Eat Sardines, Be Happy … and Sing
Midwifery Today, Issue 148, Winter 2023
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Originally published in Midwifery Today, Issue 59, Autumn 2001
When a human baby is still in the womb there is a priority, which is to feed her brain. Today we have a good understanding of the specific nutritional needs of the developing brain. The brain is mostly made of fat. This means that its basic needs must first be expressed in terms of lipids. Without being too technical, we must recall that the brain of the fetus has a real thirst for highly unsaturated fatty acids, particularly those of the omega-3 family.
The mother-to-be can use two ways to satisfy the huge demand for such fatty acids. The first is direct. It is to have a diet rich in preformed, highly unsaturated omega-3 fatty acids: in practice this means eating sea fish. Fish from the beginning of the seafood chain—such as sardines, pilchards, herring, or common Atlantic mackerels—are not polluted.
The second way is indirect. It is to make sure that the maternal body will be able to transform the parent molecule of this family—which is abundant in the land food chain—into longer and more desaturated molecules. Yet certain hormones, such as cortisol, are blocking agents of the metabolic pathway of unsaturated fatty acids. People who are not happy release cortisol at a higher level, typically when they feel dominated by somebody (e.g., an authoritarian spouse) or by a situation (e.g., being pregnant when they don’t want to be pregnant). We can conclude, from modern scientific data, that it is better for a pregnant woman to be happy.
We can also conclude that, from a biochemical point of view, to eat sardines and to be happy are the same: directly or indirectly, the mother can provide the long chain polyunsaturates that are necessary to feed the baby’s brain. Of course, both ways are not exclusive an can be complementary.
There is no simple recipe for happiness. The emotional state of pregnant women is traditionally the business of the family and the community. Today, in the age of medicalization of pregnancy and childbirth, health professionals also have a responsibility to protect the emotional state of pregnant women. One of their main duties should be to reduce the possible “nocebo effect” of prenatal care. Health professionals have a nocebo effect whenever they do more harm than good by interfering with the imagination, the fantasy life, or the belief system of the person they care for. For example, an isolated increased blood pressure at the end of pregnancy is, more often than not, a propitious sign of good placental activity: the placenta, which is the “advocate of the baby,” asks the mother to provide a little more blood. When the health professional presents this physiological response as bad news, although it is radically different from the disease of preeclampsia, the nocebo effect may be dramatic. The mother-to-be cannot be happy anymore.
Health professionals can have a spectacularly positive effect on the emotional state of pregnant women through their vocabulary, their attitude, and even their body language. They can also encourage or even organize events that are outside the framework of medical consultations. In the maternity unit at the Pithiviers hospital in France, we used to meet around the piano and sing together on Tuesday nights: pregnant women, young mothers and their newborn babies, midwives, cleaning ladies, secretaries, etc., could join the group. After singing. and often dancing, there was an atmosphere of happiness and even euphoria. Such sessions were probably more beneficial for the growth and development of the fetuses than would be a series of sophisticated ultrasound scans or a Doppler screening of the placental perfusion.
While in the womb of a singing mother, the baby can perceive enriched sound vibrations. This must be taken into consideration during this current age of professional singers, recorded music, radio and television, which is a time when most people, particularly pregnant women and young mothers, do not sing anymore. The universal lullabies have disappeared. The developing brain must also be fed with sensory stimulation.