Jillian De Gezelle

Yesterday my grandmother threw a “luncheon” so that all her friends could finally meet little miss Hazel, my amazing, gorgeous niece who is nearly 16 months now.  Some of us ladies were all discussing Hazel’s shyness and how she is so shy at first, but slowly emerges throughout the course of any social gathering to reveal her true self, which is not shy at all.  I think my sister and I are both like that as well, and I added that to the conversation, and asked my mom who was shyer as a child - me or Melissa?  She said Melissa.

I was surprised and tried to refute her answer by pointing out several stories from my early childhood.  To this my mother responded, “You weren’t shy!  I couldn’t get you to stop telling the teacher things I taught you at home, like when you explained how the sperm fertilizes the egg to everyone in nursery school!”  I remembered this story also.. when I was 4 my mother explained to me how babies were made, not so much in terms of human love making, but on the level of sperm meets egg to create baby, using a volume from a children’s encyclopedia as a visual aid.  I have a memory of an illustration of several squiggly sperm swimming toward a balloon-like egg.

My mother was helping out with my nursery school class those days, so imagine her embarrassment when I raised my hand and said, “Teacher!  Teacher!  I want to tell you something!”  And jumped up and explained human reproduction to the whole class of 4 year olds at Honey Brook Early Learning Center!

Although I’ve always known this story, the connection to what I’m still doing, over a couple decades later, never struck me until now.  Still telling everyone about reproduction only really because I have a hard time not talking about it because I still find it so interesting!

I remember being blown away when I first found out the plants also have eggs and sperm!  What?!?!

Human heredity is crazy though.. and you don’t even really realize until you see it with your own eyes.  When I looked at Hazel this time, a bit more grown up since the last time I saw her a few months ago, and she was close to my face and looking at me, “having a conversation” with me, I saw parts of myself looking at me and talking to me.  She doesn’t say a whole lot yet, but with isolated words, some sign language signs, some of her own hand motions, sounds and nodding, we did manage to have a sort of conversation.  And I saw some of my facial features, making my facial movements on a little adorable face.  If that’s never happened to you, let me just say it’s kind of a mind-blowing experience.

Kids at that age have the capacity to understand so much, even though they may not be talking at any length.  Since Hazel is still nursing, Melissa refers to her breasts as “milkies” to Hazel.  Now, Hazel has made the connection to her own, and if you ask Hazel where her own “milkies” are, she’ll look down at them on her body.  At 16 months, she already understands a fair amount of basic anatomical terminology, including vagina.  After pointing out a few body parts, prompted by Melissa saying, “Show me where your _____ is,” she was asked where her vagina was, and turned around and pointed to me!  Ha, who knows, maybe Vagina sounds enough like Aunt Jill?  We laughed at her mistake, but she pointed at me every time we asked her.  Until my mother was around, then she pointed to Grandmom Karen.

Along the same lines of kids doing/saying the darndest things, my mother pointed out that not only did I repeat things she taught me to my nursery school and kindergarten teachers, I also repeated anything my parents told me about myself.  I guess the more you hear something the more you believe it.. so I told my kindergarten teacher just what my parents always said to me, that I was “cute as a button, and just right!”

Signed,

Aunt Vagina - “I’m (still) cute as a button and just right!”

I keep a close eye on the daily science headlines from a variety of sources, and one topic that I never stop seeing new news on is breastfeeding - and its benefits to both child and mother.  Just a few in the last year, I believe, will illustrate enough.

Benefits to Child:

NY Times article covering a large-scale study (over 15,000 participants) that found that at 6.5 years of age, the breastfed children scored significantly higher on vocabulary, word matching and verbal I.Q. tests compared to formula-fed children.  Additionally, teacher ratings were consistently higher for the breastfed children.

Breastfeeding transfers immunity to babies through antibodies made from the mother, and researchers are beginning to figure out the mechanism.  This transference of antibodies is why breastfed babies have much lower incidences of GI infections compared to formula-fed babies.

Benefits for Mother:

NY Times article covering a study that found breastfeeding reduces the risk of rheumatoid arthritis in the mother.  Women who breastfed up to a year decreased their risk by 25% and women who breastfed for over a year reduced their risk by 50%!

Breastfeeding for 6 months or more has also been associated with a lower risk of certain types of breast cancer - luminal cancer as well as triple-negative cancer, which is very aggressive and particularly difficult to treat.  Another research group is suggesting that lactation-based therapies could provide a component to a natural, non-toxic, anti-cancer therapy.

WHY then, may I ask did a recent study find that 94% of the nearly 1300 hospitals surveyed in east coast states from Maine to Mississippi are distributing formula samples to new mothers, even though multiple studies have shown that hospital-based distribution of formula samples is associated with reduction in exclusive breastfeeding rates, and opposition to this has been voiced by The American Academy of Pediatrics, World Health Organization, Centers for Disease Control and Prevention, and The American College of Obstetricians and Gynecologists??

Effluent from a wastewater treatment plant in Montreal was found to contain:

(measured in nanograms of hormone per liter of water)

90ng/L Estradiol - a natural estrogen, prescribed for HRT (Hormone Replacement Therapy)

53ng/L Norethindrone - used in BCPs (Birth Control Pills), HRT, and menstruation regulation

30ng/L Levonorgestrel - used in BCPs and morning after pills

The latter two are synthetic progestagens, compounds which mimic progesterone.  Human and animal excretion is considered the primary source of natural and synthetic estrogens and progestagens found in aquatic ecosystems.  Some of these hormones have been shown to reach our drinking water as well.  These hormone levels are sufficient enough to have endocrine-disrupting effects in wild aquatic ecosystems, which are receiving the effluent.  In some fish, exposure to as little as 1ng/L of a hormone can result in hermaphroditism, feminization and decreased fertility.  The numbers found in the Montreal effluent were between 30 and 90 times that amount!  Pretty scary.

Study Reference: Viglino L., K. Aboulfadl, M. Prevost, S. Sauve. 2008. Analysis of natural and synthetic endocrine disruptors in environmental waters using online preconcentration coupled with LC-APPI-MS/MS. Talanta 76: 1088-1096.

Wow. If I didn’t urge you to see “The Business of Being Born” when it was playing in very select theaters, I’m definitely urging you to see it now. For free. Online. It doesn’t get much easier than that. I just watched it for the 2nd time and it was as amazing, emotional and thought-provoking as the first time. Two of my favorite birth scholars, Robbie Davis-Floyd and Michel Odent are in the film.  Also, the documentary is set in NYC, so many of the names, faces and places are familiar to me. If Abby Epstein and Ricki Lake didn’t make this, I would have. Seriously.

Yes, it has been more than a few months since I have posted anything. I do however have some good excuses. I’ve been real busy. I finished my graduate coursework, passed my 2nd and final qualifying exam and advanced to doctoral candidacy. Additionally, my first publication came out. Here is the reference:

Balick, Michael J., Jillian M. De Gezelle and Rosita Arvigo. 2008. Feeling the Pulse in Maya Medicine: An Endangered Tool for Diagnosis, Therapy and Tracking Patients’ Progress. EXPLORE-The Journal of Science and Healing 4(2):113-119.

I was also busy with preparations for my return to southern Belize for another season of fieldwork. I spent 3 months in the Toledo District, completing 26 interviews this trip. Now I am back in NYC for a few weeks to touch base and handle stateside responsibilities. And.. planning my next trip back to Central America in June. Last but certainly not least of the news, before heading to Belize in February, I was blessed with the opportunity to assist in 2 beautiful births. One was that of a colleague and great new friend, and the other was my sister’s first birth. Below is the story of my niece Hazel’s birth day.

I arrived in Philadelphia on December 22nd, Melissa’s EDD (Estimated Date of Delivery). I had been prepared to head to Philly at any point in the couple weeks prior, but she and the baby were not yet ready. First time moms go late more often than they go early, so it was no big surprise. By the 22nd, I had tied up all loose ends in New York, was relieved from any other responsibilities and was planning to be in Pennsylvania for Christmas anyway, so I decided to head down and wait for Melissa to go into labor. Contractions of varying degrees had come off and on for days. Eleven days later, around 8:30am on January 2nd, I was still asleep in the guest bedroom. I heard Melissa’s voice at the door, saying “Jill, it’s time.” I woke up and saw Melissa and my brother-in-law, Julian standing in the doorway. At that point I was not sure how long she had been laboring in this early stage before they decided to wake me, so I jumped up out of bed, took a quick shower and put on clean, comfortable clothes - yoga pants and a hoodie.

Melissa laid down in bed for a while, listening to her hypnobirthing music on her iPod, while the contractions were not too strong. Julian and I started to fill the birthing pool with the warmest water we could get from the sink via hose, supplemented by large pots of hot water we heated on the stove. Soon after the midwife arrived. Melissa came down to the living room and got in the pool and midwives #2 and #3 arrived. The whole practice was excited for Melissa’s long-awaited homebirth, so everyone came out for the event! We had Melissa get out of the the pool and try laboring in different positions for several hours. When she settled into letting her instincts guide her movements, she began to move like women move in middle eastern dance, as in “bellydance.” I knew this was one of the purported origins of the movements, but it was fascinating to see it so clearly. These natural movements seemed to be her instinctual response to the sensation of the contractions. They are also conducive to enabling the baby to descend into proper position.

It was a long labor followed by a long period of pushing, and the midwife thought at one point that Melissa may need to go to the hospital to complete the pushing and birth the baby, due to her exhaustion. Hearing that gave Melissa the motivation to return to the birthing pool and have some unwanted sips of sugar-spiked OJ, which rejuvenated her enough to get back in the bed and start pushing again. We could see the baby’s hair emerging and retreating with every pushing cycle. Finally her head emerged and it was such an emotional moment for everyone in the room (sister/doula, husband, mother, mother-in-law, 3 midwives and a midwife’s assistant) to see this adorable, chubby face come to light. Melissa took a quick break from pushing, then resumed and next came the baby’s upraised fist, followed by the rest of her body. With the help of midwife #2, Melissa lifted the baby onto her chest. Hazel Charlotte was born at 10:07pm! The baby started breastfeeding soon after and Melissa delivered the placenta. At this point we were all down in the living room, so after Melissa was cleaned and tended to, 4 of us hoisted her up by the sheet she was laying on and carried her up the stairs of their old Victorian house to the bedroom on the 2nd floor. Everyone gathered around to watch the baby get weighed. A very impressive 9lb 10oz!! Mind you that my sister is 5′2”, 105lbs at her non-pregnant weight. This all natural homebirth was no small feat! Melissa had a long recovery, but says it was all worth it and would definitely birth at home again.

I’ve been preoccupied with finishing up the very last of my coursework.. so I haven’t been blogging for a while, despite all the interesting articles I’ve come across, not to mention the running list of reproduction-related topics that I’ve been wanting to research and communicate on, in this form. Now the semester is over and I’m sitting in Philadelphia waiting for my sister, and only sibling, to go into labor for the first time. In other words, I will be a first-time aunt! I’ll be the doula of course. Stay tuned for blog entries about the imminent experience..

In other news, a friend forwarded me some information a month or so ago about a really interesting situation in southwestern Nigeria. In the town of Igbo-Ora, population 60,000, a local elder asserts that there is hardly a family without a set of twins or triplets. Some parents in the town even have several sets of twins! According to population experts, Nigeria as a country has one of the highest rates of multiple births, but this particular part of the country seems to be particularly populated with high numbers of multiples.

No one seems to really be quite sure why this is. Some have suggested that it is perhaps a genetic predisposition that accounts for this strange phenomenon. Most interestingly, is the diet-related hypothesis. The Igbo-Ora population consumes a local yam, called agida (Dioscorea, I imagine) in high quantities, utilizing it as a staple food. Yams contain compounds which mimic human estrogens. This was demonstrated for the first time this year by Cheng et al., who found estrogenic activity in all 7 species/varieties of Dioscorea they screened.

It’s interesting to review and compile all these different articles related to the effects of estrogen or lack of estrogen on the human body. It is related to my doctoral work and helps me to have a greater understanding of hormonal regulation of various physiological functions. For instance, one example currently very relevant is my sister’s pregnancy. She has experienced fertility issues for the last several years. In the spring, after I had been reading extensively on female hormones and health for months to prepare for writing grant proposals and beginning my research, I noticed that she had been displaying signs of estrogen deficiency. I suggested that she begin taking a mixed phytoestrogen supplement, and a month later she was pregnant! Now 9 months later, here we are this moment trying to determine if her contractions are indicative of the onset of true labor or if bebe needs a few more days before she’s ready.

Image credit: AFP

Estrogenic yam study reference: Cheng, Wei-Yi, Yueh-Hsiung Kuo and Ching-Jang Huang. 2007. Isolation and Identification of Novel Estrogenic Compounds in Yam Tuber (Dioscorea alata Cv. Tainung No. 2). J. Agric. Food Chem. 55: 7350-7358.

A major victory for indigenous land rights everywhere was won in none other than the Toledo District of Belize by the Maya people of Santa Cruz and Conejo villages. The two villages filed cases claiming that their customary land rights had not been acknowledged by two governmental entities in Belize - the Attorney General and the Minister of Natural Resources and Environment, by approving oil and logging exploration on lands traditionally held by the Maya.

The court declared that the villages hold “collective and individual rights in the lands and resources that they have used and occupied according to Maya customary practices and that these rights constitute “property”“ that the defendants must cease from any acts which “affect the existence, value, use or enjoyment of the property located in the geographic area occupied and used by the Maya people of Santa Cruz and Conejo without their informed consent.” The court ordered that the government must abstain from issuing leases, grants, concessions for resource exploitation including authorizing logging, prospecting or exploration (including for oil) and mining, as well as issuing any regulations concerning land use in those areas.

The recently delivered decision of Chief Justice Abdulai Conteh stated that Belize is obligated to respect and protect Maya customary lands based on various national and international statutes including the Belizean constitution, and the United Nations’ Declaration on the Rights of Indigenous Peoples. This is the very first judgment applied specifically to the U.N. declaration, which was adopted in September by the U.N. General Assembly.

Some may know that I conduct my fieldwork there in the Toledo District in Belize with the Maya people, so I am anxiously awaiting word on how this is going to affect the other Maya villages in the region, which are home to friends and collaborators. Hopefully this will set a precedent for decisions regarding land rights for Maya throughout Belize and indigenous communities everywhere. Few Belizeans thought the Chief Justice would rule in favor of the Maya people. What an exciting surprise turn of events!

Capsaicin, the compound found in chiles that makes them “hot,” as in picante, has been shown to have the ability to facilitate pain relief without affecting movement and touch as most anesthetics do. This could mean that mothers-to-be in labor could maintain the ability to move around during labor, know when to push and feel themselves giving birth, without the pain. Epidurals today do not allow this. The drugs used in epidurals today affect total nerve function, including those that send signals to the brain about the other non-painful sensations a person is feeling, as well as the nerves that send signals from the brain telling muscles how and when to move. Capsaicin has the ability to open channels selectively so that pain-killers given in conjunction will only enter the desired nerve cells.

The article from BBC NEWS explains how the Harvard research group used a compound which interferes with nerve signals just as conventional anesthetics do, but is actually too large to enter any nerve cell on its own. Capsaicin, however, has the unique capability of opening large enough channels in the cell wall for the large anesthetic compound to enter the cell. Channels are only selectively opened in the cell walls of pain receptor nerve cells, therefore no longer causing loss of sensation and paralysis in addition to killing pain.

Having the ability to walk, move and stand makes labor progress more quickly due to the helpful effects of gravity. But the implications of this go beyond speeding labor. Having an epidural as we know them today can often lead to what birth professionals call the “cascade of interventions,” where the administration of anesthesia (or some other medical labor or birth intervention) triggers a snowballing effect necessitating more and more interventions. Consider this scenario in which a laboring mother receives an epidural, is numb from the waist down so labor slows because she is not able to walk, move or change positions. Mom cannot feel when to push, so after trying pitocin to speed contractions unnaturally, the baby then has to be removed by forceps then requiring an episiotomy.

Here is a really nice diagram I found on the Birth International site. It nicely illustrates some of the trajectories that the cascade of interventions can follow. This one starts not with the epidural, but with induction which is often the case in these cascades. Induction is the act of artificially starting labor through the administration of pitocin (synthetic oxytocin) or other drugs. In terms of this diagram.. I think the use of capsaicin in conjunction with an anesthetic that cannot penetrate cell walls on its own, has the potential to route the cascade away from so many Caesareans and forceps/vacuum extraction methods, and the subsequent interventions.

I’ve been without a computer for the last 3 weeks.. thankfully I’m back.  Just a little plug for my alma mater.  Most Reed-related info toward the end of the two page Times article.

For the first time, scientists have succesfully gotten a surrogate animal to produce offspring of another species. Masu salmon parents conceived babies that were 100% rainbow trout. Previous attempts using fertile salmon were far less successful. This time around, however, as reported in the September 14th issue of Science, Okutsu et al. used salmon, which were sterile and unable to produce their own egg and sperm. The sterile salmon were triploid, meaning they had 3 sets of chromosomes in their cells. Humans, and most other animals are diploid, meaning we have 2 sets of chromosomes. Human gametes (eggs and sperm) contain just 1 set, then the egg and sperm combine completing the double set that codes for the new organism made of half mom and half dad. However, if you have a triploid organism, the 3 sets cannot equally divide in half to create viable sperm or egg, so these individuals are sterile, with rare exceptions.

In this study, germ cells that are the progenitors of sperm and eggs were harvested from trout and implanted into young salmon embryos. The salmon grew and developed viable rainbow trout sperm and eggs exclusively. When combined through artificial insemination, the surrogate female salmon produced offspring which were fully trout. Although salmon and trout are not endangered, many species closely related to them are. This successful innovative use of surrogates provides a technique for increasing population numbers of genetically true individuals of endangered fish species. Masu salmon reproduce more quickly than the trout do, so if the trout for example did become endangered, this technique would allow baby trout to be produced more quickly than nature would normally allow. And the technology is not specific to salmon and trout, suggesting that it could applied to other species as well… at least other fish species, it appears. Pretty neat.