In this week’s episode, we’re presenting two stories about the science of pregnancy.
Part 1: An expert in oxytocin, the hormone released during birth, Bianca Jones Marlin is determined to have a natural birth — even as the hours of labor add up…
Bianca Jones Marlin is a neuroscientist and postdoctoral researcher at Columbia University. She holds a PhD in neuroscience from New York University, and dual bachelor degrees from St. John’s University, in biology and adolescent education. As a graduate student, with Dr. Robert Froemke, Dr. Marlin examined how the brain adapts to care for a newborn and how a baby’s cry can control adult behavior. Her research focused on the vital bond between parent and child, and studied the use of neurochemicals, such as the “love drug” oxytocin, as a treatment to strengthen fragile and broken parent-child relationships. Dr. Marlin is currently a postdoctoral fellow in the laboratory of Nobel Laureate Dr. Richard Axel, where she investigates transgenerational epigenetic inheritance, or how traumatic experiences in parents affect the brain structure of their offspring. Her research has been featured in Los Angeles Times, The Guardian, Scientific America and Discover Magazine’s “100 Top Stories of 2015.” She is the recipient of the 2016 Society for Neuroscience Donald B. Lindsley Award, which recognizes the most outstanding PhD thesis in the general area of behavioral neuroscience and was named a STAT Wunderkind in 2017. She is currently a Junior Fellow in the prestigious Simons Society of Fellows. A native New Yorker, Dr. Marlin lives in Manhattan with her scientist husband, Joseph, their daughter, Sage, and their cat Santiago Ramon y Cajal, who is named after the famed neuroanatomist. Her website is www.biancajonesmarlin.com
Part 2: Science writer Veronika Meduna thought she never wanted to have children, but in her late thirties, she changes her mind.
Veronika Meduna was born in the Czech Republic but has lived in New Zealand for 25 years. She is an award-winning journalist and author with two decades of experience in radio, print and digital storytelling. She has previously produced and hosted a weekly science programme for RNZ, written seven books, and contributed to local and international media including The NZ Listener, NZ Geographic, New Scientist and Deutsche Welle. She is currently the NZ Editor of The Conversation, a global not-for-profit media organisation. Veronika works with academics and researchers to publish evidence-based analysis and news.
Part 1: Bianca Jones Marlin
I have a PhD in attraction. I should clarify. More specifically, my doctoral studies looked at the molecule that regulates the laws of attraction, a molecule called oxytocin. You may have heard about it. It’s like the love drug. Nonetheless, it’s released from our bodies during certain things that foster communication, foster connections, like holding hands, eye contact, orgasms, all the way to uterine contractions and milk breastfeeding. So it helps to foster these relationships.
What my doctoral studies looked at was how oxytocin changes a very particular type of attraction, the attraction of a mother to her child.
Oxytocin also has a synthetic. You may have heard of it, Pitocin. If you heard about it not from the medical field maybe because you Googled that on Amazon. You can buy it on Amazon to bolster your sex life. Don’t buy it on Amazon.
But you'll also find it in hospitals because it’s used to speed up birth, speed up labor and induce birth.
What we looked at in our studies was the fact that in mice, we looked at mammals, mice, virgins, they're actually just animals that have never given birth. We call them virgins but their sexual history is their own business. But these virgins, they'll hear the sound of a baby crying and they'll go up to the child, baby mouse, the pup, and either ignore it and leave it to die or they'll eat it. Yes.
But after this virgin mouse finds its true love and white picket fence and gets knocked up, it will no longer cannibalize or leave mice to die. Instead, it will take care of pups crying. This urge is so strong, this attraction is so strong that it will even take care of pups that aren’t its own and it will take care of pups into old age.
And what our studies showed was that when you added oxytocin to virgins, even without them ever having babies, they would do the same task. So oxytocin really made bad moms into good moms and bad babysitters into pretty solid babysitters.
This is pretty close for me in my life because I was blessed enough to be raised by two parents who are also foster parents, so I had foster siblings. I saw my siblings being loved in the family, being loved in my family that my parents didn’t birth them from their body but they birth them from their heart. To see that oxytocin could save the day in that matter really allowed me to dive into my studies. They really were just a big fan of oxytocin.
Then I got pregnant. In my mind I had this all painted out. I was going to be sitting with flowers behind me, like Beyoncé. My basketball belly, I was going to have my husband rub oils on my feet, like organic geranium. My sisters are going to fan my hair as like a rite of passage, and of course I was going to have like a five-hour labor, because anything less than that you can’t brag about. It’s five-hour labor.
I was going to give an all-natural birth, no medication. And my child will come out and we’ll both sing. Then I'd be walking in the halls and walking in Central Park and I'd just flip out my breast and breastfeed my baby underneath the willows, because oxytocin bonding time. I had it all planned out.
So when I went to my obstetrician-gynecologist, who was also at NYU at the time, and I told her this is what my plan was, yeah, she did just that. She laughed in my face.
And I was like, “But I won awards about oxytocin,” and she was like, “You are going to want Pitocin,” the synthetic analog, “because you're going to want this baby to get out.” And I was very firm in not wanting Pitocin. I wanted to see oxytocin operate in real time. I had dedicated so much of my life to setting this molecule. It was my turn to get it to work for me.
And she said I can do whatever I see fit but she recommends Pitocin. And deep down inside I was like, “That’s a dare.” I was in competition with the lady who’s going to be delivering my baby, which is less than ideal.
Nonetheless, Saturday morning came around and I had my first labor pain. It was the same Saturday that I had signed up for an eight-hour Lamaze class for birthing and how to give birth but, whatever. Oxytocin, I got this, right?
So we had our labor pains. My husband and I we walked around. We took pictures of me in labor. We bought champagne. We made sure the bag was packed. We put the timer on because in five hours I was going to have a kid.
Twenty-four hours later, I was still pregnant and in labor.
So that first night he stayed up with me. He did massage my feet with geranium and other like things as I hurled out the food that I ate in the day before, and my body just crushed underneath the pressure of labor pains. I thought, “What is happening? This is not the way Beyoncé made it look.”
So at the thirty-hour time point, they usually suggest that you go in when your contractions are about two minutes apart for two hours. Mine were three minutes. Three minutes apart for thirty hours. So at thirty hours I was over it.
So we got an UberBLACK, jumped into the car and pulled up at NYU. Although I was thirty hours in labor, I was like, “I’m here at NYU. I met oxytocin here, I met my husband here, now I’m going to have my baby here,” took a picture and we got into the Labor and Delivery.
At this point I’m exhausted. Every time a labor pain comes I’m just putting myself into the zone where I’m pulling my head back and forth and humming and telling like, “You're great. It’s okay. You can do it. It’s great. Oh, my gosh, it’s almost over. It’s still two minutes.” It was a whole intense thing.
So I’m in the Labor and Delivery room and they go to check how dilated you are to see how close you are to giving birth. Eight centimeters is like, okay, you're almost close. Nine centimeters, this baby is going to come out. So as the flush of labor pain comes about and I’m hearing the lady next door to me also screaming in pain, and she's like, “Where is my epidural?” Then I hear like plastic crumble, a doctor walk in and she's like, “Ahh.”
And I’m thinking, “I want that.”
My doctor comes up to me and she's like, “So, Bianca, you're two centimeters dilated.” I was going through something called prodromal labor which gives you all the labor benefits, like labor pains, but none of the labor benefits, like dilation.
So we pulled up an UberBLACK and went back home in a yellow cab because the only other option I had was to take Pitocin to initiate the labor, and I was still in competition with the doctor.
On the way home, my husband had already called our family on the way there because five hours is about thirty hours after that, so I walk into my house to find my mom, my dad. Rewind. I walk into my apartment to find my mom, my dad, my sister, her best friend, my other sister, her husband, their one-year-old and my mother-in-law all in the apartment.
At this point I haven't slept in two days. I’m walking to and fro in the hallway like a junk zombie trying to rip all aspects of clothing off my body as my husband runs behind me to throw the robe over because we have company. And that night, he fell asleep because he's been up for two days, and I still had to track all of my labor pains and I saw it at 2:00, 2:05, 2:10, 3:15 all the way to 6:00 being tracked.
Oxytocin was failing me. I dedicated so much of my life to this only to be in labor for longer than I was pregnant is what it felt like.
Day Four rolls around and I’m like this is jokes. We need to go. So we got dumped into another UberBLACK because I’m still having a baby, you guys, and we pull up at NYU. This time no pictures. I’m like, “Get me a wheelchair.” Somehow I’m fairly confident I threaten someone but I was in the room.
I was in the room and I knew it was time when I looked up and twenty medical students walked in because I gave birth in a teaching hospital. And I gave birth in the same teaching hospital I got my PhD in so I recognize some of those faces. And I did not care.
I gave birth to a healthy baby daughter. Her name is Sage. Yeah, she's awesome. They take her out and they put her on you for skin-to-skin contact, because that releases oxytocin. And I've been having oxytocin released for four days. So they put her on my chest and the first thought that came to my mind was, “Get this slimy thing off of me.” Oxytocin.
But I knew that I was going to mommy right and so I made sure I breastfed her, I made sure I did skin to skin, I made sure that I was going to have oxytocin released at all these moments. And six weeks in, after mommying correctly, I woke up to a migraine that was worse than my four days of labor pain. My husband rushed me to the hospital and they immediately admitted me because my blood pressure was through the roof.
I kept on telling the doctor that I had a newborn at home and can you just give me this pain medication so I can go home. What I was wasn’t hearing, which was what he was telling me, was that I had postpartum preeclampsia. It’s marked by high blood pressure that then leads to seizures. He told me that the most tragic thing he had ever seen was a young woman with a newborn baby come in and decide to leave the hospital and who died from seizures.
I was admitted in and for those four days I wasn’t with my daughter. I didn’t breastfeed her. I didn’t have skin-to-skin contact. And I felt that all the work that I had done to prepare for that point was just being erased because oxytocin wasn’t being released.
That fifth night after being away from her for a week, when I did get home and I was able to lay my head on the pillow and go to sleep, I realized that in the hospital I was attached to monitors and I had nurses on 24-hour seizure watch. Although I was flooded with contrast for my MRIs and contrast for my CAT scans and magnesium to keep me from seizing, I was in a safe place.
Though when I got back, I couldn’t breastfeed her because of all the chemicals that were in my body. There was nothing that was hooking me up to anything to know that I was okay. And I couldn’t go to sleep because I know if I wasn’t okay, she wouldn’t be okay.
What I came to realize is that my connection with my daughter, who’s now a year-and-a-half old, isn’t punctuated moments of oxytocin release. It’s our life together. And oxytocin operates in a myriad of interactions, from the doctor who convinced me to stay and saved my life to my friends who were supportive when I left the hospital and couldn’t breastfeed anymore because my milk had dropped, going back to work full time and talking me through not being with my baby.
I realized that every tear I shed when I was in the pump room and I only saw dribbles of milk come out that weren’t going to support my baby, and every time I had to work late and couldn’t be with her, and every time my heart broke for that, that was oxytocin. It was there the whole time.
As scientists we have this way of making sure things are clean and experiments are proper, but that’s not the way life is. We can’t always predict the outcome. What I did learn is that Mother Nature will never leave us hanging. She is a mother after all. Thank you.
Part 2: Veronika Meduna
When I was in my twenties, I knew as surely as you could that I was never going to have kids. It wasn’t even a dilemma. It was just not anywhere on my horizon.
And I had a close friend, my best friend at the time. She felt the same. We were both in relationships that felt like they’d last but having children just wasn’t in our plans. It didn’t shift when the friends around us all started first announcing their pregnancies and then announcing the birth of their children.
A few years after that, Andy and I, my husband, Andy and I moved to the other side of the world to New Zealand, but my friend and I stayed close. We maybe didn’t talk often. We might just catch up once or twice a year but we were still really good friends. It’s one of those friendships that you might only catch up infrequently but it feels like nothing has changed in between. It’s just the same.
So Andy and I are setting up our new life. We’re establishing new friendships. We’re starting in a new place. Then it happens again. The new people around us, we’re now in our mid-thirties, thirty-five, it happens again one after the other. They announce first their pregnancies and then the birth of their children. I was a little less sure by this stage but still at a distance from it all.
Then I get an email, just a short note from my friend to say that she had a chat with her man and they kind of felt that it was the other one who didn’t want children. They talked about it and found they do. In a few weeks, they were expecting the birth of their daughter.
This cut right through me. It’s one of those feelings like the floor goes out under you. I was stunned. I didn’t know what to say, what to think. I was angry, even furious. Just complete anger. Rather than feeling joy for her or being happy for her, I was angry.
And I’m going on this tailspin, just a deep dive confrontation with whatever it is, this thing that keeps me at a distance, doesn’t even allow me to come near. So I’m starting to work through some of that barrier.
As I’m starting to imagine this child in the future, I find myself going back to this child in the past. This child that’s me. This childhood that somewhere, what is it in there? I don't actually find anything huge, anything awful, anything obviously traumatizing or anything like that. It’s just a string of a lot of small things. My parents being teenagers when they had me, lots of shifting in place and circumstances, my dad becoming seriously unwell when he was actually quite a young man, my brother being born when I was a teenager, me doing a lot of proxy parenting way too early. A lot of things that taught me a lot what I didn’t want to do.
But I didn’t have much at all, in fact, nothing at all that could show me my idea of being a good parent. I couldn’t see that.
So I’m working through this. I feel like I’m inching my way closer to something but I’m thirty-eight at this point, so I was also going to see my GP just to kind of find out where I am physically.
My GP takes me through something that is called an egg reserve test. It’s essentially a suite of blood tests that measures all the hormones involved in my cycles in my fertility. It gives you a snapshot of where you are. And it comes back looking just fine, just good. Except for one hormone. Prolactin. That’s way off the chart. Completely out there.
And my GP has his suspicions so he sends me off to have a brain scan. The next time I come back to an appointment with him he says, “Well, you've got a tumor on your pituitary gland. It’s a benign growth so nothing to worry about, but your prolactin is way out there. And prolactin is a hormone that’s normally only produced during breastfeeding.”
So my body is confused. It’s not going to become pregnant easily. I need help.
This is quickly turning into an immense upheaval inside. To me, it feels like I’m turning myself inside out, but I’m not actually letting any of this out. I’m not talking to friends. I’m not talking to Andy. I’m not talking to anybody. Nothing. None of this comes out and I’m a pretty horrid person to be with during that time.
And I’m wrestling this thing so hard that, eventually, it all implodes and we break up. Then I break down. This is the point where I’m just about there, the resolution, and then there's nothing left. Everything is a mess.
Then we go through nearly five years of a crazy no-man’s/no-woman’s land. We’re not together anymore, neither are we apart. We've got lots of friends who try and support us, but it drives them spare. It drives us crazy.
Then Andy decides to leave the country and we don’t talk for a year. But then we do. And it feels tentative but it feels like a new, different thing. And it feels like something that now includes the idea of us becoming parents.
Except that by now I’m forty-two and he's about to move to Delhi for a year for his work. But then I've got nothing to lose so I take a year off from work and I travel to Delhi to meet him, in Delhi, India.
Neither of us has ever been to India and we get there and we’re just absolutely overwhelmed. Crazy place.
We had no idea what we’re doing. Where do we even start? So we Googled ‘fertility clinics in Delhi’ and there are a few.
Not long after that, we’re walking up the steps for our first waiting room. This room is full of women, mostly women, some of them alone, some of them supported by other women, some of them supported by men. Everybody is huddled into themselves. Everybody was looking down, nobody is making any eye contact. Everybody is quiet, hunched into themselves. But the walls of this room are plastered with huge posters of cute, smiling babies.
And we sit there for hours. Everybody waits for hours until they get to see this consultant. It’s awkward. It’s hugely uncomfortable. It just does not feel right. By the time we get to see the consultant, I’m really worried, feeling almost unwell.
I had read by this stage a lot about assisted fertility. I knew the risks. I knew about the chances. I knew all those stories. So I’m starting this conversation with saying, “Is this the right thing for us? Is this something we should even do?”
And in response, we get this big smile from this man and he says, “Oh, don’t worry. Nothing to worry because, just last week, one of my patients, a 56-year-old woman had twins. We can do this.”
And I go like, “That’s not what we wanted to hear at all.”
So we’re starting to extract ourselves from the place and kind of peel back from the whole idea of doing this, thinking it’s not going to be for us.
But then serendipity kicks in. Just by complete coincidence, I meet a fellow writer who just happens to be in Delhi on a placement. His wife is there too, also on a placement. She's a gynecologist. She's working with an Indian doctor who’s setting up and IVF clinic in Delhi’s biggest hospital, Moolchand Hospital, so we make an appointment.
When we get there, we meet Kaberi Banerjee and she turns out to be the most amazing person you could have on your side while you're contemplating fertility treatment. She's a mother, for starters, a working mother. Two kids, lots of stories about pregnancy and miscarriage, parenting. She listens. She's got everything we need to go through this.
Almost. There's no sperm lab at Moolchand Hospital. For his part, Andy will have to go somewhere else in Delhi.
And so we go and check out this sperm laboratory and it’s in a completely different part of the big city, crazy city. It’s in the busy street in a back block behind shops, and it’s really just a room with a long bench and there's these guys behind the bench wearing aprons looking at us, smiling at us as if we’d come to buy a beautiful Indian carpet or something.
I never get to go beyond this bench because this is men’s territory. Only Andy gets to go through there. He ends up paying quite a few visits to this place. And every time he leaves, these guys give him a little vial to hold and he has to hop on his bike and cycle through the crazy traffic in Delhi to the hospital where I’m already waiting, ready in stirrups.
We did this a few times but this more gentle approach did nothing for us, so eventually we graduate to full-blown IVF. It’s a radical process. At the time, the methods used or the procedures used were still very high doses of hormones. The drugs completely take over my cycle.
It’s radical in the sense that it pushes my body so hard to produce as many eggs as I possibly can. And out of this basket of eggs we have three embryos and they look good under the microscope. So all three of them are returned to my womb and then we have to wait for Day 14. This is the earliest after treatment - this is the earliest point where you can have a pregnancy test, the earliest point where you know whether this has worked or not.
Day 14 comes around, we have a test and it’s positive. Then we wait for another two weeks for the first scan. And we can see and we’re told that one of the embryos has indeed implanted, and we hear the heartbeat. Another two weeks later we come back for the next scan, but the heartbeat is gone.
A few days after, I’m back in hospital. I have to have everything removed and I just remember emerging from the anesthetic after this procedure and a nurse coming in with a little pottle and she tells me, “Here, this is your product of conception.”
We do this again. And again. Then our time in India is up and we come back to New Zealand thinking we can’t keep doing this for much longer. We've got to get ourselves off this. Somehow this is all too much, but let’s just do it one more time. Just one more time. The last time we’re going to try this.
So we’re back in a waiting room soon after this. Again, the walls are full of pictures of happy children and babies. Again, it feels a little bit more like a business transaction really. But we’re thinking, okay, this is going to be the last time. It will be fine. We can do this one more time.
And so we start another cycle. Halfway into it, the consultant tells us that he's got to go off to a conference and he might have to take the eggs out two days earlier than planned.
This is our last chance. This is the last time we’re doing this, I’m thinking, but I can’t get the words out.
So eggs are removed and early the morning after, the embryologist rings us to say that, yes, they did get five eggs but only one of them is mature enough to do anything with. Which they will. And if we did have an embryo from it, they would return it as quickly as possible to my womb, because it’s the best place for it.
We do have an embryo and it does come back quickly. And then we have to wait again for Day 14. By now we know people around us who go through the same thing and some of them would get friends and family around on Day 14 just to have the support that they might need whatever the outcome. For us, we decide to book a nice place out of town and just to get away from it all.
So we are driving. Andy is driving. I’m curled up in the passenger seat. The phone is between us and we know that sometime on this day the phone will ring and they will tell us what the outcome is. When it rings, none of us can pick it up. We just let it go to message. I’m curling up even more. Andy just keeps driving, keeps driving. And we do this, we just keep going, keep going, neither of us can pick up the phone. We just can’t do it.
We do this for quite a long time until, eventually I still can’t do it but Andy can, so we stop and he picks up the phone, listens to the message. I’m now tight as a spring in the passenger seat. I don't really want to know but, at the same time, I’m eavesdropping on the phone from the other side. I just got to figure out what on earth it’s saying. I’m watching his face for any hint of any information.
And it’s positive. Another positive pregnancy test. We know we are at this point again.
For the fertility clinic we've now become a success statistic. And it’s not long after this point that they actually discharge us, release us. You get a folder of papers of all the stuff, all the tests and everything that’s happened through this process, everything that they’ve gathered up, all information. And in this folder is a picture of this embryo when it’s only six cells old.
It’s thanks to the Indian doctor who has seen us through these previous cycles and thanks to friends back home that we now have a plan in place, what to do with medical support to actually see this pregnancy through to term.
And this last good egg is now nine years old, at home with his dad and, hopefully, sound asleep now.