Tuesday, October 5th 2010
A few things have made me decide to tell my conception, pregnancy and birth stories, and provide some broader context, on my blog. Of course one thing is the CNN.com story that came out on Monday. Then I was struck by how the criticisms being launched by opponents of IVF – to me personally on the CNN.com story’s comments, and broadly in the media coming off of Edwards’ Nobel Prize win – are so overtly sexist and are so related to the way I frame my research. And, earlier this semester I also had a student leave me a note in my Question Box. (The Question Box is a box I leave out for students to submit anonymous questions. Sometimes serious, sometimes ranting, often clever, it’s an interesting part of Anth 143.) This student asked whether my understanding of reproduction, as someone who studies it, affected how I viewed pregnancy and childbirth when I went through it myself.
So this post chronicles how I got to be pregnant. Later posts will discuss my pregnancy, my childbirth, and how sexism and the pathologization of women’s bodies are damaging and incorrect.
The beginning of my family
Brendan and I met in college, at Nerd School. I knew Brendan had had leukemia just a few years before, and I remember thinking that it made him calmer, more mature. I valued his thinking above the other young men I knew. Thankfully, he felt the same way about me. It took us six or seven months to start dating, and a few months after that for me to discover he was infertile. I just asked him one night, he told me he was, and that was that.
I remember feeling as though the chance to have children was slipping away, because of who I had fallen in love with. I remember seeing how Brendan turned inward a bit, in that moment, I think expecting rejection from me. He talked about how much he wanted to be a dad one day, and I thought, I fucking hate cancer. And then I figured, science will take care of this by the time we actually want kids. Either that or we’ll adopt. So I tried not to think about it. And of course, over several years, we fell more in love, and we got engaged, and we got married.
Over this period, we were both going to graduate school. I was doing dissertation fieldwork in Poland until two weeks before we got married. After a year of lab work (undiluted spit and piss stink more than you might expect) and I was in the writing stage, I moved back up to Cambridge and, for the first time since we started dating, we lived together.
Brendan, being a year ahead, finished his doctorate before me and went on to an amazing post-doc position at Children’s Hospital. I was a lecturer at Yale, and then preceptor faculty in the Harvard Expository Writing Program while finishing my dissertation. But while writing in coffee shops and libraries, I found myself intensely, painfully jealous of pregnant women. I wanted to hold little babies and smell their hair. So I started talking to Brendan about it, and it was something he wanted too. He looked into his healthcare, and it was amazing. In vitro fertilization would be totally covered. Totally covered. As in, cough up the occasional co-pay and you can try to have a baby. It made me feel almost like a normal person.
Going for it
We made an appointment with a fertility specialist. We figured it made sense to try while I was young and not a limiting factor, seeing as we already had one in Brendan. Poor Brendan had to submit to a number of tests, because it was decided that there was a very, very small chance that maybe there were some sperm in there somewhere. There weren’t, but let’s say he found out the hard way. Then there was a chance that Brendan had a single vial stored somewhere that was taken between chemo treatments. Chances were nothing was alive inside it, but our doctor was excited by this news and recommended we try IVF to see if we could use this sample.
Then it was time to figure out a backup plan. Neither of us wanted to use a stranger’s sperm. So then it was a matter of deciding who to ask.
Of course, privately, years ago, we had already discussed Brendan’s youngest brother. You see, his middle brother was his bone marrow donor when he had leukemia. We always felt it would be fitting to have his other brother be our sperm donor. But how the heck do you ask someone to be your sperm donor, especially a twenty two year old someone who, understandably, doesn’t exactly have babymaking on his mind?
We needn’t have worried. We called, we chatted, we nervously explained, and Brendan’s brother was beside himself with delight. I suspect he had always been disappointed to be the brother who wasn’t a bone marrow match. As a fifth grader with his oldest brother battling cancer and his middle brother getting holes punctured in his hip to donate bone marrow, he got his class to sit down and make paper cranes. They didn’t quite get to one thousand, but they got close.
With Plans A and B all set in terms of the sperm, it was time to figure out the eggs (I’ll spare you what turned out to be insane details scheduling and timing Brendan’s brother’s trip to coincide with my treatment). I had to undergo a battery of tests including a hysterosalpingogram and vials and vials of blood to make sure I was fertile and wasn’t harboring any nasty diseases or genetic proclivities to nasty diseases. Brendan and I also had to go to a therapy session. I felt like all my spare time went to phone calls and doctors’ waiting rooms. I understood why I had to go through it all, but resented what I had to go through when other people could just have sex and get pregnant. Once we were cleared, we couldn’t even get started with the stimulation protocol, because we had to be fit into the embryologist’s schedule: they don’t want too many embryos to watch at one time. As rational as all this was, it was hard to feel rational when I wanted to move forward.
IVF in accord with our lifestyle and environment
Our doctor was exceptional. She was hopeful in a measured way, she listened well, she was not condescending, and she appreciated the fact that I was a scholar in women’s reproduction and had a few opinions of my own. We discussed going for a very mild protocol to avoid hyperstimulation, because a higher dose would be unnecessary for someone like me: healthy, young, athletic, fecund. I said I would rather have this all not work then feel like I was so desperate to have a baby that I would risk my or my child’s health.
So we went for a lower dose. Birth control pills, then little needles in my leg, more appointments to count follicles and measure my endometrial thickness, a perfectly timed hCG shot to mature my eggs.
Fourteen eggs were aspirated in an outpatient procedure. Brendan’s sample was thawed. The sample was essentially empty. Brendan’s brother’s sample was used. My heart broke just a tiny bit when I was told that part. But then I remember thinking to myself, rather fiercely, of the incredibly strong baby that will come out of all this, and call Brendan Daddy, and how the bonds of our family would knit even closer in the wonderful blend of genes and environment that would be our child.
We risked a five day protocol before blastocyst transfer. In IVF, the most typical protocols are to transfer a three day embryo, or a five day blastocyst, back into the mother. The three day was more common in the past, but you risk the mother’s endometrium not really being receptive yet. The five day transfer would mean a few more risky days of being cultured in vitro, but a greater chance of there being an alignment with the receptivity of the endometrium. The other decision we had to make was whether to transfer more than one blastocyst. Continuing with our decision to not take risks with my or potentially a baby’s health, we wanted to reduce the chance for having multiples, so we opted for a single embryo transfer.
These were a panicked few days, waiting for the embryos to culture, hoping some would actually be left by the time we got to the fifth day. I had trouble maintaining a rational perspective, that the way we were doing this was best. But we got there. We went in for our outpatient procedure to have the embryo transferred to my body. I had to take a Valium and drink an enormous glass of water: the Valium was actually more to keep my muscles, including the muscle of my uterus, from contracting, and the water was to get my bladder as full as possible to make it easier to image my uterus using abdominal ultrasound while they implanted the embryo.
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| Our “textbook” blastocyst. |
The ultrasound and embryo transfer were excruciating, not because it was painful, but because I needed to pee so badly that I wanted to scream. You try drinking an enormous glass of water and then have someone pressing an abdominal transducer down on your bladder while someone else is making you stay still while they put an embryo in you. Then, continue to lie still there for a while before you can get up and pee.
The second the doctors left the room, I turned to Brendan and burst into tears. At least for that moment, I was pregnant. There was a blastocyst inside me, and I was so absolutely happy and terrified that I could barely contain myself. We grinned at each other like fools, clutching our picture of our “textbook perfect blastocyst” and when I finally got to go to the bathroom I hoped that I wasn’t flushing anything else down the toilet.
A new beginning
A week later while on a family vacation in Maine, I was exhausted all the time, wanting to go to sleep early, and writing it off as wishful thinking or aftereffects of the stimulation protocol. We still had another week before our official pregnancy test. So of course on the drive home from vacation Brendan and I went to the store and bought three.
The first one came up immediately and unequivocally positive.
We had our official test soon after, and it told us what we already knew. I fell to the floor of our apartment as the nurse on the phone, accustomed to such a reaction, waited for me to stop crying.
I was pregnant.
* * *
Tomorrow, I go all meta on my pregnancy.
Thursday, September 30th 2010
The “Around the Web” series highlights informative websites, and also targeted blog posts and news articles, relevant to the courses I teach. This semester I teach Anth 143: Biology of Human Behavior, an introductory-level course that covers the basics of evolution, behavioral biology, and the interaction of biology and culture. My hope is that these posts are useful not only for my current students, but other people hoping to gain background or insight into these topics.
This week I have been trying to finish up two large writing projects: a new IRB and a manuscript draft. So posting has been light. I also admit to having a little trouble figuring out whether to foreground this particular Around the Web post with some of my own thoughts about this topic. I’ve decided to risk it.
I have two main thoughts I want to offer, one on each half of the lecture I gave Tuesday; these comments will ground the links I’m sharing.
Honest signaling and mate preferences
Due to time constraints, I didn’t feel I could go into much detail about my unease about this particular field of research. Much of the work done on human mate preferences is quite good, especially the work that either links the preferences to fecundity/fertility (i.e., Jasienska et al 2004), or to actual reproductive success (i.e., Apicella et al 2007). What worries me when I teach this material in a large, introductory setting is that, despite any caveats I may offer about the research, students often walk away from lecture thinking that all women like strong, masculine men who are good hunters, and all men like young, feminine women with big birthing hips. This is simply not true. You can look at the assortment of who marries who and find a lot more variation, and that’s because there is so much variation in mating strategy. Perhaps if someone gives you a range of faces and asks you which you prefer you choose one in line with honest signals for immune health or fertility. But do you have sex with this person or enter into a long-term relationship with this person? Not necessarily, because honest signals of health are only ONE of many factors you consider when choosing a mate. Cultural conditioning, humor, kindness, proximity, religion, political leanings… these are all issues that confound choice purely for good genes. And that’s not necessarily a bad thing.
In fact, an interesting article just came out that shows how some traits in preferred versus actual mates are similar, and how some are different. Definitely worth a read!
Dr. Petra Boynton, sexpert, therapist, blogger, and all-around cool person, has a wonderful blog relevant to this week’s topic. I’ll send you over with one of my favorite posts, but check out the whole site: ten tips for successful dating.
I also have to pass on an article sent to me by a student (hooray, I love when students send me stuff!). I’m very glad Davis Shannon sent me this article about body versus face preferences in men looking for one night stands. Of course, the style of the story is pretty offensive. I was also pretty appalled at the quote from the lead author. But in addition to exposing you all to a new study on this topic, it exposes you to an example of very bad science reporting. I think this is very useful to students learning to filter good information from bad.
Finally, in an example of GOOD science journalism, I give you several selections from Not Exactly Rocket Science: one on male bowerbirds influencing mate choice in nestmaking, and one that is only barely related to this week’s topic, on masturbating squirrels. You heard me right. Go read it, it’s great.
Sexuality
I had a rather devastating interaction with a student after class this week. This student approached me and asked me why I thought there was such a thing as homophobia. The student explained that a group of male students behind him/her were making offensive jokes during my portion of the lecture on homosexuality and were dismissive of the idea that there is a spectrum of human sexual preference that is quite normal and reflected in behaviors we see in the animal kingdom. Both the student, and I, were very upset by this, and I didn’t have a particularly good answer.
Oppressive behaviors of one group of people towards another are not new. But I find it especially disappointing when I hear of my own students behaving in this way, especially when I have invested so much in creating lectures with active learning components that give them space to think critically. Like I said, I have no good answers, except to have zero tolerance for such behavior if I am ever in earshot. Perhaps if more people understood that, for some people in our society, it is a huge personal risk to simply express who you love, and those of us who have a more socially-condoned sexual preference can never quite understand the toll this can take on a human being.
Of course, it may be an additional condolence to find out that those individuals who are most homophobic are most likely to have hidden gay urges. No, I didn’t make that up. It’s SCIENCE!
And for every story of teachers suspended for assigning articles on gay animals or assistant attorney generals using internet bullying tactics on gay students, there are stories of LGBT-inclusive immigration legislation or UN efforts to end laws that discriminate against homosexuals.
References
Apicella, C., Feinberg, D., & Marlowe, F. (2007). Voice pitch predicts reproductive success in male hunter-gatherers Biology Letters, 3 (6), 682-684 DOI: 10.1098/rsbl.2007.0410
Jasienska, G., Ziomkiewicz, A., Ellison, P., Lipson, S., & Thune, I. (2004). Large breasts and narrow waists indicate high reproductive potential in women Proceedings of the Royal Society B: Biological Sciences, 271 (1545), 1213-1217 DOI: 10.1098/rspb.2004.2712
Friday, September 24th 2010
The “Around the Web” series highlights informative websites, and also targeted blog posts and news articles, relevant to the courses I teach. This semester I teach Anth 143: Biology of Human Behavior, an introductory-level course that covers the basics of evolution, behavioral biology, and the interaction of biology and culture. My hope is that these posts are useful not only for my current students, but other people hoping to gain background or insight into these topics.
This is a good week for Around the Web. There are myriad resources on the internet, as well as just some great writing, regarding evolutionary theory and the forces of evolution. I have a few more lectures for you, a few websites that provide good primers on science and evolution, some interesting blog posts… even a web comic. So here we go.
Resources on evolution
Professor Stephen Stearns never disappoints with his online lectures at Academic Earth. Check out these on the nature of evolution, natural selection, genetic drift, and how selection changes the genetic makeup of a population.
Another wonderful video resource comes from a Discover Magazine contest on how to explain evolution in two minutes or less. Greg Laden posts the winner and runner up here. Short and sweet!
But perhaps you prefer to read to learn, rather than watch. Here is a great set of lecture notes by Bora Zivkovic for his BIO101 class that teaches evolution, from genes to species.
Maybe you want to forego watching videos or reading anything, and would rather look at a single web comic. Well then, here is one often-misunderstood aspect of evolution, very clearly demystified!
Edited to add: Robert Luhn at NCSE emailed to kindly point out I left out two great resources… one being, of course NCSE, and the other being Understanding Evolution, at Berkeley. Thanks Robert!
Blog posts on evolution, the media and scientific literacy
While I have tons of posts on evolution, I thought it would be interesting this time to highlight some recent ones that discuss how the media talks about Darwin and evolution.
At The Guardian, Adam Rutherford wrote an article entitled “Beyond a ‘Darwin was wrong’ headline: The media love to give undue coverage to flimsy attacks on evolutionary science. And leave others to clean up the mess.” In it, he writes about why heavy coverage of a rather problematic book by non-evolutionary biologists Fodor and Piatelli-Palmarini entitled “What Darwin Got Wrong” is problematic.
Rutherford quickly clears up two issues for his readers:
Of course, there are plenty of things that Darwin got wrong. That is the nature of science, and indeed good scientists love to be wrong. It means that the theory will subsequently be refined to be more right. Darwin knew, as does every subsequent evolutionary biologist, that natural selection is the major, but not the only contributing factor to evolution.
Fodor and Piattelli-Palmarini seem oblivious to this. They base their whole argument on either misunderstanding what real evolutionary biologists think, or by simply ignoring it. They describe processes in evolution that are easy to understand and are part of evolutionary theory, and quote them as a means to knock down that exact same theory. Repeating and enhancing these brainwrongs so elegantly, as Burkeman does [a journalist Rutherford criticizes for giving attention to the book with the Darwin was wrong headline], simply makes matters worse.
First: in science, we expect people to be wrong all the time, and for lots of things that we once believed to turn out to not be true. Evolutionary theory doesn’t fall into this category because it has been so robustly supported in so many studies, over so many decades, that even we skeptical scientists are now quite happy with it. Second, a critical reading of this book is necessary by those who seek to cover it.
Ed Yong weighed in on a similar issue when he covered a journal article on phylogeny in his post Do new discoveries rewrite evolutionary history? There, Yong discussed the phenomena of scientists and the media shouting from the rooftops that the history of some lineage has been rewritten because of a new phylogenetic analysis or new fossil finding. He reviews an article by Tarver et al in the Proceedings of the Royal Society: Series B that looked at claims of “rewriting” evolutionary history in the reconfiguration of catarrhine (apes and old world monkeys) and dinosaur phylogenies when new discoveries are made. Go have a look, it’s very interesting!
Finally, this post isn’t directly about evolution but I think describes the problems in how we define scientific literacy very nicely. Alice Bell wrote this lovely post The Myth of Scientific Literacy, and to me, this post links to those about how to communicate science, particularly evolution, because of what we think our students know, and what they actually know and believe, when they arrive in college classrooms.
