Why can’t science tell us what triggers labor?

I’m 40 weeks + 3 days pregnant and counting. I’m waiting on the border of my patience for my baby to be born. I have heard the phrase, “When the baby decides to come…" countless times each day for the past few weeks, and the wording has gotten under my skin.Babies don’t make decisions. How could they? They don’t know what the options are. They come blindly into the world, forced out of the womb by basic human biology. 

But what constitutes that basic biophysiological function? What pushes a woman’s body into spontaneous labor? What do we actually mean when we say “the baby decides?”

I asked my doctor at a third trimester appointment, and she told me (disappointingly) that no one knows. I demanded to know why there wasn’t more research to find out. She said that there is research, billions of dollars worth, because pre-term labor accounts for a disproportionate amount of spending in our health care system. Everyone would like to know how to stop labor from happening. Certainly, what initiates labor is part of the question. But the best answer my doctor could rustle up was some combination of the baby colluding with the mother’s body to trigger labor.  

With each subsequent appointment, the science of starting labor appeared more and more fuzzy. My doctor would check to see if I was dilated or effaced, starting around 36 weeks. Every time, she turned up with nothing. “But that doesn’t mean anything,” she said. “You could go into labor tomorrow. But you probably won’t.” 

I brought up a friend whose doctor had told her she would be waiting for another week, and then went into labor that night. “I’ve been wrong like that before,” my doctor said. “But I’ll see you next week. Or maybe earlier.”

As I’ve gotten into full-term territory, it’s become clear that the indicators of labor indicate barely anything. I had prodromal (false) labor starting on my due date, and I continue to have frequent Braxton-Hicks contractions. No one knows what specific purpose they serve in getting the body ready for labor, but my doula assures me that they are signs that everything is headed the right direction. I lost the mucus plug and again, a good sign, but it could mean labor is a few days away - or one to two weeks. Who knows?!

As a result of this lack of knowledge and control over possibly the most important event in my life, I’ve turned to “natural” induction techniques, which other parents are quick to offer up. Science’s ruling position on this has been totally thrown off. I’ve turned eagerly to drinking raspberry leaf tea, calculating astrological charts for ideal birth dates, and acupuncture. I know that nothing is proven to work, even if a friend swears it put her into labor with her second. Out of all the natural induction techniques, acupuncture has been the most studied. But the study I read last night showed that the often-quoted successful results have not been replicated by the same research team that produced them. 

Looking further into the research with Google Scholar, I found only one paper that attempted to answer my basic question, “What initiates labor?" - from 1983.

Science is obviously more focused on interventions for babies in danger than with my frustration of having to wait to deliver a healthy, full-term baby. And I know I’ve been very lucky to have a very healthy pregnancy, and that the “problem” of this gap of knowledge isn’t an actual problem for me. But - I want answers, gosh darn it! I’m tired of folky sayings and anecdotal evidence. And I’m way pregnant, so shouldn’t I get what I want? 

Thoughts on Dr. V

I’ve been thinking about the controversial Grantland story, “Dr. V’s Magical Putter,” since I read it on Friday night. Much has been tweeted, written, and reacted to. I am adding my two cents because, despite my obsessive consumption of all the tweets, writings, and reactions, I still can’t stop thinking about it. And my husband refuses to have a informed conversation about the ethics of this piece with me due to his self-proclaimed lack of interest. Thus, the turning to vent on Tumblr. 

I’m not going to sum up the story, which has been done, again, many times elsewhere. I read the story only with the information from a tweet that the main character committed suicide - not who, how, or why. My early impression is that it was a very well-written, engaging read, the type that generally ends up in Best of Whatever Genre type-lists on Longform at the end of the year. That was, until I got to the end of the piece. When it was revealed that Dr. V had killed herself, the reaction of the storyteller felt hollow and left me confused. He called his story a “eulogy.” It was not. Eulogies are respectful of the dead person. This story was not. He also did not reflect upon what seemed obvious given the lead up: the role of the story in her death. 

This is not to call Caleb Hannan a murderer. That characterization is extremely unfair, and I’m disturbed by the way that these types of exaggerations always find a willing crowd to reinforce them. (And how some outlets cover the story as “Twitter is freaking out about this thing!" People tweeting en masse is not in itself a story. It is the appeal of Twitter.) But it is undeniable to say that Dr. V warned Hannan that his story was akin to a hate crime - something very bad was going to happen. He did not seem to take that line seriously, because she was a quirky and increasingly unhinged character. The perfect type of character for a career-making story. Stakes were being raised! The plot was deepening. To turn back now would be folly. 

The consequences of following this story to its conclusion are tragic. Dr. V is dead. (The way Hannan informs the reader is particularly insensitive to Dr. V’s memory and the reader: “‘Well, there’s one less con man in the world now’ …his seemed like an especially cruel way to tell me that Dr. V had died." Just unwrap that for a minute, while I sit here making frustrated sounds.) And as terribly as I think Hannan conducted himself towards the end of Dr. V’s life, I feel sympathy for a journalist in this kind of shit storm. This story could have happened to a lot of people: Case in point, Bill Simmons at Grantland named his entire editorial team that went through a seven month process, without anyone ever raising the issues that he admits ultimately condemned the story. I bet they pressed “publish” thinking it was another sure Grantland winner on the end-of-year Best of Sports Writing list. 

But speaking of Bill Simmons’ editorial letter, I was very impressed with the way that he took responsibility for really, truly screwing up. I deeply believe that editors should have their reporters’ backs, no matter what. My critique of the letter is that he took almost too much responsibility, while there is still much to be said about what happened during reporting. It was a freelance piece, always on the brink of not being published. It sounds like Dr. V’s death occurred before the editors had a serious hand in shaping the story. Only Caleb Hannan will be able to provide answers into the process - when he might have had second thoughts, or not. How he felt about Dr. V herself, whether he had a clue of the risk he was taking by following the story. I don’t think you can blame editors for saying, “There’s not a story here yet, come back later.” That is an editor’s role. What the freelancer does in the meantime - how he gets the story - is his responsibility.

When you get down to brass tacks, Hannan did not act in accordance with journalistic ethics. Here are the sections of the Society of Professional Journalists Code of Ethics on Minimizing Harm that I feel are relevant:

Journalists should:

— Show compassion for those who may be affected adversely by news coverage. Use special sensitivity when dealing with children and inexperienced sources or subjects.
— Recognize that private people have a greater right to control information about themselves than do public officials and others who seek power, influence or attention. Only an overriding public need can justify intrusion into anyone’s privacy.

Right there. The conversation that my husband did consent to have with me involved him invoking the self-harm done by government officials who have lied - and Dr. V did also lie. But her lies did not change the effectiveness of the product she sold, and not wanting to reveal that she was trans is not the same as a lie. As a company founder, she is still a private individual, and the public did not need to know that she was trans. I sympathize with a reporter’s annoyance when the subject tries to dictate the terms of the story, but Hannan should have seen why she insisted on the story being about Science, not the Scientist, and have spoken with her and written based on that understanding. 

Bottom line, this story is terrible for everyone involved, and a person is dead. No amount of hand-wringing about ethics can change that.

/Rant.

Tags: thoughts

How a new mindset changed my future, and maybe my baby’s future, too

I had a weird realization yesterday, while sitting in traffic, that I went through my entire formal education without liking to learn. I was a good student. I got good grades. I learned things. But I only wanted to learn the things that I was good at already. It’s only been the past year or so that I’ve truly appreciated and taken advantage of my ability to learn.

I’ve been thinking a lot about this because of a book called Mindset, by Dr. Carol Dweck. My husband, who is an educator and grad student and geek for educational psychology research, introduced me to it. The ideas and research are really interesting, but the book itself is not an great read, so I’ll save you the trouble. 

The gist is that people can be categorized into either having a fixed mindset or a growth mindset. According to the book’s website: “In a fixed mindset, people believe their basic qualities, like their intelligence or talent, are simply fixed traits.” For example, you’re good at math. You’re a natural athlete. Your innate talent and ability leads to your success. And if you’re not successful, that’s the hand you were dealt.

Quoting the website again: “In a growth mindset, people believe that their most basic abilities can be developed through dedication and hard work—brains and talent are just the starting point.”

It’s the book’s argument that the growth mindset allows people to learn and develop to their “full potential” while those with fixed mindsets remain stuck trying to prove themselves and hide their deficiencies rather than overcoming them. 

I’ve lived most my life with a fixed mindset. I was always good at reading and writing, and I was constantly praised for being a talented writer. Things I wasn’t good at, I abandoned interest in. One telling example is that I still automatically tune out when someone starts talking in numbers or trying to explain a graph. It’s become a reflexive instinct, because I know that I won’t understand. (Coping mechanism: Ask good questions after nodding head silently.) And if I was considered the “best” but was challenged at it - I would resent the challenger, rather than trying to get better. I gave up on the oboe immediately after a girl who was obviously more “talented” at music beat me out for a seat in the better high school band. Luckily being the best at the oboe is not necessary to join a rock band in Austin. 

Things started to change when I left my full-time radio job for freelancing and small business ownership. It became apparent very quickly that I had a lot to learn about things they don’t teach you in school. Filing taxes, using Quickbooks, how to price myself, getting jobs, networking. I didn’t really like learning those things, but for the first time, I appreciated why I was learning them. I would say I finally developed my active like of learning when I taught myself how to edit videos - and then to shoot video, and then add titles, graphics, and make DVDs (all from YouTube). It was immensely satisfying to do myself what I previously had to outsource. The world of what I could do started opening up. I wasn’t stuck as an “audio person” as I had defined myself, I was everything I could learn how to be.

What really helped accelerate my learning was to just start saying yes to everything. When a client asked me if I could do something I didn’t know how to do yet, I said yes. And I learned it. Now, I’m eager to have people ask for new types of videos, so I have the opportunity to spend time learning new things.

There’s a chapter in Mindset on parenting, or how to raise a child with a growth mindset. (Another thing I’d like to learn how to do.) It’s all sorts of beneficial for their development - rather than getting frustrated when they’re not the best or when they fail, they realize that they need to work at it rather than feeling cheated or entitled. Here’s the catch: You can never tell them they’re good at anything, or acknowledge any positive attribute as a fixed trait. No “you’re so cute!” No “you’re so smart!” Praise sounds more like this: “I’m proud that you worked/studied/trained really hard and that’s why you achieved your goal.” Kind of dry, but more meaningful?

I doubt I’ll ever be able to avoid letting it slip to my child that he is the cutest, but I really believe that emphasizing work and dedication over talent and ability will help him understand and develop his abilities in a mindful way. I wish I had known before I hit my late twenties, why I should have liked to learn all along. 

This reporter claims to have handed in his laptop and uses only an iPhone and iPad for reporting and editing. 

I have heard of this extreme behavior before, and I could not possibly get on board. I think it’s fine for down and dirty, super quick turnaround news reporting, but you’re inevitably sacrificing quality of sound and any suaveness of craft. 

He’s basically using the pre-installed voice memo app and SoundCloud to send in audio for the newsroom to put together his pieces.

I just don’t know why anyone would go actually want to turn their laptop in. That stuff is still useful!

Tags: audio thoughts

SXSW and Storytelling

This is cross-posted from my blog at Reflect & Record.

I’m sorry if you haven’t heard from me during the past nine days. I fell into an alternate world that descends onto Austin, Texas, every March. It’s called South By Southwest.

This year, I had a badge and was excited to go to the Interactive Festival. There were several panels on digital storytelling, and their presence in the schedule of the hottest tech conference in the country means that digital storytelling is a hot topic, with widespread interest.

On Monday, I sat down to a talk in the Austin Convention Center called “Cinematic Storytelling.” It featured Michael Senzon of CNN Digital; Olivia Ma of Youtube News; Blake Whitman of Vimeo; and Katy Newton, who is a Knight Journalism Fellow at Stanford University, and a former documentary filmmaker and video producer at the LA Times.

My background is in journalism, and I’ve seen the shift from formulaic TV news reporting to what’s being called “cinematic storytelling,” first-hand. The bottom line is that people are not just getting their news from traditional outlets like TV, newspaper, and radio.

Big players like YouTube (see Olivia Ma) have stepped in, and now anyone with a cellphone camera can create news. And people are turning to Vimeo (see Blake Whitman) for the most creative video and multimedia that’s being produced around the world. These forces are re-defining what audiences want to see and come to expect from the media they consume, and traditional outlets are trying to keep up.

I can certainly understand that. My first experiences with creating videos were for a media company born as a traditional news outlet, and there’s no manual for understanding how to adapt to a rapidly changing media landscape. Katy Newton (I believe it was her) mentioned that some newspapers initially thought, “Hey, we’ll have our reporters shoot videos and it will be great!” only to realize that it’s an entirely different format from print, and not every video is worthy of being on the LA Times website.

I had hoped for a discussion of what the term “cinematic storytelling” really means and how it’s being done now, because presumably the idea of telling a journalistic story like a movie isn’t a new idea. It’s called a documentary. But like most journalism-focused panels I attended at SXSW, it ultimately came down to a discussion of “old” media’s business model.

Are people with cellphone cameras and Instagram undermining the work of documentary photographers? Is a citizen journalist as valuable as a trained journalist? Do people prefer watching cat videos over the six o’clock news, and if so, will Boxing Kitteh and his ilk bring down the New York Times and CNN?

My feeling is that this conversation will be moot in few years, when we can all agree that these things (including cat videos) have different values in our culture, and the high-quality stuff is worth paying for. The important thing is figuring out a way to pay for it.  

Tags: video thoughts

jayrosen:

Master manipulator with nerves of steel.

I cannot recommend highly enough episode 460 of This American Life, in which Ira Glass and crew have to retract and apologize for an earlier show based on Mike Daisey’s one-man stage play, ”The Agony and the Ecstasy of Steve Jobs.” The facts you need to understand the new episode, simply called Retraction, are in this New York Times story.

Daisey’s play is about terrible working conditions in Apple factories in China. It became a hit, raising awareness of the issue and adding pressure on Apple to improve those conditions. But it was based on a lie: that Daisey had himself witnesssed what he presented as the record of his experiences in China. In many cases he had not. And he lied to the producers of This American Life when they tried to fact check his performance before putting excerpts of it into their show. 

All of this becomes clear in Retraction, which is an extraordinary display of transparency in corrective journalism. (So listen! It’s an hour.) Daisey is interviewed for the show about his deceptions. He tells Ira Glass that he always feared this day would come. Well, it came. And when he was asked to go on This American Life to account for his lies, he had only two choices. Sane choices, I mean.

Choice One: To agree to be interviewed and prepare to be stripped naked, on air, as a kind of cleansing act. You are revealed to millions of people as a bald-faced liar and a cheat about the things you care about the most, but by being ruthlessly honest and unsentimental with yourself, you stand a chance of coming out of it with at least some dignity. But if you cannot go through with that, there’s…

Choice Two: Don’t go on the air. Let them talk about you and send a note with your regrets. 

There is no choice three. 

But Daisey took door number three, anyway. That’s the one where you say to yourself…

I’m a master manipulator with nerves of steel. I can talk my way out of this, out of anything. This is just another performance! And I am one of the great performers out there. Of course I will have to concede ground, and that’s going to be embarrassing and painful, but I can also gain ground by winning people over to the greater truth beneath my deceptions. Which is… I really care about this! Through the magic of theatre, I made audiences—big audiences, who love me—care! Now they care about something they damn well should care about! Ira Glass couldn’t do that. I did. The New York Times wouldn’t do that. I would. Me and the magic of theatre, which is my love. I didn’t betray my love. I betrayed his love, Ira’s, and, yeah, that was wrong, but beyond that he has nothing on me. For I am a master manipulator with nerves of steel…

What you hear in the show is this very performance coming completely apart— before your ears, as it were. Ira Glass picks up on it right away. He realizes what Daisey came into the studio to do. And he permits a monstrously over-confident man to audibly disassemble himself. (Transcript.)

So this is what Daisey wrote on his website:

What I do is not journalism. The tools of the theater are not the same as the tools of journalism. For this reason, I regret that I allowed THIS AMERICAN LIFE to air an excerpt from my monologue. THIS AMERICAN LIFE is essentially a journalistic ­- not a theatrical ­- enterprise, and as such it operates under a different set of rules and expectations. But this is my only regret. I am proud that my work seems to have sparked a growing storm of attention and concern over the often appalling conditions under which many of the high-tech products we love so much are assembled in China.

The post doesn’t have a title. I suggest: Fuck it. I take door number three.

I agree: You should definitely listen to this episode, and the original episode if you haven’t already.

My favorite part was when Ira Glass told Mike Daisey, “I feel terrible… for you.” As much as Mike Daisey is a liar and his lies were unethical and bold-faced, I can understand how and why he crossed the line into manipulating This American Life. He wanted that audience. I can understand how and why he justified it to himself.

My second favorite part was the long silences before some of Daisey’s answers. If anything, TAL knows what makes great radio.

Tags: thoughts

Am I an entrepreneurial journalist?

Have you heard of entrepreneurial journalism?

I hadn’t, until last week, when I stumbled on this blog.

Adam Westbrook calls himself an entrepreneurial journalist. He makes online videos, and he makes them in order to make money. He freelances, which means he’s basically running his own business. In his spare time, he dishes out excellent advice about how to treat journalism like a business.

This new term - and the ideological shift that goes with it - struck me as brilliant. The traditional way of thinking about newspapers, magazines, and public radio is as institutions. The New York Times, our local papers, and our other preferred media with long histories have always been there for us, and they should continue to exist by some unalienable right. But they’re businesses. And they’re struggling with the economy, and the fact that people are now getting what they used to pay for for free. Traditional media outlets can’t pay people what they deserve, and they can’t hire as many people as they need.

For the past decade, or at least since I entered journalism, there’s been a struggle to redefine the business model. Whether it’s the paywall for the Times or talking about funding for NPR, it’s clearly a time of transition for everyone. There was this recognition: The way things worked for centuries isn’t working anymore. We need a new business model. And as newspapers and radio programs struggle, they pass the pain on to freelancers.

When I left my job to work on my own, I thought of myself as a freelancer. But really, as soon as I left, I should have thought of myself as an entrepreneur. That would have been a healthier attitude. I had assumed I would go at it on my own for a few months, and then start looking for a new job. But as it happened, I fell into being an entrepreneur, and I managed to combine my interests and skills from journalism into a business.

So I was an entrepreneur and a freelancer. But now I discover that all the jobs I’ve created for myself are actually a symptom of being a entrepreneurial journalist. When I’m working for Reflect & Record, I still feel like a journalist. I’m asking questions, I’m presenting stories. It’s just that I have to think about marketing, and selling, and taxes, and all of that business stuff. That’s what I should have been doing when I started freelancing.

I have two businesses. I have two sets of business cards - so how did I not realize this before? The good thing is that they’re both growing. And now I can think of my working self as one whole: an entrepreneurial journalist.

Headline of the week.

I feel like the writer could have done a better job of supporting the legitimacy of this scientific research. Not sure how, but I just have that feeling.

Tags: Thoughts

Humans are incapable of consuming less, so let’s consume better

That was the thesis of Matthew Nordan’s talk at SXSW Eco. Nordan is a venture capitalist who titled his Wednesday talk, “Consuming Better: What Neuroscience Says About a Sustainable Future.” Going into the talk, I was curious to see how neuroscience and sustainability tied together with venture capitalism. Turns out I wasn’t alone. The room was packed, and by the time Nordan started speaking, it was standing room only.

He started by talking about our resource issues - essentially, the core of sustainability. Our energy and water supply is dwindling, and solutions that involve other limited resources, say, lithium batteries, create what Nordan called “playing wackamole” with our resources. The easiest answer is that we should consume fewer resources - but real-world experience shows that’s totally unrealistic. Nordan posed the question, “Are we fundamentally incapable of consuming less?”

He quickly answered: Yes. Here’s where neuroscience ties in. He cited a study close to my heart, a study I often mention when the conversation turns to wine. Antonio Rangel at Cal Tech, who I interviewed back in 2008 for EarthSky, found that people enjoy wine more when they think it costs more. (Here’s the backstory.) The point being, we like things that are “more” rather than “less”. That’s what our brains are showing. “There are many studies like this,” Nordan said, and then moved on.

With the fact that we can’t consume less established, Nordan said that the best thing to do is to get people to feel like they’re experiencing something that’s better than what they had before, but has less impact. For example, a better performing car that’s also electric, or something similar. He described several business strategies that could be considered sustainable. The ideal situation is to “deliver truly better consumption.” That is, products and technologies that have no drawback compared to what we’re using now, and also have less impact. That’s where venture capitalism comes in: How do you find and invest in these game-changing technologies?

I really enjoyed Nordan’s talk. He was talking about the same old problems in a new and interesting way, and thanks to a Power Point where he debated himself on video, it was also entertaining. 

My one qualm was the use of “neuroscience” in his title. I think his thesis is interesting and provoking on its own, but the scientific evidence didn’t stand up to truly support it. I love that study, but it’s not really neuroscience. Rangel is an economist who uses an MRI. When I asked Nordan for more evidence after the talk, he mentioned Dan Ariely at MIT - a well-known behavioral economist. It didn’t take away from my enjoyment of Nordan’s talk, but it did leave me wanting more. What does neuroscience say about a sustainable future? It might be mum on the question.

Can design be worldchanging?

This week I’m attending SXSW Eco, the brand new conference that addresses sustainability in the public, private, and academic worlds. I just got married over the weekend (!) so I had to rush back from a post-wedding retreat to catch Alex Steffen’s keynote speech.

alex steffen

I was a long-time follower of Steffen’s Worldchanging.com, an online magazine that focused on what it called a “bright-green future” and folded a few months ago. It was relentlessly optimistic about the future, and emphasized how urban design could change the world. Steffen seemed to be the obvious driver for the website, and he penned long essays about his vision. Admittedly, I was a bit of a skeptic about our bright-green future. There’s great design ideas out there in concept, but how many can make a difference? I was interested to see if Steffen could make me a bright-green believer.

Steffen started by establishing that goals for emissions reductions are either overly ambitious or not clearly defined, and even the way we measure our emissions (“footprint” in sustainability parlance) is not a solid accounting tool for reductions. As a planet, we’re barely moving in the direction of carbon neutrality. Meanwhile, the world is becoming more urbanized everyday. People are moving to the cities, and our emissions are determined by the “systems” or infrastructure we live in. Therefore, Steffen says, it makes sense to make cities more efficient. “The number one way to tackle climate change is to build more compact cities,” he said.

From there, he outlined a few ways in which design can reduce emissions. Creating denser cities, increasing walkability, and better public transportation are all obvious targets to reduce urban emissions. He also mentioned a number of interesting new apps that can help people understand their footprints, in order to make their lifestyles more sustainable.

At the end of his talk, I emerged bright-green neutral. Hearing Steffen speak was better than reading one of his essays. He was logical and realistic. The most intriguing idea was that technology is enabling people to see their own consumption - and does that mean that data may change their behavior? But I’m unfortunately cynical about “worldchanging” sustainability. The people who are interested in sustainable design and checking out the size of their footprint is one small segment of the population. I think talk about how design can change the world must be rooted in a policy discussion involving energy efficiency. Because at the end of the day, sustainable design is only one type of design. And “business as usual” design - and emissions - are far easier to do.