Like a Mother A Feminist Journey Through the Science and

Culture of Pregnancy

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For Mom and Noli Jo, who made me

“Nothing is more tenacious than the life we are made of.”

Cover
Title Page
Dedication
Epigraph

Introduction

Part I: One of You

Part II: Two of You

Part III: A New You

Acknowledgments
Notes
About the Author
Copyright
About the Publisher
 Introduction

The moment I found out I was pregnant, I was hungover. While epic
evenings of drinking were mostly behind me (after I hit thirty, my
hangovers had morphed into cruel, multiday affairs), the previous night had
been a rare, fun exception. I was sleeping it off, my heavy breathing
interrupted by the ring of my cell phone.
The night before, my husband and I had martinis at our house before
heading to our favorite neighborhood restaurant for a pizza with anchovies
and pickled peppers. I’d lost a pregnancy a couple of months prior, and a
big part of our grieving process had been to give ourselves a break from
focusing on anything baby-related. So, embracing our ability to act
spontaneously, we ended up having a big night out like the ones we used to
have when we were first getting to know each other and falling in love.
Conversation, laughter, and affection (also cocktails and wine) flowed in
the familiar, easy way that they had not in the weeks following my
miscarriage. After dinner, we decided not to go home. We went to a ’90s R
& B night at a club; I drank tequila and danced to Mariah Carey.
When my doctor called with the news the next morning, it felt as though
my barely conscious brain had been jolted awake. During the months after
my miscarriage, my period had not returned (and, let’s be honest, we
weren’t having much sex anyway), so the possibility of pregnancy wasn’t
on my radar. When I saw the number on my phone screen, I scrambled out
of bed and tried to pull myself together, as though he might actually be able
to see me over the phone. I was in no condition for this.
 “Hello!” I said with forced energy. The fake sound of my own voice
startled me. “Hello, hi, this is Angela,” I tried again.
“Good morning, Angela.”
As soon as I heard his voice—unnervingly calm—I stopped moving. I’d
recently had blood drawn to measure the level of the pregnancy hormone
hCG (human chorionic gonadotropin) in my body. The test was supposed to
offer insight as to whether my uterus was back to its pre-pregnancy state or
if it was still holding on to any “retained products of conception,” the
clinical term for the placental and fetal tissue that can remain after a
miscarriage. If the test results revealed the latter, I might need a surgical
procedure of dilation and curettage (D and C) to “completely evacuate” my
uterus. What I was hoping to hear was that my hCG level was back to zero,
that my uterus was empty. That my cycle—and my life—could finally go
back to normal.
My doctor cleared his throat. “I think you’re pregnant,” he said.
“No, I don’t think so,” I replied confidently, dismissively.
He paused.
“Sorry, let me start over. Angela, this is your doctor calling. I’m calling to
tell you that you are pregnant. Last week, your hCG level was six. Today it
is 1,033. The only way that happens is pregnancy.”
It was as though he had whispered an electric secret in my ear. The
unexpected news was a pulsing live wire that I could neither control nor
ignore. Pregnancy’s current raced through me, giving off sparks of
uncertainty and possibility. My mind flooded with an endless stream of
questions, including a panicked, “Did I just pickle my embryo with
tequila?”
Immediately after hanging up the phone, I began Googling.
“You may have heard that an occasional alcoholic drink is okay, but it’s
best to be on the safe side when you’ve got a baby on board,” I read on the
What to Expect When You’re Expecting website.1 “Why? Alcohol enters
your baby’s bloodstream in the same concentration as yours—and takes
twice as long to leave it—so whatever you’re drinking, your baby’s
downing one, too.”
Uh-oh.
“But what about that night out with the girls (and a few too many
margaritas) a couple of days before you found out you were pregnant?” the
next sentence continued. “It happens to many moms, and (what a relief!)
there’s no need to worry.”
Whew. Wait, what?
The rules on my computer screen seemed definitive yet contradictory,
vaguely rooted in science yet pulled from the ether. I consider myself a
generally calm and sensible person, but just minutes into this pregnancy, I
was reeling with paranoia and confusion. I worried that the alcohol I had
consumed the night before had already damaged the fragile (sesame seed–
size, according to BabyCenter) life-form inside me, one I had spent the last
months wondering if my thirty-six-year-old, past-its-reproductive-prime
body and dusty, cobweb-lined uterus could even support.
This was my first clue that over the next two years, I would have many
more questions than there would be sufficient answers.
My hunger for information was insatiable. I turned to books—classics
like What to Expect When You’re Expecting and the Sears The Healthy
Pregnancy Book and The Baby Book—as well as online communities such
as BabyCenter, The Bump, and What to Expect. I was looking for guidance,
but after hours of reading through posts that used a strange lexicon of
acronyms I didn’t recognize (BBT, EBM, IC, LO, TTC) and texts that felt
outdated, I never felt like I was being spoken to—and I still didn’t have
answers to my questions. These resources are written by doctors and
mothers who present their opinions as definitive, which, as someone whose
experiences fell outside those lines, left me feeling insecure, overwhelmed,
and, often, judged.
If you’ve ever leafed through the pages of a pregnancy guidebook, you
know what I’m talking about—the subtle (and not so subtle) finger-wagging
implicit in even the most innocuous-seeming advice:
Scientific research has not yet determined whether cell phone radiation is harmful to
mother or baby. Don’t wait for the science to be “conclusive.” Certainly don’t sit around
with your tablet or your cell phone propped up on your belly. Even stashing your cell
phone in your purse may be too close.

Don’t put any plastic containers in the microwave; choose glass or ceramic instead.
Think about what is important to you and how you want to honor this very special time
in your life. Be a strong “mama bear” and focus on protecting yourself and your baby.2

This attitude isn’t limited to books—just look at the way pregnancy and
motherhood are typically portrayed in popular movies and television shows.
In American culture, motherhood is inextricably tied to the language of
morality. Over and over, the message reinforced to expecting mothers is that
there’s a “right” and a “wrong” way to do things: You are a supposedly
“good mom” if you abstain from caffeine and alcohol while pregnant, don’t
gain excess weight, plan a so-called natural childbirth (for the record, I
believe that all birth is natural, no matter how it happens), breast-feed for at
least a year, and glow with happiness throughout the whole process. You are
a “bad mom” if you have the occasional glass of wine during pregnancy,
experience anxiety or ambivalence about having a baby, look forward to an
epidural, feed your baby formula, or take a pull off a joint once the kids are
in bed because children are exhausting. This cultural standard is so well
established that we even joke about it, proudly proclaiming ourselves “bad
moms” when we stray from these expectations. We are trying to reclaim a
term that we’d be much better off abandoning.
During pregnancy and the first few months of my daughter’s life, by far
the best advice I received came not from books or websites but from other
pregnant women and new mothers. Some of them were close friends (or
their older sisters) who lived across the country, others were friends of
friends, people I barely knew. In pregnancy and motherhood we found
camaraderie, a feeling that we were in the trenches together. We didn’t
necessarily have hard science to explain such perplexing phenomena as
getting a transverse or breech fetus to turn head down, cluster feeding,
perpetually leaky and/or saggy breasts and vaginas, and the slow healing of
C-section incisions, but we had our own experiences and instincts. We were
an army fighting for sanity and information. We texted back and forth at all
hours of the day and night.
These frantic texts led me to deeper questions about female physiology
and biology, as well as our society’s expectations of and policies toward
mothers. Questions about breast-feeding, in particular, nagged at me. I’d
been told over and over that breast-feeding was best for babies, especially if
they were sick, because breast milk was “good for immunity.” But no
health-care provider or book ever articulated exactly how or why breast
milk helped babies’ immune systems.
I wanted to breast-feed and, luckily, it went pretty smoothly for me and
my daughter. But I had friends whose bodies were less cooperative, whose
work environments were not accommodating of pumping milk, or who
simply enjoyed the convenience of formula feeding. Their babies, like
mine, were happy, healthy, and thriving. Considering that during the first
few months of my daughter’s life I spent more than eight hours a day, both
at home and at work, breast-feeding and pumping, my body exhausted,
sore, and depleted, I felt I was owed a better explanation.
But the answers to my questions couldn’t be found at the doctor’s office,
either. That’s because so much about female bodies—though they play the
most crucial role in the continuation of our species—remains mysterious.
We still haven’t even managed to figure out what exactly triggers labor—
the physical process by which every single human is brought into the world.
The lack of understanding and knowledge of women’s biology has had
cruel and damaging consequences when it comes to pregnancy and
childbirth.
Although miscarriage is very common, we rarely talk about it openly,
leaving women to endure it quietly and alone, often convinced that
something they did may have caused it. Without solid data about the impact
of drugs, both prescription and nonprescription, on a fetus, pregnant
women’s consumption is highly regulated and restricted, which can feel
infantilizing and oppressive. An incomplete understanding of female
anatomy, including the organs, muscles, and fascia involved in childbirth,
have led to years of women suffering—unnecessarily—from postpartum
incontinence and pain.
Instead, the void is filled with opinions and information from sources that
are not always accurate and often rooted in particular value systems. They
frequently leave women feeling confused, alone, afraid, or, worse, ashamed.
As a result, our culture has adopted the belief that sacrifice and suffering—
in silence—are simply the costs of becoming a mother.
When my daughter was an infant, I worked as the staff food writer at a
newspaper in Seattle. A large part of my job was asking questions and
finding experts who could answer those questions. Fueled by the urgency of
new motherhood, I decided to apply my work habits to what was now my
other full-time job: mother. I found an evolutionary biologist who studied
human milk, set up a Skype date, and asked her all my questions about
breast milk.
What I learned astonished me—not just the biological facts about the
substance that my body was producing but also that there was so much
more data available about breast milk, and research being conducted on it,
than I ever would have known. The information gave me a new admiration
for my body—and it felt to me like information that should be common
knowledge. So I turned what I learned in that interview, along with my own
experience with breast-feeding, into an article—one intended to celebrate a
beautiful biological process as well as advocate for more support for new
mothers.
To my surprise, the article went viral. Its success helped me see that it
wasn’t just me who was desperate for this sort of information—there were
many of us. In an era of rapid screen scrolling and short attention spans, it
turned out thousands of people across the world—and not just breast-
feeding moms—wanted to read thousands of words about science, women’s
bodies, and motherhood. They wanted to share the piece with their friends
and families, to engage in spirited debates and conversations about it.
As I continued seeking answers (I had many more questions about
subjects beyond breast milk), I learned that we are currently awash in fresh
knowledge about pregnant bodies: How the placenta develops and how
important the organ is to our overall health. How the perceived risks of
drugs and alcohol reflect public health policies more than the findings of
the latest research. How the difficulty and length of labor can be
dramatically reduced with something so simple as the constant support of
another human being. And how the cells of our children, whether we carry
them to term or not, live on in our bodies for a lifetime.
The more I learned what was not in the pregnancy guides I’d read, the
more I knew this was knowledge that could not only inform women but also
help to mitigate our fears and anxiety. In a culture in which our bodies are
routinely scrutinized, and often criticized, these discoveries felt to me like
hope: information that might put us in awe of our physical forms, even hold
us in a profound, celebratory embrace.
Unfortunately, much of this emerging science remains largely out of the
reach of the over four million people who give birth in the United States
each year. It can take decades for knowledge to trickle down—through
updated academic textbooks, medical school curricula, a new generation of
health-care providers—finally to us, the people who need this information
the most. This lack of knowledge impacts our health and bodily freedom.
When we don’t know and appreciate our bodies—when we feel
disconnected from their inherent cycles and rhythms—our power, rights,
and choices are more easily taken away from us. This disembodiment is
part of what makes it possible for a male elected official in 2016—without
shame, second thought, or consequence—to say of pregnant women, “I
understand that they feel like it is their body. I feel like it is separate—what
I call them is, is you’re a host.”3
Control over our own bodies is an essential freedom, but it’s one women
have never been able to take for granted. We live in a society that, even as it
relies on us to exist, continually conspires to remove us from our bodies and
to punish us when we exercise our rights to—or not to—reproduce. True
female reproductive health, which is the foundation of everyone’s health,
requires that the social systems in which we live allow us to make informed
choices about what is best for each of us.
Science is an ongoing, imperfect process and its scope is far from
complete. For centuries, the territory of human biology was limited mostly
to the bodies of white men. Science has taken us this far but must continue
to evolve and respond to people’s real-time experiences in order to serve all
of us. In the meantime, we have each other—communities of women and
parents, telling our stories, holding each other up with our shared
experiences. I picture them as spiderwebs strung up throughout the world—
an infinite, if sometimes invisible, network of strength.
This book is not meant to be a traditional pregnancy guidebook with
advice on what or how to do things. It’s intended to be a resource rooted in
emerging science and real-life stories. Its lines of inquiry follow my own
experiences and curiosity, which are wide-ranging but by no means
complete. I’m not an expert. When I started working on this book, I was
mostly a tired and desperate new mom with a long list of questions. The
stakes have always felt high and deeply personal; it’s precisely what has
motivated me. In research and writing, I’ve learned a lot—and it hasn’t
always been comfortable. As I’ve heard from and spoken with many
different people about their own journeys, I’ve had to confront my own
biases and assumptions. Looking back on the article that led to the
opportunity to write this book, I realize that the ease I had with breast-
feeding created a blind spot about just how hard it can be for others. How
the pressure, intentional or not, that we place on new mothers—not just to
breast-feed but to enjoy pregnancy, to give birth a certain way, to “bounce
back,” to be happy—is unnecessarily stressful and harmful.
This book is subtitled “A Feminist Journey Through the Science and
Culture of Pregnancy.” Women in America have been denied power and
agency for so long that, as many of us benefit from the gains made by the
work of the feminist movement, it can be hard to remember how many of us
haven’t yet gotten the same opportunities. Forty years ago, when I was
born, mainstream feminism didn’t necessarily take into consideration the
concerns of my mother, an immigrant from the Philippines with three young
children who worked full-time. As with so many other subjects, most
dominant discussions, scientific studies, and representations of pregnancy
do very little to acknowledge the incredible range of experiences. I wonder
if eventually the title of this book, which relies on the gendered term
“mother,” will feel out-of-date as our understanding of who gets to
experience pregnancy and birth, as well as our views of gender, continue to
evolve.
We need to keep telling our stories, but we also have to learn to listen.
Our stories—and the diversity of our perspectives—are invaluable.
No book on pregnancy can or should offer an ideal model of it, because
there is no one correct way to become a mother. If pregnancy and
motherhood have taught me anything, it’s that I have zero interest in
judging people or the choices they make. What matters to me is that we
have real choices—and the information to get there.
We owe it to ourselves to learn, to demand science and evidence, to seek
out the full spectrum of information as it exists now. As much as I’ve
learned from the experts that I’ve interviewed, though, I’ve learned just as
much, if not more, from my “mom friends,” as well as the acquaintances
and strangers who have generously shared their stories with me. Their
commitment to parenting every day, to giving over their bodies, whether
they feel like it or not, breeds its own hard-won wisdom.
And so we should insist, too, that medical professionals and scientists
listen to us, the people on the front lines having the babies. Our bodies are
telling us stories and giving us new clues and information every day.
“We are volcanoes,” wrote the American novelist Ursula K. Le Guin.
“When we women offer our experience as our truth, as human truth, all the
maps change. There are new mountains.”
My hope in writing this book is the same as Le Guin’s: “That’s what I
want—to hear you erupting.”4
 I
One of You