The science of pregnancy gets more and more fascinating. To think of the mother simply ‘hosting’ her baby is so, well, 1973. What’s going on in the womb is really a marvelous co-operative venture that may last a lifetime, as Dr Kristin Collier, an Assistant Professor of Internal Medicine at the University of Michigan Medical School, explains in the following interview with MercatorNet.
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MercatorNet: For most of us, Pregnancy 101 means there’s a baby developing inside the mother, attached to the placenta by the umbilical cord. And, thanks to ultrasound and the photographs of Lennart Nilsson, we know what that looks like. But there’s a lot more to this inside story, isn’t there – could we start with the placenta?
Dr Kristin Collier Yes! There is so much more to the “inside story.” Since you asked about the placenta, let’s spend some time exploring this organ, as part of the “inside story.” The placenta is amazing. Why you might ask? Well, for one, it is the only organ made in cooperation by two people. It is made from the growing baby’s tissue and the mother’s tissue together. Therefore, the placenta is known as a ‘feto-maternal’ organ. It is the first time that mother and baby come together to do something in cooperation.
The placenta, as many of your readers know, is the organ through which the baby and mother interface. This name ‘placenta’ is derived from the Latin word for a type of cake, as it is a flat organ and averages about a pound in weight. It is attached to the wall of the mother’s uterus and is connected to the growing baby by his or her umbilical cord. The placenta is the only purposely transient organ in human beings.
It also is amazing because it functions as many organs in one. The placenta helps the prenatal child get rid of waste, helps provide nutrition and also produces hormones and protects the baby against infection. The placenta is acting like a lung, kidney, gastrointestinal tract and the endocrine and immune system. Pretty amazing for this one organ to have so many important functions.
In New Zealand, the indigenous Maori people have treated the placenta with reverence, traditionally burying it in ancestral land, which reinforces a link between people and land. Their intuitions seem to prefigure the importance of “the afterbirth” that science has discovered…
This information is beautiful to hear. It sounds like these indigenous people recognized the importance of the placenta even before modern science started to take a deeper interest. As you mentioned, the placenta has long been called the ‘afterbirth’ as it is delivered after the baby. This ‘afterbirth’ often got short-shrifted in attention as an ‘afterthought’. But no longer.
In fact, the placenta is so important, that the National Institutes of Health (NIH) in the United States has a research arm dedicated to the placenta called the Human Placenta Project (HPP), and on its website says ‘The placenta is arguably one of the most important organs in the body.’ A healthy placenta is not only crucial for healthy development of the prenatal child, but also affects the health of the child and mother for years to come.
On a side note, it sounds like the Maori people were into the field of human ecology even before the field had its formal name. This is unsurprising as these fields of study are often just a way to give a formal name to something that has been there the entire time, often practiced authentically by indigenous peoples and only recently fractured by modern life and technology.
Is there more to discover about this ‘transient organ’?
Yes, there is always more to discover. One goal of the human placenta project is to better understand the placenta with the ultimate goal of improving maternal and child health. One interesting thing we know now about the placenta, although the full extent of this knowledge is not fully understood, is that along with functioning as many organs as one, there is a unique transfer of cellular material that happens across the placenta.
In science, microchimerism refers to the presence of a small population of genetically distinct and separately derived cells within an individual. In pregnancy, small amounts of cells travel across the placenta. Some of these cells are the prenatal child’s cells that travel from the baby into her mother, and some cells also pass from the mother into her child. The cells from the prenatal child into her mother are pluripotent, which means they haven’t yet differentiated into the type of cell specific for one organ or tissue in particular. These cells find their way into mother’s tissue and start acting like the tissue in which they find themselves. This process is known as feto-maternal microchimerism.
That is fascinating! In what ways can these fetal cells protect the mother in later life – or put her at risk?
Their full impact is still being understood, but some of these cells have been hypothesized to help mom in the time after birth and also for years to come. For example, these cells have been found in Caesarean sections incisions helping to make collagen to help mom heal after a surgical delivery. These cells have also been found in the maternal breast and have been hypothesized to help reduce mom’s risk of breast cancer in her later years.
The ’gift’ of these cells from the baby, entering into mom’s body and helping her heal and protecting her from cancer, is amazing to think of and really challenges our ideas of people as autonomous beings. In reality, many human beings carry remnants of other human beings in their body. These cells may even play a part in how future siblings are spaced.
What is also interesting, these cells that enter the mother are allowed to survive and are not attacked by the mother’s immune system, even though they are somewhat ‘foreign’. This again speaks to a cooperation, at the cellular level, between mother and child. And it would be one thing if these cells were inert and existed as a gift of sorts, from the child in the mother, but to think of these cells in some ways benefiting the health of the mother really speaks to a radical mutuality at the cellular level between two people that only serves to enhance our understanding of the maternal-child bond.
And what are the implications for involuntary pregnancy loss?
Miscarriage can be a devastating event in the life of both the expectant mother and father. I’ve heard from many women that they felt, even after they lost their baby, that their baby was somehow always still with them in a way. And now, through the knowledge of the science of microchimerism, we know that this is true. Many women do have the presence, in their bodies, of a biological piece of their child and this cellular material may be aiding and assisting her not only now but in the future in ways we are only beginning to understand.
Obviously this science throws new light on the abortion debate, in particular on a woman’s autonomy when it comes to ending a pregnancy. She would be ending an irreducibly cooperative venture rather than a ‘kidnap’ (as Judith Jarvis styled it) and harming herself as well, would she not?
Every dehumanizing ideology succumbs to the same temptation – to see the undesirable other as a non-person. In the abortion debate, as in similar debates around marginalized vulnerable populations, language is used when describing the undesirable other that is dehumanizing. In the abortion debate, the prenatal child is referred to as a ‘clump of cells’ or even as a ‘parasite’.
As my friend Charlie Camosy writes in his book Resisting Throwaway Culture: How a Consistent Life Ethic Can Unite a Fractured People, we must resist appeals to individual autonomy that detach us from our duty to aid others, and resist language, practices and social structures that detach us from the full reality and dignity of the marginalized. A radical view of autonomy that leads to the end of another human life is one that is anti-life and oppresses the rights of another in the name of ‘freedom’.
So yes, the language that should be used to highlight the beautiful cooperation that exists in the dyad of the mother-prenatal child relationship instead has been perverted to one that brings to mind a cancer, an infection or a crime (like a kidnapping or hostage situation). Those of us who feel called to stand up for the vulnerable and marginalized among us, should call out such language not only in the abortion discourse but also in the discourse involving other marginalized vulnerable populations.
In a world focused on avoiding pregnancy it’s not surprising that we have heard little or nothing about these amazing pregnancy facts. Are there other reasons?
That is an interesting question. I don’t know why this information isn’t more widely known. One reason is that there are so many other ‘practical’ things to know when you are pregnant that these other details of awe and wonder get marginalized.
Having had four pregnancies myself, I remember getting inundated with information around things to expect in pregnancy regarding my body – physical changes, symptoms etc. I remember reading in a book about what my baby was doing and looking like at each week of gestation, but I don’t remember getting information that exceeded the ‘practical’ domain.
Pregnancy and childbirth are wondrous, miraculous events! In my opinion, using language that reflects awe and wonder doesn’t discredit us in medicine, but only legitimizes the emotions and feelings the pregnant mother is likely already feeling.
What are the theological implications of these scientific insights, in your view?
I am not a theologian, however in talking with those who are, I’ve come to think of biology now, more generally, in a relational sense that mirrors the nature of God. The scriptures speak of a God who is in relationship with his people. We then would only expect that God, being the author of biology, would create our bodily nature in a way that was also relational – even down to the level of the cell.
And in particular, when I think of the science of fetomaternal microchimerism, I think of the theological implications of cells from the incarnate word of God, Jesus Christ, in his mother, the Virgin Mary. We can say that Mary not only carried the Son of God in her body when he was in her womb, but that she likely carried his cells in her body throughout her life in a way that further magnifies her position as the glorious Theotokos. This highlights Mary’s glorious position as the Mother of God in a way I had never thought of before.
Kristin Marguerite Collier is an Assistant Professor of Internal Medicine at the University of Michigan Medical School where she practices general Internal Medicine. She serves as an Associate Program Director of the Internal Medicine Residency Program and is the Director of the Program’s Primary Care Track. In addition, she is the Director of the University of Michigan Medical School Program on Health, Spirituality and Religion. She was interviewed by Carolyn Moynihan, Deputy Editor of MercatorNet.