I love this book’s discussion of becoming the “outlaw mother,” of redefining the contours of motherhood and understanding that way YOU choose to do motherhood doesn’t have to look the same way others do it, or the way society makes you think it “should.” I also truly appreciate how vulnerable the author is in sharing the details of her personal story, which is certain to normalize the experience for women who find themselves in similar situations, as well as helping them feel less alone, which is invaluable.
However, I have a real problem with a very misleading sentence at the end of Chapter 23: “In cases of rheumatoid arthritis, an autoimmune condition that causes severe joint inflammation, fetal cells can help the mother’s body heal.” (Page 229)
In this chapter, she’s talking about the way fetal cells can migrate into the mother’s body, and how scientists are trying to understand the impact of this genetic transfer, which is a very interesting subject for sure. Some research does suggests that these fetal cells could contribute to tissue repair in the mother, and it is an interesting theory that might explain why some women with rheumatoid arthritis (current research suggests less than a third) DO experience remission while pregnant.
But the word “heal” (and the fact that this is a single sentence, with no follow-up explanation) is a big overgeneralization. The extent of the healing role of fetal cells found in the mother’s body is still under investigation. Also, if RA symptoms do happen to improve during pregnancy, this could also be due to hormonal and immune system changes, not solely due to fetal cells.
Either way, RA remission during pregnancy, for whatever reason it happens, is not the same thing as being “healed,” which seems to indicate a permanent recovery. In reality, many women with RA (current research suggests around 50%) experience a flare once their baby is born - and for many women, both myself and many I have personally met, postpartum symptoms can be quite severe and potentially even worse than prior to pregnancy. I’ve also met many women who didn’t develop RA until right after a pregnancy, which seems to suggest the changes to a mother’s body created by pregnancy are not necessarily/always positive.
There is little to no information out there on how to approach motherhood with a chronic illness like RA - and pregnancy resources often talk about a mother’s health as if she should have perfect control over it, which clearly we don’t. This leaves many women with chronic illness with feelings pretty similar to what the author described: wondering if it’s even realistic to be a mom in the first place, wondering if they can ever possibly do it “right,” wondering if they might pass their condition to their children, wondering why their path to motherhood looks so different from what they see around them. In book that otherwise seemed very detail-oriented, and where the author consulted many top doctors and scientists, this misleading sentence disappointed me.