The evolution of our understanding the development of the baby prior to birth is a fascinating and ongoing story in obstetrics. It is fair to say that during the first half of the 20th century, the general consensus was that the pregnant uterus was protective and inviolable. What we knew about the fetus was minimal and much of it was wrong.
The advent of the amniocentesis in the middle fifties was heralded as a giant step towards understanding fetal physiology. It was not until the sixties that listening electronically to the baby’s heart became routine during labor and delivery.
When ultrasound was introduced starting in mid-seventies, it took the practice of obstetrics by storm. One could hardly keep up with the new technological advances and information. We were actually able to see the infant, measure its growth, measure the amount of amniotic fluid, see the baby moving around and changing position, see him/her swallowing amniotic fluid or identify its gender. We were able to make prenatal diagnosis of abnormalities. Intrauterine surgery before birth was attempted and made some progress, but we are still far from being able to do that with impunity. I expect fetal surgery to become “routine” in the next 10 to 15 years.
It is not an exaggeration to say that the technological boom of the last 40 to 50 years, would boggle the minds of our predecessors, if they could see and appreciate it.
But the world of the unborn is still a mystery in many ways. Is the baby aware of its environment? Is he/she happy? Do they feel unhappy sometimes? Do they like music and if so what type and what is the significance of it, if any. I remember a patient of mine who had music played to her unborn baby on a daily basis. She came to the conclusion that the baby moved vigourously to rock and roll, but was soothed by the music of Mozart. How much learning, if any, can the baby acquire? There is evidence that the baby in utero is able to differentiate between the mother’s voice and that of a stranger.
It was taken for granted, that before birth the infant was protected from the external environment. As it turns out, now we know that it can be favorably or adversely influenced by the mother’s own environment. When the mother smokes, the baby “smokes”. When she drinks alcohol, the baby “drinks”, sometimes with disastrous results. It appears that whether the infant, as an adult, will become a diabetic or have high blood pressure is somehow predetermined, by yet to be fully understood influences, before birth. While the uterus does protect and nurture the baby’s growth and development, the infant does not start his life at birth with a “new slate” unique to him. Its genetic background had been already determined from the day of fertilization. After that, multiple influences will further mold and determine what that infant will or will not be as an adult. Sometimes quirks of nature may abnormally influence its development. Other factors, however, are also modifying or altering what he/she will turn out to be.
I fully expect that future technological advances will make possible to correct an abnormal genetic pattern or modify external influences so that to avoid certain abnormalities or diseases.
If it sounds like science fiction, it is not. Just imagine our grandparents at the turn of the 20th century thinking about the Internet! It is just a matter of time before we will be able to master our own future, avoid chronic diseases, and control our life in ways that we can’t even imagine today. Much of that will be done for us before birth. Certain diseases will be corrected before birth. Some work in this area is already being done now. There are, of course, and there will be, many ethical issues that we will have to wrestle with. But it will be done, no doubt in my mind.
I wish I could come back, for a while, in the year 3000, and see how primitive we really were in our life! Wouldn’t you?
About the Author:
SILVIO ALADJEM MD, an obstetrician/gynecologist and Maternal Fetal Medicine (high risk obstetrics) specialist, is Professor Emeritus in obstetrics and gynecology at Michigan State University, College of Human Medicine, in Lansing, MI. He is the author of “10,000 babies: my life in the delivery room” now available on Amazon, Barnes and Noble and other book stores. Dr. Aladjem published extensively in Scientific Medical Journals and wrote several textbooks in the specialty. He can be reached through his website, www.drsilvio.com.
You can read more of Dr. Aladjem’s posts on Imperfect Women by clicking here. Dr Aladjem also answers questions of medical interest related to pregnancy in a recurring post here at Imperfect Women. You can read more details about this feature and ask a question by filling out the form here.