Friday, October 12, 2007

A bone to pick...

I’ve been reading with interest about the controversy surrounding whether Lucy’s 3.2 million-year-old fragile remains should be put at risk as she is publicly displayed, for the first time outside of Ethiopia, at the Houston Museum of Natural Science between now and next April.
In my mind, however, it is Lucy’s legacy that has put us at risk.
When you see her - and you should -- peer at her frame and ponder one of the more profound questions of our time: Is that why the cesarean rate is so high?
The first time I laid eyes on Lucy’s likeness, it was a mocha-colored cast of her 47 fossilized bones, encased in glass and hung on the wall in the American Museum of Natural History in New York.
At the time, about a year after my son was born, I was trying to understand why human birth is both a natural physiological process that has successfully (over)populated the earth, as well as a painful experience that leaves little room for error.
That day, in New York, I stared at Lucy’s replicated half-remaining pelvis, which was originally dug out of the ground in Ethiopia in 1974, and sighed as my son squirmed in his stroller beneath her.
“So small!” I shrieked to no one in particular.
Granted, Lucy, living on a diet of nuts and berries and the occasional carcass leftovers, probably stood only about 3.5 feet tall, and weighed about 60 pounds. (Males of her type would have been taller.) But indeed, Lucy’s legacy – as the museum’s slick marketing materials state – is profound in that her fossil shows us how humans evolved from knuckle-dragging ape-like creatures, with roomy pelvises, to upright creatures that became more intelligent.
And therein lays the problem. Lucy’s pelvis was narrower than those of earlier primates. Her pelvis had to be smaller to support efficient walking on two feet. If she continued to walk with the aid of arms on the ground, her stance would have been wider and, when bipedal, she would have rocked from side to side, like chimps do when upright. Meanwhile, our ancestors became increasingly intelligent – meaning their crania enlarged.
Ah, Lucy’s legacy. Big head, small pelvis: The modern consequence of such bad anatomical math plays out every day in hospital labor and delivery units around the world. In America, we can understand Lucy’s legacy in the popular cry for epidurals. We can feel Lucy’s legacy in the rush for the scalpel, with nearly one out of every three births in the U.S. now by cesarean section. And we can ponder Lucy’s legacy as babies are born larger and larger with every passing year. For the record, our pelvises are not getting bigger.
As I sit here, pregnant again, wondering how my own obstetrical drama will play out (the first time ended in a c-section, of course but I am not worried this time), can someone in Houston do me a favor?
Tell Lucy I have a bone to pick with her.


Mitchell Clan said...

I have a real problem with the supposition that babies are getting larger and larger every year. We have no proof of this at all. In fact, the way we are now electing cesareans and inductions, we don't have an accurate picture of birth at all. We are affecting the "average" size and "average" gestation on a daily basis at a phenomenal rate. We don't even know what normal babies do during labor, because we cut them out at 40 weeks or 12 hours after induction begins. Times up!
Two of my family grandfathers, born in the 1870's and 1900, respectively, were both over 9lbs and no one thought a thing about it. They weren't even from the same branch.
Why are we falling for these bad statistics and forced ideas that we "can't" birth...with no evidence to prove that assertion! Our cesarean rate didn't climb with our pelvis size climbed in the last 20-70 years as we evolved from having babies to having 9 to 5 professionals delivering our babies.

Tina Cassidy said...

Mitchell, I don't at all disagree with you, especially about casual inductions and elective cesareans and overreactions to women supposedly being past their due dates. Statistics show that these trends are happening at alarming rates in this country. HOWEVER, stats also show that the average size of a baby has increased significantly, even in the last 50 years. Why? Mostly because our diets have changed, women are avoiding cigarettes and alcohol and we are downing vitamins like never before. Now, I am not saying that we should be doing more sections and inductions because babies are getting bigger. Instead, we should be reverting to more natural ways to enable nine-pounders to enter the world, as a midwife likely did with your large grandfather. The bottom line is, having a baby has always been a tight fit given the head to pelvis ratio. There is rarely much room for error. I believe having a woman labor on her back (due to an epidural) is not going to help a nine-pounder out. So I think we agree.

N said...

Congrats on your pregnancy! I hope you are planning a VBAC!

Tina Cassidy said...

Thanks. And yes, I am planning a VBAC.

Mama V said...

My birthing class instructor talked about how labor hurts like it does (and a baby's head is the size it is in proportion to the mother's pelvic bones) so that we'd be able to stop and take notice (thereby saving the baby's head from being dropped on the floor).


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