed to carry our babies and also to be carried as babies.

Bums come into play here too.

You probably think your big bum's for bipedal endurance running don't you? Or you might assume it evolved to give a stone-tipped spear a lot of extra oomph while impaling a wooly rhino hide.

Wrong. And wrong again.

Our big bums develop early in life because, like armpits, they build grab'n'go babies as well as well-designed grown-up baby carriers.

source

Bums plop nicely on a forearm and most certainly give babies and moms an advantage at staying together. Bums on moms (if not completely liquefied and fed to baby) steady her while holding such a load and also provide something for a baby slung on her back to sit on. Once babies lost the ability to grasp onto moms, babies' bodies had to adapt to be portable objects and moms bodies had to adapt to never drop those portable objects (at least not too far). No doubt big bums, like sturdy armpits, evolved before slings and home bases were ubiquitous in our species. 

Here's another one: The pregnancy "mask."

All those pigmentation changes that we describe as a side effect of the hormones are much more than that. Those new brown and red blotches that grow on a mother's chest and face, those are functional. They're fascinators. A mother's body makes itself more interesting and loveable for the busy, brainy baby on its way. Once we started decorating our bodies with brown and red ochre and pierced shell, bones and teeth, selection on these biological traits was relaxed. But they still persist. Why not? A human baby can't be over-fascinated, can it?

Oh, and fire. That was the best thing that ever happened to babies which means it was the best thing that ever happened to everyone living with babies. Quiet, serene, fascination, those flames... which also happen to process food for toothless babies whose exhausted, stay-at-foraging parents, would much rather swallow the food they chew up for themselves.

The baby also grows fascinators of its own. The big long hallux. Yep. Our big toe is long compared to other apes'. This is where you say it's an adaptation for bipedalism but you'd be only half right.

© naturepl.com / Ingo Arndt / WWF

The length makes it easier to reach with our mouths, as babies. And we teethe on that big toe. Imagine a world with no Sophies! That's what our ancestors had to deal with. Toes as teething toys doesn't seem so ridiculous when you remember that our long thumbs evolved for sucking.

Anyway, this long hallux was a bit unwieldy so thanks to a lucky mutation we stuck it to the rest of the foot and this turned out to work rather well for bipedalism.

Now that it's been a few minutes into this post, you must be sitting there at your computer thinking about boobs.

Yep, babies explain those too! The aesthetic preference for large breasts, by both males and females, is just nostalgia and allometry. You know how when you go back to visit your old kindergarten it looks so tiny compared to your memory? While you're a small human, you spend quite a lot of time with breasts, focused intently on them. But grow your early impression of breasts up in proportion to your adult body's sense of the world and, well, that's quite a big silicon kindergarten!

Your desires, your preferences, your tastes, your anatomy now, your anatomy when you were a baby... everything is babies, babies, babies. Even bipedalism itself.

Gestating a large fetus would not be possible if we were not bipedal. Think about it. All apes are bipedal to a significant degree. What pressured us into being habitual bipeds? Growing big fat, big-brained babies, that's what. Can you imagine a chimpanzee growing a human-sized fetus inside it and still knuckle-walking? I doubt the body could handle that. The spine alone! If you walk upright and let your pelvis help to carry that big fetus, you're golden. Obviously it worked for us.

I could go on forever! But I'll just give you one more example today. It's one you didn't see coming.

Women live longer than men, on average, and a large portion of that higher male mortality rate (at older ages) is due to trouble with the circulatory system. Well, it's obvious why. I'm looking at my arms right now and, complementing these brown and red fascinators, another part of my new mom suit is this web of ropy blue veins. Is this because my baby's sucked up all my subcutaneous fat from under my saggy skin, or... Or! Is it because my plumbing's stretched after housing and pumping about 50% more blood than normal by the third trimester. If my pipes are now, indeed, relatively larger for my blood volume and my body size then, all things being equal, that should reduce my risk of clogging and other troubles. Most women experience a term pregnancy during their lives. I'm sure this explains most if not all of the differences in mortality between men and women.

Like I said, that's just the start. And although I haven't provided evidence for many of the things I wrote, that shouldn't matter. These are just-so stories and they're terribly fun to think about. They're nothing close to approximating anything as lovely as Kipling's but they're what we humans do. If you're not a fan of today's post, hey, it's not like it passed peer review!

'Obstetric dilemma' skeptic has c-section and remains skeptical ... & ... Why my c-section was natural childbirth

This is a new kind of Tale for me. The rock'n'roll's turned way up, and every couple sentences I have to stop typing to twirl a blue hound dog, a bear holding an umbrella, a Flying Spaghetti Monster, and other oddities that I strung up to hypnotize this little guy into letting me type one thought at a time:

The thing that needs to be hypnotized.
Or the three wise monkeys say: The thing that makes it impossible to create or to dwell on the negative. (e.g. his birth by c-section)

That young primate's the reason I've been quiet for a while here on the MT. And he's the reason I'm a bit more emotional and I cry harder than usual at Rise of the Planet of the Apes (those poor apes!), Cujo (that poor dog!), and other tearjerkers. But he's also the reason my new favorite animal is plain old, fascinating, and dropdead adorable Homo sapiens.

In anthropological terms, he's the reason I'm overwhelmed, not just in love but in new thinking and new questions about the evolution of human life history and reproduction, and then what culture's got to do with it and with our reconstruction of it.

Some context would help, probably.

For the past few years I've been challenging the 'obstetric dilemma' hypothesis--the idea that hominin mothers' bipedal pelves have shortened our species' gestation length and caused infant helplessness, and that antagonistic selection between big-brained babies and constrained bipedal mothers' pelves explains childbirth difficulty too.

[For background see here or here or here or here.]

As part of all that, I've been arguing that the historically recent surge of c-sections and our misguided assumptions about childbirth difficulty and mortality have muddled our thinking about human evolution.

So, once I was pregnant, you might imagine how anxious I was to experience labor and childbirth for myself, to feel what the onset of labor was like, and to feel that notorious "crunch" that is our species's particular brand of childbirth. Luckily I was not anxious about much else the future might hold because modern medicine, paid for by my ample health insurance, would always be there to make it all okay. After a long pregnancy that I didn't enjoy (and am astonished by people who do) I was very much looking forward to experiencing childbirth. In the end, however, my labor was induced and I had a bleeping c-section.

But my bleeping c-section's only worth cussing over for academic reasons because the outcome has been marvelous, and the experience itself was out of this world.

We'll get to the reasons for my c-section in a second, but before that, here are the not-reasons...

First of all, I did not have a c-section because I fell out of a tree with a full bladder.

Second of all, shut your mouth... a c-section was not inevitable because of my hips.

Okay, you got me. I've never been even remotely described as built for babymaking. My hips are only eye-catching in their asymmetry. One side flares out. It might be because when I was 15 years old I walked bent-kneed for a few months pre- and post-ACL reconstruction. That leg's iliac crest may have formed differently under those abnormal forces because, at 15, it probably wasn't fused and done growing yet. If you like thinking in paleoanthropological terms like I do, then my left side is so Lucy.

Anyway. I'm not wide-hipped. However, guess how many nurses, doctors, or midwives who were involved in our baby's birth think my pelvis was a note-worthy factor in my c-section? Not one.

Hips do lie! Inside mine there's plenty of room to birth a large baby. Two independent pelvic exams from different midwives (who knew nothing of my research interests at the time) told me so, and it sounded like routine news to boot. Although one midwife asked me "do you wear size nine and a half shoes?" (no, I wear 8) which was her way of saying, "Girl, you're running a big-and-tall business. You got this."

What you probably know from being alive and knowing other people who were also born and who are alive (or what you might hear if you ask a health professional in the childbirth biz) is that most women are able to birth babies vaginally, even larger-than-average babies. And that goes for most women who have ever lived. Today, "most women" includes many who have c-sections because not all c-sections are performed because of tight fit between mother's birth canal and baby's size. As I understand it, once the kid's started down into the birth canal and gets stuck, a c-section's no longer in the cards. So performing c-sections for tight fit is a preventative measure based on a probability, not a reflection of an actual tight fit. In the mid 20th century, tight fit used to be estimated by x-raying pregnant women and their fetuses. Can you imagine? And this was right about the time the obstetric dilemma hypothesis was born. I don't think that's a coincidence.

Here's a list of reasons for c-sections. Tight fit is included in the first bullet point. Tight fit is one of the few quantifiable childbirth risks. No wonder it's so prominent in our minds. That list excludes "elective" ones which can be done, at least in Rhode Island, if they check the box that says "fear of childbirth". And that's not even close to a list of reasons why women around the world and throughout history have died during or as a result of childbirth. For example, about a hundred years ago women were dying all over the place because of childbed fever.

Anyway, we should assume that I am like most women and expect that I could have given birth the way Mother Nature intended: through my birth canal and with the participation of other humans. Oh yeah, when it comes to humans, social behavior and received knowledge are part of natural childbirth. Even this natural childbirth (which has inspired a forthcoming reality television show featuring women giving birth in the wild!) involves the supportive and beneficial presence of other humans as well as the culture that the mother brings to the experience.

But a c-section's just culture too, so could it be part of "natural" childbirth, then?

I'm inclined to blurt out yes, of course! because I don't support calling anything that humans do "unnatural." But I know that's not something everyone agrees with. It's politics. For example, many of you out there don't flinch an inch at the subtitle of Elizabeth Kolbert's book, "The Sixth Extinction: An Unnatural History."  And given the present energetic movement against childbirth interventions, describing c-sections as "unnatural" as climate change could help minimize unnecessary ones for those who wish to give birth vaginally.

So there we have it. These are the two enormous issues raised by my own little c-section: What can it teach us about the evolution of gestation length, infant helplessness, and childbirth difficulty? And could it be considered natural?

One way for me to get at these questions is to try to understand why I experienced "unnatural" childbirth in the first place. So here goes.

Here's why I think I had to have a c-section:

1. My pregnancy ran into overtime.

This is expected for nulliparous mothers. I visited one of my OBs on my due date. He put his finger on the calendar on the Friday that was two weeks out and joked, "Here's when we all go to jail." Then he asked me, "Who do you want to deliver your baby? I'll see when they're on call before that Friday and schedule your induction then." And I chose my favorite midwife and he scheduled the induction.

All right so I was running late compared to most women, but that's still natural, normal. But it also means risks are ever-increasing by the day. And no matter how small, that the professionals know how to mitigate the biggest risks of all, *deaths*, means that they try to do that. They're on alert already as it is, and then they're even moreso on edge when you're overdue. Especially when it's your first baby and you're a geezer, over 35 years of age.

Now, does going overdue mean the baby keeps growing? Maybe, but not necessarily and not necessarily substantially. Both of us, together, should have been reaching our maximum, metabolically. There's only so much growing a fetus can do inside a mother.

When I approached my due date, and then once I went past it, I tried to eat fewer sweets to make it less comfortable in my womb. I also went back to taking long, hard walks, five milers, even though it was hard on my bladder because I thought that might help kick him out too. I even ran the last of my five miles the day before my induction, to no avail other than the mood boost it gave me.

2. I didn't go into labor naturally by my due date or by my induction date 11 days later. 

Although my cervix was ripening, when I went in to be induced I was only dilated 0-1 cm. I had 9+ more to go before the kid could get out at 10. So a balloon catheter was inserted and filled with water, and I had to tug on the tail of it, which tugged the balloon, which put pressure on the cervix. It dilated enough that it fell out several hours into the process, and by morning I was dilated 3-4 cm. This was exactly the goal of the catheter, this many centimeters. All was going well. However, that the cervix did not open on its own is already a missing piece of going "natural," of having my own biology contribute to my childbirth experience. So starting this way is already derailing things, making it difficult for anything natural to follow, naturally.

3. The fetus's head was facing the hard way: sunnyside up.

This was assessed by the midwife and cradling my belly in a bedsheet, with me on all fours, she and I could not twist him into a better position. His head, she said, was probably why I did not dilate naturally. When I asked an OB during my postpartum check-up, "What dilates the cervix?", he said "We don't know. But I can tell you it's not with the head like it's a battering ram." Well, then... hmph. And then I asked him if women carrying breech fetuses have trouble dilating their cervixes, or going into labor naturally, and he said not necessarily. No. Hmph.

Regardless of what causes cervical dilation, if the head isn't facing the right direction, it's notoriously tough to get down into the birth canal, let alone through the birth canal. It's not impossible, not even close. But it's not looking good at this point either. Perhaps the contractions will jossle his head into a better position, they said. And the contractions should further dilate the cervix.

4. Contractions didn't get underway, naturally, after the catheter dilation, so the drug pitocin was used. 

Induction and pitocin increase the chances that a mother will ask for drugs to help with pain and that she will have interventions, like a c-section. See for example this paper. What the causes are, I'm not sure. But pointing out the correlation is useful at this point because at this point, without even getting into hard labor yet, and without finding out whether my cervix does its job, I'm more likely than ever to be going to the operating room.

5. After six hours of easy labor and five hours of intense labor, my cervix never dilated past 5 cm.  

It needs to get to 10 cm to get the baby moving into the birth canal. Just like with due dates, I think that blanketly assigning this number to all women is probably not consistent with variable biology, but it's how it's currently done. And maybe any higher resolution, like "Sally's cervix needs to hit 9.7 cm", is pointless.

After several hours pitocin-induced contractions--which at first felt like the no-big-deal Braxton-Hicks ones I'd been having numerous times daily for the whole third trimester--I only dilated 1 cm more. That's even when they upped the pitocin to make them more intense.

But after they saw I'd made essentially no progress and that I was napping to save my energy for when things got bad, they woke me up and broke my bag. It would be nice if they could have let my labor progress slowly, if that's what my body wanted to do, but remember, my personal biology went out the window as soon as induction began. And then when that amniotic fluid oozed out of me, that's when bleep got real.

Every two minutes and then every one and a half, I grabbed Kevin's extended hand and breathed like an angry buffalo humping a locomotive. It was the worst pain of my life and I was afraid I'd never last to 10 cm, so I took the stadol when I told the nurse my pain was now at a 9 out of 10 (all previous answers to this question were no higher than 2). I was going to avoid the epidural no matter what, even at this point, because I was more afraid of the needle sticking out of my spine for hours of labor than I was afraid of these contractions. I have no idea if the stadol dulled any pain, because the pain just got worse, but it did help psychologically because it put me to sleep between contractions. There was no waiting with anxiety for the next one and time flew by. But after five hours of this, I had not dilated any more. But I had vomited plenty! And although I'd fended off the acupuncture (FFS!), I folded weakly and, for the peace of mind of a wonderfully caring nurse, I allowed a volunteer to perform reiki on me. And what a tragedy it was! Wherever she is, there's a good chance she gave up trying to help laboring women, and she may have given up reiki all-together.

The hard labor story ends at five hours because that's about when the nurse actually screamed into the intercom for the doctor. My contractions were sending the fetus into distress.

6. After five hours of intense labor, the fetus was experiencing "distress" at every contraction, as interpreted from his heart-rate monitor. 

Basically, he was bottoming out to a scary heart-rate and only very slowly coming back to a healthy heart-rate just in time to get nailed by another contraction. By the way, this is the official reason listed in my medical records for my c-section: fetal distress.

I know that a heart-rate monitor on the fetus is another one of those medical practices that increases the chances of an "unnatural" childbirth. That's probably because all fetuses are distressed during labor, but observing the horror, and then guessing whether it's safe to let it continue is seemingly impossible. So at some point, like with me and my fetus, they get alarmed and then how do you back down from that?  They gave me an oxygen mask which immediately helped the fetus a bit, but like I said, hackles were already up at this point. Soon thereafter we had a talk with the doctor about how I  could go several more hours like this and get absolutely nowhere with my cervix, and then there are those life and death matters. She never said c-section. I had to eek out between contractions, "So are you saying we need to perform a c-section?" and she said yes, and urgently. A c-section sounded like the only solution at this point both to battered, old me, to clear-minded Kevin, and clearly to the delivery team (and in hindsight, it still does to Kevin and me). Then, lickety-split, the anaesthesiologist arrived, got acquainted with our situation, and made me vomit more. And then like a whirlwind, Kevin's putting on scrubs, and we're told to kiss, and I'm jokingly protesting "I'm a doctor too!" while being wheeled into the operating room because I cannot walk through my contractions.

It's bright white, just like Monty Python said it would be. I sat on the crucifix-shaped operating table to receive all the numbing and pain killing agents through my spine. Somehow they pulled this off while I was still having massive contractions. Then I laid down, arms splayed out to the side, and they drew a curtain across my chest, a nurse told me how creepy it was about to be, and they got to work.

Although the c-section wasn't painful, I could feel everything. This was my childbirth experience. I felt the incision as if she was simply running her finger across my belly, and I felt the tugging and the pressure lifting from my back as they extracted my baby from me. After that, and after I got a short glimpse of him dangly over my left arm--"He's beautiful! He's perfect! He's got a dimple! He growled!"--I continued to feel many things, probably the birth of my placenta, etc...

But I didn't know what exactly I was feeling until I watched a video of a c-section on YouTube. Kevin helped fill in the details too. He had caught a naughty glimpse of the afterbirth scene before being chased back to his designated OR spot with the baby. Thanks to him (and that video) I know now that I was feeling my enormous muscular uterus and some of my intestines being yanked completely out of a small hole right above my pubic bones and then stuffed back in. For a few moments, it must have looked like I was getting re-inseminated by a red octopus.

I tell everyone that it was like going to outer space to give birth. And this, if you know me, is an exciting idea so my eyes are smiling and I sound dreamy when I say "it was like going to outer space to give birth!" I bet you're thinking it's the Prometheus influence, but you'd have the wrong movie. The correct one is Enemy Mine. And it's much more than that, actually. I was as jaw-dropped and awe-struck by humanity during my childbirth experience as I am by space exploration. The orchestration, the specialization, the patience, the years of study, of planning, the calculations, the dexterity. To boldly go. Wow. Like I said, humans are my new favorite animal.

I was back in our little room quicker than most pizza deliveries, where our bright red new baby was trying hard to nurse from his daddy. Then he nursed from me. And the story's all mushy weepy cuddly stuff from now on. So let's not. Let's remember what we're here for. Okay. Right.

7. The cord was wrapped twice around his neck. 

We found this out when he was cut out of me. That didn't help with moving him around in utero to a good position, nor did it help with oxygen flow during contractions! This would not have inhibited his safe vaginal birth, however, at least not necessarily.

8. He was enormous. His head was enormous too. 

He came out a whopping 9 pounds, 13 ounces, 22.25 inches long, with a head circumference of 15.5 inches. They say that's heavier than he'd be if born vaginally because he didn't get all the fluids squeezed out of him. But still, that's large. According to the CDC he was born as heavy as an average 3.5 month-old boy. His head was about the size of an average 2.5 month-old.

Red line is our baby's head circumference at birth. (source)

Way back at the mid-pregnancy ultra-sound, we knew he was going to be something. And then if you'd seen me by the end, like on my due date, you might have guessed I was carrying twins. I was so big that my mom joked she thought maybe a second fetus was hiding behind the other one, undetected.

Smiling on my due date because pregnancy was almost over. 
(By the way, I could still jog and I dressed weird while my body was weird.)

If I hadn't had the means to eat so much like I did during pregnancy, perhaps he wouldn't have grown so large inside me. If I hadn't lived such a relaxed lifestyle while pregnant, maybe he wouldn't have grown so large inside me. If I didn't have a medical safety net waiting for us at the end, perhaps I would have been scared into curbing my appetite from the get go. I gained 40 pounds. With this body, but in a different life, a different place, a different time, maybe I wouldn't have. Probably I wouldn't have.

His size has got to have influenced a few of those other contributors to my c-section. But clearly it's more complicated than his size. And this brings us back to the obstetric dilemma. Let's say he was too big or that his large size screwed everything up, even if he could technically fit through the birth canal. Well then, why didn't I go into labor? Labor triggers are, to me, a significant problem when it comes to explaining the evolution of gestation length in humans, and whether we have a unique problem at the end.

If our pregnancy length is determined by available energy, energy use, and metabolism (here and here) then women like me who go overdue, who are clearly not killing our babies inside us either, are just ... able to do that. But doing that clearly leads to problems in our species (one of the few known) that has such a tight fit to begin with.

If our pregnancy length is determined by our birth canal size, and any anatomical correlates, then why didn't I go into labor before my fetus got so big? What went wrong? What's frustrating too is, for my n of 1, we'll never know if I could have given birth vaginally because I never got the chance to try.

These seem like simple questions but they are deceptively complex. And I think there will be some exciting discoveries to come from medicine and anthropology in the coming decades to explain just how our reproduction works which will in turn help us reconstruct how it evolved.

What's my birth experience got to do with evolution? Why, everything. It's got everything to do with evolution, because if it's not evolution, it's magic.  And that's kind of where I'm coming from when I say that my c-section was still natural childbirth. It wasn't unnatural and it certainly wasn't supernatural. Sure, it's politics. I'm invested in the perspective that humans are part of the evolving, natural world and want others to see it that way or, simply, to understand how so many of us see it that way. But it's not just evolution that's got me enveloping culture into nature and that's got me all soft on the folks who drive fancy cars who cut my baby out of me.

Who knows what could have happened to my son or to me if we didn't have these people who know how to minimize the chances of our death? It's absolutely human to accumulate knowledge, like my nurses, midwives and doctors have about childbirth. Once learned, it's difficult for that knowledge to be unseen, unheard, unspoken, unknown. Why should we expect them to throw all that away so that we can experience some form of human being prior to that knowledge?

Nature vs. Culture? That's the wrong battle.
What matters is which one can fight hardest on my behalf against the unthinkable.

Maybe childbirth is so difficult because it can be. We've got all this culture to help out when things get dicey, with or without surgeons. On that note, maybe babies are so helpless because they can be. We've got all the anatomy and cognition to care for them and although the experiment would be impossible, it's doubtful any other species but ours could keep a human baby alive for very long. It could just be our dexterous hands and arms, but it could be so much more, like awareness of their vulnerability and their mortality,and (my favorite pet idea) awareness that they're related to us. Culture births and keeps human children alive with or without obstetricians. It's in our nature. Maybe it's time we let all this culture, our fundamental nature, extend into the operating room.

Not only can they stand and walk, they can even run!

If I believed in God, I'd feel like the apple of her eye right now. It's because of the timing.

Just as I'm succumbing to a little old-fashioned thinking and deciding maybe now, at 34 weeks pregnant, I'll stop running and stick to the bike, a friend (an angel?) sends me this article in the USA Today about a woman who's also 34 weeks pregnant:

"Pregnant runner finishes 800 meters at U.S. nationals"

Alysia Montano just doing her thing, which happens to also show the world what pregnancy can be. (source)

She's still running like a cheetah.

And guess what? Cheetahs get pregnant too! Always have!

And you know what? Gazelles get pregnant too! Always have!

So whether you see hominins as the predators or the prey at any given time in human evolution, the pregnant ones, at least in our direct lineage, were obviously doing all right. (Flashback to similar thinking, here.)

There's footage of Montano on the move, and an interview about it all at ESPN. Those questions reflect some old-fashioned thinking that I wish the interviewer had explicitly distanced herself from. That's because we're in the future now. Women aren't asked to stop being active, strong humans just because they're growing a kid. In fact, those of us who are active and who have good healthcare and routine pregnancy check-ups are encouraged by our midwives and doctors to stay active, to stay fit throughout pregnancy.

Society expects non-pregnant women to do the same. Society also expects kids growing outside the womb to do the same. Is any of that any different? Do people actually think that all their female ancestors sat on ass while pregnant?

I guess some people don't think. Or maybe they haven't had a rich enough education in both history and natural history to give them the context for thinking about this. Maybe they take a doctor's (god's?) or a scientist's (god's) Word at any given moment, no matter how many decades ago it was uttered, as scripture, forever and ever amen. Especially when it comes to babies, those little miracles.

There are so many of us who've spent our entire lives being active, and as a result are pretty strong human beings. This goes for women who have no choice and must labor physically during their lives to stay alive and well and to keep their families alive and well. But this also goes for women in places like the U.S. where many women have had the opportunity to be athletes as little girls and throughout their lives.

Many of us products of Title IX are reproducing and we sure as hell aren't going to have healthy pregnancies being inactive, being someone else for nine months.

I hope every woman watches Montano and takes inspiration from her if she'd like to. And that might include getting a new and informed, dare I say futuristic, doctor if her current one's holding her back.

I also hope people see Montano running strongly (and disgustingly fast) so that they'll maybe think twice before admonishing a pregnant stranger for lifting that bag of dog food. Or for tsking at her for hiking on any inclines because she should know better and should stick to the flat paths congested with strollers and flip-floppers instead. 

Me, 32 weeks pregnant. On top of Mt. Sargent, Acadia National Park.

To the women and men of our society who have culturally limited expectations of the female body: Watch this video of Montano and then think, react, and act accordingly--with that much broader picture of "woman"--to the rest of us, pregnant or not.

We're everywhere, us active pregnant ladies, but it's something else to see such a prominent one put herself out there like Alysia Montano did. I hope that her two swift laps around that track will go a long way toward expanding minds about expanding uteruses.  

Getting hip about hips

Holly Dunsworth's recent paper and very fine posts here on MT ( the lead-in, the story, what it means for your pregnancy, and cultural and philosophical implications) skillfully discussed important issues about the kinds of explanations people offer for various of our traits.  One of the most subtle, and important, was her explanation of the fact that there can be variation among individuals around a species' characteristic trait (which she discusses here).

In this case, as she pointed out, not all women have the same gestation length, there is variation in metabolism within species, and so on.  Yet, there are general characteristics of a given species that differ from the similar trait in other species.  In other words, the trait is not rigidly fixed, and variation within species and species differences can both be consistent with the same general accounting for the trait.

One way to account for this is to consider the genetic basis of what we call metabolism.  Metabolism, like many if not most traits, is the result of many different processes taking place, and these are brought about by the action of many different genes (often hundreds of them), reacting to conditions in the environment. In this case, those conditions involve diet, type and level of activity, perhaps climate and more.

Different environmental experiences can add variation to a trait like metabolic activity and so on, modifying the exact trait value--like days of gestation for an individual fetus.  Random effects (chance) also almost always plays a role, since no two humans are identical.  Similarly, all the contributing genes, and the regulation of their timing and level of expression, are subject to mutation and vary among individuals.

Successful gestation and maternal survival and infant care can be affected by this genetic variation and for obvious reasons the selective effects can be brutally stark.  Maternal or fetal mortality are huge potential fitness effects.  So there is no doubt that gestation and delivery can be under strong natural selection.  However, that doesn't mean selection favoring one precise direction or trait, or one gene.

Most selection will basically strongly affect women or fetuses who do not 'behave' successfully enough to be born.  But each instance will involve different genotypes, and the selection affecting any given variant in a given gene will likely be very small.  The distribution of the trait in the population--such as hip-width or gestation length--will have some mean (average) value and some amount of variation.  These can change gradually over time, or tend to hover around some rather stable values.

If selection occurs for some other functions that may involve the trait (that is, something about the skeleton or diet and metabolism) distribution of the trait can change.  If this were to happen differently in isolated populations, they will diverge and eventually become different species.  Even just chance meandering of the trait values could leave them different between species.

As a result, each species will have its own mean trait value, while individuals within the species can vary.  This is, I think, just the pattern Holly was describing in her recent post.  It is largely the consequence of causal complexity.  This is not a yes/no, Mendelian pea-like kind of trait in which there are only 2 or 3 states in the population, one of which is favored and the other lethal, so that different species evolve to have only one or the other variant.  It's the result of many different contributing factors.

And this, naturally, ties into the whole issue of the complex nature of genetics underlying traits that, like the ones considered here, are not just simple.  That's why it is difficult to identify 'the' gene or a few genes 'for' the trait, because that's not how the trait is produced.  And that is the problem with GWAS or other attempts to simplify the basis of what we are or what happens to us.

How to apply an evolutionary hypothesis about gestation to your pregnancy

To get up to speed, click on Part 1 here and Part 2 here to learn about the paper I'm writing about below...Or read it for yourself in early view here at PNAS. 

There have been some very personal reactions to the press that came with our recent paper on the evolution of human gestation length.

And I don't mean this kind:

I mean the what about my short/ long/ weird pregnancy? kind.

Result of googling "weird pregnancy"

This research has always been wrapped up in questions about human variation and even draws upon observations of human variation in gestation length. So I'm not surprised it's causing people to reflect on their own experiences. And I'm also not totally surprised because I've been on the planet long enough to know that if you claim to know anything about pregnancy, you get all the stories.

But I didn't fully anticipate how strongly our work about humans as a species would be seen as work about "me." I guess we're only human.

So today's post is for all the people who read media about our paper and are dying to know what it's got to do with their own pregnancy.

Some things first.
1. I see the world through evolution goggles. Take that as close to literal as you can.

2. I have more scholarly experience with skeletonized (dead) and fossilized (extremely dead) humans than living ones.

3. I am not trained in medicine or health sciences.
4. I will not give medical advice.
5. I do not know what doctors are, or should be, telling pregnant women about eating and exercise.
6. It took me five years to write this paper from first notes to publication and I needed the help of brilliant experts to make it as strong as it is. I do not expect to fully appreciate its implications on the week it is published--not for human evolution, not for pregnant human mothers, not yet! If you have ideas... go on with your bad self and test them! I'll try to do the same.

Here we go, then...

How to apply an evolutionary hypothesis about gestation to your pregnancy

#1 thing to think about. 

Evolution is everything about you, but it is not all about you.

When reports of our research say "moms" we're not talking about you in particular. We're talking about "moms" in a general comparative evolutionary context, species-wide, primate-wide, mammal-wide.

#2 thing to think about. 

The EGG hypothesis explains species-level phenomena

Many evolutionary papers like ours are about understanding species level phenomena and comparing differences and similarities between species to better understand those phenomena, to explain whether patterns exist and, if they do, how or why.

So using the EGG hypothesis to explain why you gestated 9 days past your due date is a little bit like this: Try using the broad ecological and biological rules and patterns that explain variation in body size across mammals to explain why Fred the elephant is 9 cm taller than Frank the elephant. That's a challenge. That's what you're attempting to do if you read our paper (or reports on it) and think of yourself first rather than your species.

Here's another way to think about it. You might have seen our paper described as finding, "Metabolism, not the hips, limits gestation."  Metabolism might get you thinking of yourself but the hips hypothesis (obstetrical dilemma; OD) never did right? I could be so so wrong but nobody thinks that there's some way the fetus can sense when its head or shoulders are about to be too big to fit through the birth canal and then initiates labor so it can escape. Nobody thinks that the mom's body can detect when the baby is about to get too big to pass through her birth canal and initiates labor so it can escape. Nobody really thinks that these sorts of mechanisms exist in mothers do they? (It's possible but I don't know of any literature suggesting this.) So the hip constraint hypothesis (OD) was never about individuals, it's about our species over evolutionary history, with hips shaping our gestation length to be the right length for babies to escape in time. Generations over deep time... that's where your brain needs to be with this EGG idea too.

Sure, we need to consider individual human variation, like yours and mine. To formulate the EGG hypothesis we drew heavily upon Ellison's (2001; and in our paper) metabolic crossover (MC) hypothesis for the timing of human birth: Babies are born when they begin to starve in utero. This happens when the needs of the fetus surpass the mother’s ability to meet them or, in other words, cross over to become larger than what the mother can provide. Labor is then triggered and carried out by a complex biochemical process. Some of the evidence he provides includes:

Gestation length can be truncated according to metabolic parameters.

• Gestation is shorter in mothers with lower body fat composition and lower metabolic rates (Klein et al., 1989; Ellison, 2001)
• Mothers living at high altitude can give birth earlier than counterparts at low altitude (Lichty et al., 1957)

Gestation and fetal growth can be increased according to metabolic parameters.

• Fetal brain size pathology à longer gestation (Higgins, 1954)
• Increase maternal caloric intake à neonatal increase (Prentice et al., 1981)
• Increase maternal caloric intake à preterm births decrease (Prentice et al., 1981)

The MC is very much about individual within-species variation and it's possible that the MC explains all individual variation in gestation length among humans, however, that's uncertain right now. Since it's specific to the biochemical pathways of humans, the details of the MC don't apply to other species with different physiologies. However, the idea that human gestation is limited by mother's metabolism--the cornerstone of the MC-- is what EGG applies to human/hominin evolutionary history and to gestation in other primates and other mammals as well, since a mother's body size (a nice proxy for metabolism) predicts fetal size and gestation length across mammals.  This is really not news to a lot of researchers considering the body of research supporting it.

It's a useful method in evolutionary biology to look at variation within a species and use it to hypothesize why variation exists between species. That is what we have done with EGG. Mother's body sizes differ between species like say, humans and orangutans, and so do their metabolic traits! EGG suggests variation in metabolism between species explains variation in gestation length. It predicts that species do not exceed their species specific metabolic ceiling during pregnancy. It will be exciting to find out whether some species give birth well before they reach their metabolic capacity!

#3 thing to think about. 

Evolution is about common ancestry and change over time. "Ideals", "optimization," "standards," "greater value in this form, lesser value in that one"... these do not exist in nature except in our minds.

You worrying that you gestated too long or too little compared to the species average is a bit like you worrying that you're shorter or taller than average, have a larger or smaller head than average, have more saliva than average, or that you can't intentionally fart. Stop worrying about your normal variation. Variation exists because it works. There's safe wiggle room around most traits and sometimes there's even full-on spasmodic dancing room. We'd be extinct if there wasn't any room for variation in how to survive and reproduce. Celebrate your weirdness, your slightly long healthy gestation, your slightly short healthy gestation, your big healthy baby, your small healthy baby, your freckles, your asymmetrical face, your hairy knuckles, your lack of wisdom teeth, your pterodactyl toes. Who cares! If life's getting on with your weird ass, then you can certainly get on with life.

Further, it helps if you don't require EGG to be all about adaptation. It could be. But it's easier to think of it as just the way it is. Mothers can only gestate so long. Period. The mechanism that initiates labor based on those metabolic cues (MC)... totally adaptive! The process the EGG explains? Not really ... a limit's a limit! How could it surpass it? It would be physiologically  impossible. Adaptive ideas aren't necessary for EGG unless it's somehow adaptive to keep the fetus inside mother right up until that threshold. Which is possible. But it could also just be the only way to trigger labor. And so we're back to the EGG being just how it is.

***

So how should you apply this evolutionary hypothesis to your pregnancy?

It sheds light on why it's difficult to give birth. It sheds light on why babies seem so helpless compared to other primates.

But regarding your specific individual details that differ compared to other human mothers and their babies?  Please talk to your doctor who's your main brain on this. And read read read read read, if you're interested.

There are some pretty cool cultural and philosophical implications of our paper. I'll save those for tomorrow's post.


References
Ellison, P. 2001. On fertile ground: A natural history of human reproduction. Cambridge: Harvard University Press. [link to book on amazon]

Higgins LG. 1954. Prolonged pregnancy (partus serotinus). Lancet 2: 1154.

Klein, J, Stein Z and M Susser, (1989) Conception to Birth: Epidemiology of Prenatal Development. New York: Oxford University Press.

Lichty JA, Ting RY, Bruns PD, and E Dyar. 1957. Studies of babies born at high altitude. Part I. Relation of altitude to birth weight. American Journal of Diseases in Childhood 93: 666-669.

Prentice AM, Whitehead RG, Roberts SB, and AA Paul. 1981. Long-term energy balance in child-bearing Gambian women. American Journal of Clinical Nutrition 34: 2790-2799.

If it causes harm in mutant mice, should it cause alarm?

I clicked on the link to the article called "Is it folly to take folic acid?" and I'm betting many of you would too if you saw a headline like that. 

The provocative title reeks of those that tell us bananas might actually be poisonous or that we should beware the dangers of broccoli.

The story opens with an acknowledgment that pregnant women 'round the world are encouraged to take folic acid supplements to reduce risk of birth defects. The government even fortifies our food because it's so effective.

But wait, there's "a new mouse study [that] shows that folic acid supplementation can itself sometimes increase the risk of birth defects or even cause the death of embryos."

What? How could that be? The results are actually from experiments "in mice genetically predisposed to giving birth to embryos with neural tube defects."

So the lesson is not to stop taking folic acid supplements if you're pregnant; it's to stop giving folic acid supplements to mutant mice. 

Now tell me... why the scary headline next to the photo of the blissful pregnant woman? 

Because I clicked on it, didn't I?