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0:00:00
Ben Radford: Welcome to Squaring the Strange, the podcast that examines all manner of the mysterious and the mundane through a critical lens. So let’s square the strange.

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0:00:10
BR: Welcome back to Squaring the Strange. We are in episode 67 and we have with us this week, as we often do, Celestia.

Celestia Ward: Howdy.

BR: Howdy. And we don’t have Pascual. Pascual? Yes, I’m correct.

0:00:36
CW: No, he’s not here.

BR: He’s not here unfortunately, but he will be back soon. But meanwhile, we have a topic that is near and dear to our hearts and particularly yours, Celestia

0:00:58
CW: Yeah, it’s just about five inches below my heart, I think. We’re gonna be talking about pregnancy woo today, and I’ve been kind of wanting to do this topic, and just, you know, little things have popped up that I’ve been saying, oh, we could do a Swayso on this aspect of this, you know, what to expect when you’re expecting book or that aspect of common urban legends about pregnancy. And it just kind of coalesced into, oh, crap, I’ve got enough stuff for a whole hour here, at least. And wow, you could do a whole series. I’m sure people have. I’m sure if you look, you’ll find podcasts just about pregnancy and about all the stuff that people are told during pregnancy. So the first thing I learned when I let people know I was pregnant was that it opens you up to this whole community that you did not even know was really there, namely a word of mouth community, almost a folklore community. My mother told me and her grandmother told her community.

0:01:59
BR: The wisdom of the masses.

0:02:01
CW: Yes, the friend of a friend and even medical doctors and nurses. I know another young lady who is pregnant right now that we know each other through the Center for Science and Wonder. It’s a very secular, very skeptical group and she’s rolling her eyes because her mother-in-law is an OBGYN nurse and she says, yeah, we’ve got confirmation genetically and on the sonogram that we’re having a boy and my mother-in-law insists it must be a mistake because if the fetal heart rate is above 150 that means it’s a girl. And no, there’s no information for that. She’s just kind of got this myth or legend stuck in her head that if the fetal heart rate is above 150 it’s a girl even though you have confirmation it’s not. So yeah…

BR: But my understanding was that if you’re carrying low, it’s a girl.

0:02:50
CW: Oh, yeah, I’ve heard that, too. I’ve also heard if you’re carrying low, it’s a boy.

0:02:54
BR: I’ve heard that’s contradictory. So let’s see which one of these is true. They can’t both be true.

0:03:00
CW: Well, I’m carrying kind of high, I think, but I think it might depend on your bone structure to believe it or not.

BR: Well, let me ask you this. Why is why is this such a fertile topic for woo and misinformation?

0:03:16
CW: Well, you know, there’s a couple reasons I’m assuming. Number one, baby books and pregnancy books are just everywhere. You can go to Amazon and buy a hundred books on how to enjoy your pregnancy, how to eat your placenta, all sorts of other things. And in the medical community, there’s also a desire to make the expectant mother feel comfortable. So I think there’s a level of tolerance for a lot of things. I spoke to a friend of mine who is, her name is Karen Shriver East, MSN, RNC, MNN, and she’s getting her DNP, her doctorate in nursing practice, and she’s done maternal and newborn nursing since 1991. And one of the things she told me is, you know, for pain relief, we just, you know, whatever makes makes the person comfortable. If they want Reiki, if they want whatever they want to bring into the birthing room to control their pain, it’s fine by them as long as it’s not actually doing medical damage to themselves or the baby. And so there’s a level of tolerance that you might not find in other practices. It’s very holistic-centered. A lot of people are choosing to have their child at home myself and my three siblings were all born at home with absolutely no care yes we all made it to tell the tale so that’s good but it doesn’t always go that way and I’m certainly not going that route however one thing I have noticed dealing with all the doctors and the insurance and the testing and the things that go wrong administratively because you know yeah I don’t know what the average medical experience is, but my insurance has been wrongly copied down. I’ve had I’ve been sent to the wrong place. I’ve had appointments messed up. I’ve had all sorts of things have just kind of gone wrong in the administration of the health care.

0:05:07
CW: I don’t really I don’t really have complaints about the doctors themselves. But like any bureaucracy, there’s a lot of stuff that can go wrong just between the filing cabinet and the phone. And that can be incredibly frustrating and make you lose confidence. I’ve gained a whole new understanding for why exactly people throw their arms up and say, forget it, I’m going to buy a kiddie pool and have this kid in the backyard while I bite down on a stick. So I’m not advocating that, but I’m starting to understand it.

BR: Ouch.

0:05:42
CW: So that said, we’re going to talk about a few things on this episode. I’ve taken a lot of notes and of course I’ve got 1100 pages in books between What to Expect While You’re Expecting and another book, The Mayo Clinic Guide to a Healthy Pregnancy, both of which are widely available and probably the best-selling books on the topic. None of this is medical advice, however, listeners. This episode is not a medical advice episode. Do not take anything we’re saying as medical advice. Talk to your personal health care practitioner. I’m just going to do a tour of things I read about and things I learned on some deep dives and some interesting information when it comes to growing another human being inside you.

0:06:29
BR: Well, certainly, you know, in the realm of folklore, there’s lots and lots of stuff about pregnancy and babies and, you know, carrying low, carrying high, and the midwife tales or old wive tales, which may or may not overlap with midwife tales. One of the ones that jumps to mind, there’s lots of stuff, but one of the ones that jumps to mind is the old belief about maternal impressions. And it used to be believed that an expectant mother’s experiences would imprint directly on the fetus. That’s one reason why hundreds of years ago, expectant mothers would be particularly cautious about being frightened or scared, for example. The idea was that if a woman’s walking in an alley and a black cat jumps out and terrifies her, that experience would imprint on the baby and the baby might have feline eyes or a tail or something else like that. That actually, one example, perhaps a random one, but one example that I think of is John Merrick, the Elephant Man. Oh. As I recall that story, there was this notion that, in fact, it’s been a long time, it’s a David Lynch film if I’m not mistaken. It terrified the hell out of me when I first saw it and I haven’t seen it since then. But there’s, if I’m not mistaken, there’s one scene where there’s rampaging elephants in this sort of dark area and it’s sort of this dream sequence. And that reflects the notion at the time that John Merrick’s mother was frightened or had some terrifying psychologically traumatic experience that then translated into his condition. And that’s, you know, again, this was widely believed for a long time. And one of the tragedies, of course, is that that in a way blames the mother.

0:08:22
CW: Absolutely.

0:08:23
BR: And you know there are many many reasons for birth defects and deformities and to have this notion that well it’s the mother’s fault because she wasn’t careful enough to avoid being scared, she was too histrionic at things. It really is just really, you know, it just sort of adds insult to injury for the poor mother and family.

0:08:49
CW: Well, and in some form that even persists now. I’ve got a friend of the family who she’s got like a few kids and one of them is, shall we say his temperament is a little problematic. He’s not a very nice grown up, but she even recounts to this day that during her pregnancy with that child, she was really angry at her husband who soon became her ex-husband and she was like, I was so angry the whole time I was pregnant and I know it had an effect on his personality, on the baby that resulted. And you know, it’s one of those really lodged in folkloric or possibly even psychiatric aspects of pregnancy and hormonal development on the brain that it’s hard to shake.

0:09:36
BR: Well, yeah, and part of it’s because, you know, there is a certain plausibility to it. I mean, we know for a fact that women, for example, shouldn’t drink or certainly drink heavily.

0:09:48
CW: Oh, now you tell me.

0:09:49
BR: God. You know, I mean, there are various medically grounded pieces of advice regarding what women should and shouldn’t do, as you well know, because it will, in fact, or certainly has the potential to, in fact, harm their kid. And so for the general public, there’s an easy leap between, well, she shouldn’t drink, but why is it that she shouldn’t drink? But if she’s terrified, why wouldn’t that hurt the kid? Or if she’s angry at her husband or something, why wouldn’t that translate into some sort of manifestation? And you also see this in the belief about body memories. And that’s something I’ve done some research on. We should do a whole show on that but it’s this notion that psychology imprints on the body in the experiences and so and you’ll see this for example in massages people talk about Oh, well, you know, there’s a knot in your back. Was there some traumatic experience recently? And again, there’s there there’s a there’s a hint of truth To that. I mean, it’s certainly true that the psychology can manifest itself in physical disabilities disabilities, but the idea that a specific thing causes a knot in your back or a bump on your head or on your feet is a little more dubious.

0:10:57
CW: Well, that’s almost like a human physiological version of the stone tape theory when it comes to ghosts.

BR: Yes.

CW: Something traumatic happened in this house and it’s, you know, the impression of that bad thing is in the walls like a recording.

0:11:10
BR: Exactly.

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BR: So what are a couple of the examples you found?

0:11:28
CW: Well, one that kind of worried me early on that I read about in, again, What to Expect When You’re Expecting is the idea of baby brain. I had my friends warning me about this, especially the first trimester, they say you’re extra fatigued, you’re extra kind of drained out because your body is building a placenta and apparently that is a difficult thing to do. It’s a bit taxing on your system. It’s the idea that you get dumber or at least more forgetful due to some physical change in your brain that’s been nicknamed baby brain, placenta brain, pregnancy brain or momnesia.

BR: Momnesia, really?

0:12:05
CW: Yes. People say that this is an early onset thing, you’re going to notice it in the first trimester and you won’t get rid of it until that kid is like a toddler or sleeping through the night year, year and a half later. Many of my friends with children warned me about this and there’s even sort of an evolutionary just so explanation for it. Some people say that, well, this helps the woman prioritize her coming baby because she’s just going to forget about everything else. She’s just going to focus on the child and she’ll forget about her car keys and her cell phone and her appointments and everything else on her grocery list and such. Now, interestingly, in some of the rat studies, mother rats actually show an improvement in multitasking ability once they get pregnant. But any good skeptic knows that you read a rat study with the mantra, rats are not humans. So how real is it and is it something we have to worry about? Which quite frankly, Ben, if we had to worry about it, you guys would have been on my case months ago for forgetting stuff left and right. Has that has that been happening?

BR: Not left and right.

CW: Okay, not left and right. I am usually a multitasker, so I do drop balls occasionally as I juggle. Well what to expect while you’re expecting says quite confidently that it’s a real physical phenomenon and that a woman’s brain cell volume actually decreases, which is a change triggered by hormones and for unexplained reasons, moms expecting girls are more forgetful than those expecting boys, but don’t worry your brain will quote plump back up a few months after delivery now the book doesn’t cite any studies on this and I came to sort of read much of what’s in the book what to expect while you’re expecting with a big grain of salt Especially after I got past the section telling me that I should spend the extra money to buy organic non-GMO produce because it’s worth it for my unborn child and me.

0:14:05
BR: So in a way, this show could be titled, What Bullshit to Expect When You’re Expecting.

0:14:14
CW: Yes. Well, this book casts a wide net and the authors are very careful to sort of take you on a little tour of what many people believe about pregnancy without completely discounting it but without fully advocating it.

0:14:32
BR: So this is a form of “they say”.

0:14:34
CW: Yes, there’s a lot of “they say” in this book and so once I got to the section telling me I should go buy some non-GMO organic produce, I promptly ordered another book. But to combat baby brain, get this, the What to Expect While You’re Expecting book says, ginkgo biloba will boost your memory, but sadly it’s not considered safe to use during pregnancy. So yeah, it’s telling you to take ginkgo biloba to help your brain improve, but at least it does go to the lengths of telling you not to take herbal supplements. They’re not a good idea during pregnancy. So I give it a couple of points for that at least.

0:15:14
BR: Yeah, I guess, you know, hey, you know, you could use this, but don’t. Well, how about just not say it or just tell people flat out don’t.

0:15:24
CW: Yes, well, they don’t really take a hard stand either way. They’re very, like I said, and we’re gonna go through a lot of this as we get through the other topics I’ve got here. The what to expect while you’re expecting is kind of an every man’s guide. It’s not a very specific list of evidence-based recommendations. It’s just kind of a, oh, and some Chinese practitioners think this, and many doulas advocate this, blah, blah, blah.

0:15:54
BR: Is Dr. Oz a contributor to that book? I don’t recall.

0:15:57
CW: No, he is not. I would be very upset if he got any of my money for this book. So turning to the next book I bought right away, The Mayo Clinic Guide to a Healthy Pregnancy, it’s a somewhat shorter, well shorter, it’s like only 500 something pages instead of 600 something pages, book that really takes a strictly medical tack. There’s some talk about feelings and legends, but they flat out call something an old wives tale if it’s an old wives tale and good for them. So on page 138 of the Mayo Clinic guide it says, quote, there isn’t enough information to support the existence of baby brain. Women frequently report cognitive changes, especially forgetfulness, but studies examining the relationship between pregnancy or early motherhood and changes in a woman’s ability to think, however, have produced conflicting results. Because the concept of baby brain is so widely accepted, some experts suggest that pregnant women and new mothers are more aware of everyday cognitive slips. As a result, they mistakenly perceive themselves as having trouble thinking. So, in short, what they’re telling you is don’t assume you’re experiencing a cognitive decline. And I really got to say, there’s a lot of cognitive bias that happens. Another tour de force that I have had in terms of understanding stuff is realizing how susceptible we all are to confirmation bias. You are expecting this list of things that could happen to your body or your mind while you’re in this pregnant state, and you notice all these little things, and you’re like, Oh, I’m smelling the aroma of something cooking. It’s said that my sense of smell would get heightened while I’m pregnant. That must be happening. Every little thing is just a little marker of, oh, this thing is happening to me because I’m pregnant.

0:17:53
BR: And you see this in many areas. I have friends who are in their 40s and they say, well, I sometimes forget things or I lose my keys, whatever else, you know, must be, I’m at that age.

0:18:05
CW: A senior moment.

0:18:06
BR: Right. When in fact, I mean, I, all of us have done that all of our lives. We just don’t pay, you know, when we’re in our 20s, we don’t think, oh, we were just like, oh damn, give me the keys. Right. But so at a certain age, maybe in the 40s or 50s, whatever else, we begin attributing it rightly or wrongly to age. Whereas the exact same phenomena had happened 20 years ago would have been either ignored or not attributed to something else

0:18:31
CW: Yeah. Well, I Went through a little tour online of the studies I could get my hands on and from web MD quotes a 2010 study led by Helen Christensen PhD at Australian National University at Canberra and it was published to the British Journal psychiatry and it was published to the British Journal of Psychiatry. She says, when focused on a task, women who are pregnant or new mothers do not have quote, cognitive deficits and they perform as well as their non-pregnant contemporaries. And she further told WebMD in a later interview that women may have memory lapses and change their focus to children and upcoming birth, but this does not mean they have lost their capabilities. Now her test is fairly large. It cast a pretty large net over about 1240 women aged 20 to 24 that were part of a larger cohort. They were, but the women who were aged 20 to 24, about 1200 of them, and they were recruited to establish baselines. And then they had follow-ups in 1999, 2003, and 2007. And out of the women who had taken the baseline testing, 188 of those became mothers between the study check-ins, and 76 were pregnant with their first child at just the right time to be studied. So rather than relying on which many of these studies do rely on just self-reported data, this researcher actually established a baseline first, which allowed for data to be measured for them both before and during their pregnancies individually.

BR: Okay. That makes sense.

CW: Yeah, which is very important and she did not find any sort of decline and her findings led to a daily Telegraph headline proclaiming, pregnant women’s brains are not mush. So bully for that. I might be a little biased here. I really don’t want to think of my brain as turning to mush. But if it is, I want to know about it. Christian Jarrett, who wrote for the British Psychological Society, looked over the research and found, not surprisingly, that self-reported studies, as I mentioned, always seemed to turn up evidence or evidence, in quotes, of baby brain. Two-thirds of women report having trouble with memory or attention that they ascribe to pregnancy. But in objective studies, such an effect was far trickier to tease out. A meta-analysis by Julie Henry of the University of New South Wales in Sydney and Peter Randall at the Australian Catholic University in Melbourne, which was published in 2007, looked at 14 different studies conducted over 17 years and concluded that it is those that placed quote, relatively high demands on effortful processing and specifically, measures of free recall and the executive component of working memory that found a reliable, albeit small, deficit among pregnant women. So methodologically, depending on what you test, you might get evidence of an effect or you might not. It’s worthwhile to note here that there’s also a societal bias at work. Even a bias that casts women in sort of a negative light as being a slave to their hormones like such perceptions can also influence and have influenced self-reported studies on PMS and menopausal cognition. So all of these also need to be looked at in light of some confounding factors. Now, Ben, you’ve never been pregnant, so I’m going to let you know a couple of things here.

0:22:09
BR: Okay.

CW: Pregnancy brings sleep disturbances. It can be from just not being comfortable when you get further on. You have to sleep on your side a lot, and if you’re not used to that, it kind of disrupts your sleep a little bit. You’ve also got some anxiety and sometimes some scary pregnancy dreams. I had a weird one last night about eating ice cream out of a lobster. I’m not sure what that means.

0:22:30
BR: Sounds like something Dali would have come up with.

0:22:33
CW: Yeah, a little surreal. I don’t really have food cravings, but I’ve been having a lot of weird dreams about eating weird stuff. Anyway, there’s a whole new level of multitasking that happens in your life. Suddenly, you have a time limit and you’ve got to rearrange your house, buy a bunch of new baby furniture and supplies, and fit in about a thousand doctor visits as well as juggling the bills from all that because it all costs money. So give a person all these new tasks and take away a lot of their sleep and see if they perform a little bit worse on tests or feel a little bit dumber or more forgetful.

0:23:07
BR: I expect I would.

0:23:08
CW: Yes. So confirmation bias and confounding factors definitely enter into it. Now, I also looked at evidence for this physical change that supposedly happens to your cognition. I also looked for evidence in terms of imaging studies, and they have had a few studies that have lent support to what’s looking like a myth on the outside to me, but when you see actual black and white, there it is in a photograph, in an MRI, it’s hard to really dispute that. But let’s take a look at some of those. In 2002, a brain imaging study by Angela Oatridge et al, at Imperial College School of Medicine, found that women’s brains shrank during pregnancy, and then recovered their previous size a full six months after birth. But that study used only nine healthy women. It was studying the differences between healthy women in pregnancies and five women who had preeclampsia.

BR: So the end was nine?

0:24:10
CW: Yes, the end was not the whole total and was 14 but five of those women had preeclampsia. So it was only nine healthy brains that they looked at and the researchers themselves said that the results were speculative. Now, also I could not find any indication of how much they shrink. Are we talking a shrinkage of 0.0001 or 0.02? I don’t know, but it did say it was statistically significant, but again, it’s an N of only 9. So, and then moving forward, a December 2016 study in Nature Neuroscience by Elselin Hukzima and her team in Barcelona used MRI imaging to take a look at the brains of 25 new mothers. So, at least it’s a bigger N size. And they found a decrease in women’s gray matter during pregnancy and that persisted until about two years after their child was born. Do you know much about gray matter?

BR: No.

CW: Yeah, well, it’s a little murky. These volume changes overlapped with brain areas that responded to babies’ postpartum. That is, these are the same areas of the brain that lit up when mothers interacted with their newborns. And so the volume changes actually predicted measures of maternal attachment. The women who showed more decrease in gray matter in these areas were actually more attached to their infant when the baby was born. So it does point to an adaptive process going on in the brain in preparation for bonding with a child, perhaps. Now, unfortunately, I found a lot of really sort of slapdash, quickly composed articles touting this study as, well, science has explained why pregnant women get really dumb and forgetful. Their gray matter is shrinking. That’s not exactly what happened. That’s overreaching and the study itself disagrees with that assessment. In interpreting this study, it’s important to parse out shrinking as something that is not inherently good or bad. It’s just a change to the composition of your brain. Gray matter losing volume means that there’s a change taking place, but we shouldn’t succumb to the knee-jerk reaction of assuming, oh no, my brain is shrinking. That means I’m getting dumber. The brain is very elastic. It repurposes itself. And the researchers themselves noted that they did not find cognitive decline or pregnancy-related memory loss.

0:26:39
BR: So, what’s the point? I mean, if you…

0:26:41
CW: Well…

0:26:42
BR: Wouldn’t the relevant factors be things such as cognitive decline or memory loss?

0:26:49
CW: Exactly. And if you found the two of those together, if the gray matter shrunk and you found objective studies determined cognitive decline, then you could sort of make that lump of, okay, that might be connected there. However, this might clear it up. There’s a PhD quoted here that I think kind of says it perfectly. This is from a 2017 article in Healthline.com by Kimberly Holland discussing that study. If the thought of a shrinking brain is alarming, it shouldn’t be, says Robert Frumke, PhD, neuroscientist at New York University’s Langone Medical Center. Instead, think of it as the brain is making itself smarter and more efficient. Quote, there’s a difference between an apparent reduction in gray matter and the brain shrinking, he told Healthline. The brain itself doesn’t shrink. It’s not at all clear what actually goes on when gray matter is reduced. Frumke offers an easier way to understand this change. Think about this as a form of spring cleaning. It makes things more organized, streamlined, coherent to prepare mothers for the complexity and urgency of child care, he said. Quote, If neurons are closer together or neural connections reorganized to disregard irrelevant synapses and preserve important synapses or otherwise able to more effectively, reliably, and rapidly process critical information, it’s easier to imagine why this might make sense and help the maternal brain respond to the needs of her baby. So now I’m kinda hoping for a supercharge to my brain after reading that.

0:28:24
BR: Well it certainly highlights the difficulty in getting really solid, reliable, qualitative and quantitative research. It’s inherently difficult to measure these sorts of things and particularly when we’re talking about like for example confirmation biases in pregnancy, people say, well, I tried X and it turned out fine. All right. Well, that was one pregnancy. You didn’t try Y, did you? By definition if you tried something then you chose a particular course of action and the fact that it turned out well could be attributed to that or it could be irrelevant to that.

0:29:02
CW: Yeah and there are so many other factors and particularly with neuroscience.

0:29:06
BR: Well I mean part of it is you run into the difficulty of doing adolescent and baby and fetal research, including, for example, in psychology, right? You quickly run into ethics problems because you can’t ethically pick a hundred newborns and isolate half of them and basically abuse them or not expose them to light or whatever else and certain things. I mean, there’s very, very clear and strong ethical considerations. And so because we are concerned and science is concerned about ethics and human development, it does mean that it’s not always crystal clear exactly whether a particular substance is going to have a particular effect on a fetus.

0:29:48
CW: Well, yeah, that’s another reason why a lot of the studies for expectant mothers are simply self-reported. You can’t expect mothers to, you can’t separate them into blind groups and have 10 of them purposely sleep deprived themselves and the other 10 not, you know, without separating confounding factors. It’s very difficult.

0:30:12
BR: Absolutely. Well, let me ask you this. So what to what extent do you see the naturalistic fallacy appear in pregnancy woo?

0:30:19
CW: Well, oh, geez, it well, when you’re reading the book, what to expect when you’re expecting it on, it’s on practically every page. So I hit chapter 3 and a whole half of that chapter, it’s titled by the way, Your Pregnancy Lifestyle to give you a heads up about what that chapter is about, and half of it is just titled Complimentary and Alternative Medicine. The authors, like I said, they do a bit of tightrope walking in trying not to really say a single bad thing about CAM, while they don’t really outright endorse it either, because I think they’re trying to avoid lawsuits, but also avoid alienating the hippie moms that are reading the book.

0:30:58
BR: So, but what’s the point? If you’re going to give both sides to a story that there aren’t both sides to, then you’re misinforming your readers.

CW: Yes, they are, but they’re doing it in a way that allows them to not be sued, I think. Just my opinion there. I got a lot of that feeling as I read through and imagined these paragraphs being formulated.

0:31:23
BR: Yeah, but if, I mean, if, they’re not gonna be sued for saying that acupuncture is not effective for pregnancy. I mean, that’s non-actionable statement. They’re not gonna be sued by an acupuncture association.

0:31:37
CW: What I’m saying is they’re walking the line between getting sued by saying acupuncture will cure you, which it doesn’t. That’s wrong medical information. But they also don’t want to alienate readers. It’s a very mass marketed book. They want they want to appeal to everybody, including the moms who are full in, like knee deep with this stuff and would immediately return the book for a refund if they said anything bad about their pet aspect of CAM.

0:32:07
BR: You mean the goop moms?

0:32:08
CW: Yeah, the goop moms and the mommy bloggers and you know, there’s a whole…

0:32:14
BR: Step one, remove the jade eggs. Step two…

0:32:18
CW: Yes, I recommend Science Moms to anybody out there. Coven Synopathy and a number of her colleagues have put out a lot of articles combating the goop moms and all the woo that gets thrown at expectant mothers and mothers of young children. Anyway, so in this section on complementary and alternative medicine in the book, What to Expect When You’re Expecting, it suggests that there’s something to a lot of this, you know who knows it’s not not not scientifically proven, but… bere I’ll quote from a quote from this section on acupuncture acupuncture has been working its medical magic for thousands of years to relieve pregnancy woes or later on about moxibustion many in the CAM community say moxibustion – Which is the burning of mugwort an herb near the little toe can turn a breech, baby, so…

0:33:15
BR: I’m sorry can you can you read that in like in like real English?

0:33:21
CW: They are saying that many in the CAM community right say that if you take some mugwort, which is like a smelly herb, and you burn it right by your little toe, your baby if it’s breech will turn itself right side up.

0:33:38
BR: Oh, OK. That OK. It didn’t make sense the first time you said it, but I get it now.

0:33:42
CW: Apparently, I have no idea what the mechanism would be. But if you burn an herb by a certain part of your body, it’ll make your kid do a backflip.

BR: Ipso, facto.

CW: Anyway, I’ll quote page 78 here, which talks about the whole idea of CAM. Pregnancy isn’t an illness. It’s a normal part of the life cycle, making the holistic view of health and well-being that CAM encompasses, which integrates not only physical influences, but nutritional, emotional, and spiritual ones too, seem like a pregnancy natural. And for more and more pregnant women and the traditional medicine doctors and midwives who care for them, it is. A variety of CAM practices are currently being used in pregnancy with varying degrees of success, including, and it goes on for pages and pages describing acupuncture, acupressure, moxibustion, chiropractic, massage, reflexology, hydrotherapy, meditation, hypnotherapy, biofeedback, and herbal remedies. Yeah, again, you’ll see how carefully crafted it was to not say that studies show this will work for you, it just says more and more women are using it and the practitioners believe blah blah blah, you know, so it’s kind of walking that line. Now I was particularly interested in massage because there are definitely conflicting things that you are told about massage when you are pregnant. What to expect while you’re expecting says on page 154 and then it repeats it again, the next page, that if you massage the area or if someone massages the area between your ankle bone and your heel, it could trigger contractions. They don’t specifically say this is a reflexology idea and that no doctors really believe this. They just say-

0:35:29
BR: They don’t add that caveat, why not?

0:35:31
CW: They just say, watch out if you get a foot massage. Now any pregnant woman knows your feet swell up, you put your feet up, your husband walks by and lovingly gives you a foot rub. What? Wait, hold on, you’re telling me that I could go into early labor because of this? No, no, that doesn’t make any sense. Why wouldn’t your doctor warn you about this if this was really the case? Well, I looked in the Mayo Clinic guide and I found no such warnings about massaging your feet and though it does mention that massage is great for relaxing your muscles and releasing endorphins and even controlling for pain during the labor process, but nothing at all about early labor or it being a danger in the first trimester. And many mom-to-be sites encourage pregnant women at all stages to put up their feet and you know and get a massage. It helps. So is it dangerous or does it help with circulation? Is it good or bad or is it a little of both? Where does the truth lie? Again I I did not have a year or two to do a deep dive into this so don’t take anything I’m saying here is medical advice talk to your doctor but most massage places will not book an expectant mother even for a prenatal specific massage in their first trimester and the place that I normally go to actually for my massages will only take pregnant women in their first trimester if they have an authorization from their doctor. And I could not get one. My doctor’s office just has a blanket, like, nope, no massages in the first trimester. And the reason I was given was, oh, well, it can release toxins from your muscles and during the first trimester, you know, the embryo is more susceptible to that. And on the surface, that sounded okay, reasonable. But I found plenty of information out there refuting the idea that massage actually releases toxins.

BR: I was about to say that. And I’m like, hold on, hold on.

0:37:29
CW: Again, you have that magical word, toxins and detoxing. Now I know lactic acid does build up and massage can help get rid of it, but lactic acid forms from exercise and if you let just about an hour pass after you exercise hard, the lactic acid buildup is gone anyway. So, it will feel great and it will help your circulation, but massage doesn’t really detox anybody.

0:38:01
BR: It reminds me of some of the research I did into so-called miracle springs and healing waters in several places including up at Ojo Caliente in northern New Mexico. One of the most common benefits to not only just going into the hot springs and all that but also getting a hot wrap was the idea of sweating out toxins. I heard this all the time. Everyone is like, of course you sweat out toxins. As I began researching it, it pretty quickly became clear to me that you don’t actually sweat out toxins. You sweat out mostly water, a little bit of urea, but that’s not how the body gets rid of toxins, is through sweat. Sweat is a way of controlling your body’s temperature. It’s not a way of reducing toxins.

CW: If you don’t want to expose your fetus or your embryo, whatever stage you’re in, to toxins, well, ladies, don’t have your liver removed while you’re pregnant.

0:39:03
BR: That would be my first guess.

0:39:06
CW: Hold on to your liver. That’s what takes care of the toxins. You’ll be all right as long as you don’t do that. Now, going through various massage websites, which again, massage is so integrated with the whole, the whole world of woo that it’s hard to really find anything that you’re certain about on anything online about massage. I did however find a ton of people saying this is such a myth. It is absolutely a persistent myth that massage does any harm in the first trimester. There’s a lot of massage therapists certainly who are saying that and you know you don’t want somebody pushing directly into your abdomen or anything, but for typical massage work it’s not going to really present a problem, however and this is where I sort of saw a connection between other skeptical topics and this particular pregnancy issue correlation and you know how the anti-vaxxers point to the fact that I had my child vaccinated and that week we discovered he was autistic. There’s a correlation there due to time. Well, most women who miscarry will do so in their first 12 weeks, the first trimester. And if a woman happens to miscarry on the same day she gets a massage or the same, you know, a couple days before or even the week that you had a massage, it’s easy to see somebody just blaming the miscarriage on the massage treatment, even if there was no actual medical connection. So now, similar to vaccine blaming, there’s an association with time there and unfortunately, for massage places, liability. Unlike vaccines, getting a massage is not a vital part of the public health and safety. You know, your doctors aren’t telling you, you need to get a massage, otherwise, you know, your kid won’t be able to go to school unless he gets a massage. No, vaccines are necessary and massage is just nice. So it just struck me that, again, this is my theory here, that it’s far easier to simply have your spa avoid pregnant women during their first trimester and that way your insurance will be lower and you won’t have as many lawsuits. I said at least my massage place said that they will take you if you have a note from your doctor but good luck. I think there’s a lot of blanket. Women are forbidden from doing a lot of stuff just because it’s easier to lump them into all just, no, don’t do it. Any little thing, don’t do it.

0:41:35
BR: Yeah, better it’s easier for them to just say no and not deal with it rather than actually parse out and try and justify it.

0:41:43
CW: Yeah, yeah, so and you really do feel this desire to be careful and it’s not a case where you ask for forgiveness rather than permission. You just, oh maybe I shouldn’t do it, okay I’ll skip it. I shouldn’t take a hot bath. Okay. I won’t take a hot bath. I shouldn’t okay All right, you just go without so Anyway now I asked you know soon-to-be. Dr. Karen East my friend. I asked her about about massage to induce labor or Massage massaging certain trigger points possibly inducing early labor, and she said no no she hadn’t really heard of that happening Although I do have another friend who says her sister works in dabbles in complementary and alternative medicine and she has no medical degree or any letters after her name, but as a part-time job, she massages pregnant women’s feet to help them induce labor. And I said, well, so I’m asking my friend, how does this work? Well, how does your sister do this? Oh, well, she has to do it sometimes for a few hours and sometimes for like a week. And I’m like, so she’s massaging the feet of pregnant women who are past term, who are like –

BR: About to give birth any time now.

0:43:05
CW: Yeah, they’re over their due date. And sometimes she has to do it for like a week. But then they do eventually hit that point of being in labor. Oh, OK. You can see what possibly might be happening here.

BR: Yes.

CW: Again, soon-to-be-Dr. Karen East did tell me that you can argue that a massage on the feet or anywhere else will help release oxytocin and when a woman is close to her due date, oxytocin is one of the hormones that leads to contractions. And you know, once the whole system is ready, it’s one of those little trigger hormones. And in fact, a synthetic form of oxytocin is what’s used by doctors to induce labor for women who medically induce. While massage can release oxytocin, Karen just told me, hey, if you get to that point, go for your nipples, nipples are better. And I said, what? She said, you’re gonna get a lot more oxytocin from rubbing your nipples than you will having your feet rubbed and so, you know, that’s good to know good to know and –

BR: Maybe an awkward request under certain circumstances, but…

CW: Well, this is something you can do at home, you know before you get to the hospital and with a partner and everything else and speaking of partners that I’ve also heard from people that sex can help bring on labor. If you’re anxious for that to happen and you’re toward your due date or a couple of days past your due date, having sex at term is supposed to help. And Karen said many nurses and doctors recommend that. Now, for the same reasons, oxytocin will be flooding through your body if you’re having a really good sexual experience. And so that’s one of the trigger hormones and the progesterone and prostaglandins from semen will actually help soften the cervix which is something that needs to happen before any sort of dilation can start. I looked into any way to confirm or deny this and there aren’t that many studies for again for the reasons that you just can’t separate women into controlled trials for something like this. Rebecca Decker in a video series called Evidence-Based Birth cites several observational studies that do show a significant difference for women who report having sex right around term. Namely that the ladies who are getting it on, they end up having a lower chance of needing to medically induce labor and the lesser chance of going late like late, like into 41 weeks of pregnancy. However, it’s still hard to tell whether it was the sex that was actually helping speed things along or simply a product of what’s called the healthy user bias. Namely that women who were healthier, who felt better, they’re more likely to be having sex in the first place at term. So they’re the ones feeling up to sexual activity and because their bodies were healthier, they’re the ones who had a lesser chance of having to be induced or going extra long.

0:46:08
BR: Yeah, so once again we sort of see the difficulty in teasing out exactly what the causes and effects are.

0:46:15
CW: Yeah, now Rebecca Decker did cite one actual randomly controlled trial, but it involved a little over a hundred mothers and it was pretty flawed since it only really involved the doctors advising one group of women Yeah, go ahead and have sex, you know to have sex toward your due date and The other group they didn’t tell them not to they just left it up to them and they didn’t really advise for it or against It so when all was said and done both of the groups ended up having about a similar amount of sex. It was you know, like 40% versus 60%. It was and so that really makes it not really a test of anything.

0:46:56
BR: Yeah. I mean the the the criterion shouldn’t be were they advised to have sex the criterion should be did they have sex?

0:47:03
CW: Yeah, and again that that form of parsing out the data falls prey to the healthy user bias because if they if they’re having sex that means they felt up to it. So regardless, my husband is a pretty big proponent of this science and he likes this option much more than rubbing my feet for a week.

BR: That makes sense.

CW: So any listeners out there who if you’re nearing your 40-week mark and you want to bring on labor, if your water hasn’t broken and your partner has no STIs and you’re feeling up to it, go for it. a little bit of sex and see what happens.

(MUSIC)

0:47:43
BR: I remember a few years ago, one of the topics that I looked into was water birthing and it made the news back in 2010 because supermodel Giselle Bunchen, I think is, did I pronounce her name?

0:48:05
CW: I don’t know, I’m not up to date on my supermodels.

0:48:07
BR: You should be. Anyway. She gave birth to her son, Benjamin, a fine name, at home in her bathtub, and it was part of the trend of what are called water birthing. It’s this notion that because humans are made of water, and of course water is essential to life and the fetus spends virtually all of its time as a baby immersed in water that it goes back to the naturalistic fallacy that water is good, water is life and therefore it would be good to have a baby in water in a pool or bathtub or something.

0:48:49
CW: Yeah, I’ve heard arguments about, oh well, you know, the world is this cold, you know, harsh place, you get, you know, lights are on you and it’s like, ah, you’re out of your womb. And they want to reduce the shock of that transition. So if you come into a pool of warm water first and then you gradually, you know, get taken out of the water, it’s supposed to be less harmful to the baby. And again, this goes back to the whole notion of, oh, I’m reliving trauma from my childhood. You know, people who recreate their births and their passages through the womb. I’m not sure how much to give, how much stock to give any of it. I will say, I don’t know if you knew this about me, Ben, but I come from with the name Celestia. My mom was a little bit of a hippie. And I think I was I was having a conversation with her as you do because you start talking about all sorts of stuff to your mom when you find out that you’re gonna have a kid and I said well I’m getting frustrated with my doctor’s office mom, but but don’t worry I’m not gonna go buy a kiddie pool and just you know fill it with water and a dolphin and have it have it in the backyard and she turned to me and said in all seriousness, you know, we almost did that with your brother.

0:50:01
BR: Well, the American College of Obstetricians and Gynecologists doesn’t recommend water births, saying that instead children that are born in hospitals are safer, if for no other reason than professional medical help is nearby in case of complications. So their issue wasn’t necessarily that water births are inherently dangerous. It was more a matter of if you’re doing it somewhere outside of a hospital, then if there is something going wrong, then there is danger to the child.

0:50:35
CW: Yes, yes. So, speaking of birthing, the birthing process and what happens when you give birth, I want to fast forward. Now, I’m not there yet. I can’t claim any personal experience with this, but I want you to picture this okay. You’ve just okay.

BR: I need the I need that the movie cue the –

CW: Okay. Put your feet up and picture this bad, okay You’ve just given birth the miracle of life has occurred and minutes later as you’re cradling your baby the dark slimy organ that has been feeding your baby in the womb slides out of your vagina It’s the afterbirth, the placenta.

0:51:13
BR: You lost me already. I’m already, I’m not, I’m not there. This is already deviating from my level of comfort.

0:51:20
CW: Okay, I figured it might. So the placenta, nature’s little sponge-like fetal support system, is now sitting in a bloody lumpy pile of spent vessels on the floor. And it’s about to be whisked off into a biohazard bag and tossed out. And I ask you, at this point, what sensible mother wouldn’t look at that and say, hold on, wait a minute, do you mind if I eat that? We’re going to talk about eating placenta, also known as placentophagy.

BR: Hopefully it will be brief.

0:51:53
CW: Now I’ve got to give a little credit to a listener here, Kelly, one of our listeners in Las Vegas here actually. She requested we look into this and it was months and months and months ago. And so we’re finally getting to it, Kelly. There you go. And boy, that was an interesting tour of reading online as I looked into the habit of eating placenta.

BR: Better you than me.

0:52:15
CW: Well, animals do it and Kardashians do it. So it’s got to be a good idea, right?

BR: That does not follow. That is the non sequitur.

CW: Well, other mammals do it. And let’s look at why. Is there any reason to eat a placenta beyond simply the wild animal type instinct of a mother bear, that inner voice that tells her, I am a wild animal and my next meal might not come for quite some time and there’s calories in that pile of stuff and it smells bad if I don’t do something with it, there’s gonna be a predator that’ll smell it and come kill us, so I better just eat it. Now, that’s animals. Animals do a lot of things that humans don’t necessarily need to do or you don’t necessarily want to do. But people have started in droves to do the placenta eating thing anyway. I found all sorts of weird things that women do with placentas. Some people like to bury them in their yard for good luck and plant a tree above them. Some women soak them in brandy and then save the brandy and drink it once they get into menopause. Some people dip their placenta in paint and make art with it by flopping it onto a canvas like a little stamp and don’t even get me started on Lotus Birth.

0:53:41
BR: As it happens, our friend Kevin wrote an article on Lotus Birth in the July-August 2018 issue of Skeptical Inquirer. Lotus Birth, for those who don’t know, is not cutting the umbilical cord after delivery and there’s a whole article on that if people are interested.

0:54:01
CW: Yes, I was going to recommend that. She also touched on it in an article for Forbes. You can actually buy little placenta bags on Etsy and put your placenta in the bag while you wheel your baby around. It will have a little accessory. Aside from the lotus birth thing, which is a whole other topic, let’s talk about eating your placenta or consuming it in pill form at least. Now in the 60s and 70s Placentophagy was practiced by a few hippies in communes here and there. I’m pretty sure my mom didn’t do that I’ll ask her but I’m pretty sure that was beyond beyond her realm of hippiness. But lately it has taken off alt-med practitioners and natural-minded doulas and midwives have in about the recent decade touted placenta as this sort of cure-all solution for everything from postpartum depression to pain relief to a way to improve your milk production. And the anecdotes have multiplied left and right about the benefits of this relatively new practice. It’s worthwhile to tell people that while other mammals do it, there’s no evidence that any human culture on earth has a tradition of eating placenta. A PhD named Mark Crystal has been studying it for 30 years and he says there’s just no historical basis for people eating their placentas anywhere on earth in history and mind you, there are several cultures out there that practice cannibalism and that’s well documented, but not placenta eating. So nevertheless, companies have been quick to help meet this brand new demand. For a few hundred dollars, you can have your placenta like dried up and turned into powder and put into capsules or just turned into jerky or smoothies or bunch of different things. Amazon has an ebook that has 25 placenta recipes ranging from placenta taco… Are you still uncomfortable, Ben?

0:56:06
BR: Go on.

CW: Okay. And these recipes range from placenta tacos, which is kind of ironic, to kebabs and pate and there’s a paperback on placenta tinctures and edibles and another book touting placenta as a way to attain quote magic post baby recovery.

0:56:29
BR: So if there isn’t an actual anthropological origin to this, where did it come from?

0:56:37
CW: That’s a good question. That fellow who’s been studying it for 30 years has not found the patient zero that first decided to try it. But like I said, there were a couple of communes in the 60s and 70s that wanted to go back to nature and start doing it. But we don’t know exactly why or how it started, but it’s been taking off and now celebrities are doing it left and right. And you know, who do people pay attention to more? Their doctors or celebrities that they follow on Instagram? So therein lies the problem here. But I of course went to my books. The Mayo Clinic Guide has absolutely nothing at all on eating placenta. They don’t even mention it, which is probably a sign that there’s really not much to be gained from it. What to Expect While You’re Expecting does have a section on placentophagy on page 362. It says that, quote, Tribal women do it. Chinese medicine has advocated it for hundreds of years. Now, both of those are wrong. I found out that Chinese medicine, as I said, no, tribal women don’t do it. There’s no history of doing this. And Chinese medicine, while it uses some powdered placenta along, always along with other ingredients to supposedly cure a few random ailments, it’s never been eaten as a postpartum practice in China. That’s not the case. The only downside that the book, What to Expect, mentions in the first several paragraphs is that the price companies charge is pretty high. And so it helpfully states that you can do it yourself with a kit or you can find instructions online. No, no, no, no, no. Why are you telling moms to do this? Don’t tell moms to do that with their placenta. That’s a bad idea. That’s a bad, bad book. But anyway, it does at least end the section by mentioning that there’s a very real possibility of bacterial infection and getting sick from eating your placenta. So more on that soon here. Many doctors haven’t been quite sure whether to endorse the practice or not until recently. In October of 2017, a group led by Dr. Alex Farr, F-A-R-R, published an eleven-page paper in the American Journal of Obstetrics and Gynecology stating that physicians should actively discourage the practice of eating placenta due to the absence of clinical benefits and the presence of risks. Now, any positive effects were only evident via anecdote or surveys filled out by self-selected participants and they were likely heavily influenced by emotional factors and placebo effects. After the encapsulation process, the placenta does not really contain vitamins or hormones in any sort of amount that would be helpful.

BR: So there’s no real reason to?

CW: Yeah, there’s no there there. Though it does have small amounts of oxytocin, remember that magical hormone we were talking about, there is no evidence that oxytocin can actually be absorbed and utilized when you take it in a ground up pill form like that, that is by eating it. Again, if you want oxytocin, just rub your nipples, ladies, it’s easier and a lot cheaper.

0:59:57
BR: Or have someone else do it.

0:59:58
CW: Yeah, or have somebody else do it. More importantly, there are no standards currently in place for preparing a placenta for ingestion. And certainly, you’re not going to have well-regulated standards if you have people doing it themselves at home based on online instructions. So this cottage industry that has sprung up to offer placenta snacks is all self-regulated. Now, the authors of this paper state that the encapsulation process is not adequate in getting rid of potential pathogens. And once the placenta is out of view, it starts decomposing right away and it becomes a hotbed of bacteria, a playground for pathogens, if you will. So we’re talking pathogens like streptococcus.  mother passed a streptococcus blood infection to her newborn, an infection that was found to have originated in the placenta capsules she had been taking. The baby survived after a hospital stay in two weeks of some pretty serious antibiotics, but you know we’re talking newborns here. It could have been easily been deadly. A lot of the benefits that placenta is supposed to give can be achieved by, well, birth. Do you want your milk to come in? Well, birth triggers your milk coming in. You need pain relief? Well, that starts also happening after birth. You know, you experience a spike of tremendous pain and then after you give birth, it gets better. So, it’s really easy to ascribe these actual things that are going to happen either way to, oh, I took placenta tablets and look what happened. Well, it’s easy for a miracle salesman, even if it’s a well-meaning person, an honest person like a midwife who simply wants the best for her clients. It’s easy for people to ascribe these benefits to some other outside factor you did like preserving your placenta and taking it in pill form. So you’re giving credit where credit’s not due. If you want to adhere to nature, then trust the nature inside yourself too. And as the mother, once the baby and the placenta are out, stuff will happen to you as a result of birth. And hopefully everything goes fine. And if your body does need some help, look to proven scientific medically sound practices that don’t carry an unknown risk factor because when you think about it, streptococcus is a natural thing too. If you do want to preserve something just because it makes you feel cool and mom-ish, rather than burying a placenta in your backyard or soaking it in brandy, invest some money in banking cord blood. Your child might actually have a medical need for that someday.

1:02:43
BR: Good advice.

CW: And that’s about all I have. In your perusing and doing the research on it, obviously you found some sources which were, shall we say, less than credible, but others that were much more above the line. You mentioned, for example, the Mayo Clinic. What are some recommendations you’d have for skeptical science-based, evidence-based perspectives on pregnancy?

1:03:10
CW: Well, I mean, start with your doctor. If you have a bad feeling about your doctor, you go in and they’ve got a reflexology chart on the wall, then make sure you have a good evidence-based MD on your side as you prepare to give birth. And I’ve been reading a lot of articles by Coven Synopathy and other science moms out there. She does a lot of writing about various aspects of birth. She’s just come out with a couple more on forceps birth versus C-sections, and you can really get the statistics that you want from articles like that, rather than the mommy blogs that are like, I had such a wonderful experience with my lotus birth, and it was just, I feel so close to my child now. Avoid anything that talks mostly about feelings and personal experiences, and go instead toward studies that have statistics laid out, medical outcomes laid out and even alternative explanations for some of those.

1:04:11
BR: Sounds like great advice.

1:04:13
CW: Well, if there’s one thing you’re not going to be short of, it’s advice because everybody’s going to be giving it to you.

1:04:25
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1:04:53
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1:05:22
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Transcribed with Cockatoo