The following is transcribed from a podcast featuring Julie Gunlock and Chelsea Follett discussing the latter’s op-ed, “Scientific and Medical Advances Saved My Baby.” The full podcast can be heard here.

Julie Gunlock:

Hi everyone, I’m Julie Gunlock, your host for the sixth episode of the Bespoke Parenting Hour. For those new to this program, this podcast is focused on how parents should custom tailor their parenting style to fit what’s best for their families, themselves, and, most importantly, their kids. Today, we are going to be talking about pregnancy. I’m going to reach way back, gosh, over a decade now — that’s so weird; I feel like I just had my babies. I’m going to reach way back in the memory bank and think about my own experience, talk about my own experience. I have a great guest on today. This is sort of a hot topic right now. Sadly, I should say sadly, it’s a hot topic right now.

Late last week, Chrissy Teigen — she’s a model, she’s a very famous model and entertainer, she’s the wife of John Legend, the singer John Legend — suffered a miscarriage. She was quite public about it. She posted some really gutting, very sad pictures and a statement about it on Instagram and it was on Twitter, and just a very, very sad statement. She’s gotten some criticism for being so public. I feel like we live in times where people have the ability to be public, and some people just are very public people. It’s sad to see some people weren’t so kind to her. But that is a tragic situation. Certainly pregnancy, and the risks associated with pregnancy and miscarriage and all of those issues, are on people’s minds right now.

There’s a new study out about drinking coffee when pregnant, another annoying study designed to scare pregnant women. We’ll talk about that a little bit. And, of course, we’re still dealing with COVID nationwide, so it’s just a very scary time to be pregnant. I think on a good day, on a non-pandemic day, our culture makes us feel like it’s scary to be pregnant, but it must be doubly so during the pandemic. My guest this week is a good friend, Chelsea Follett. She’s the Managing Editor of HumanProgress.Org, which is a project of Cato Institute. You should all follow Human Progress on Twitter. I think they’re on Facebook, Chelsea can tell us. Anyway, you should always follow Human Progress. It’s a wonderful project out of Cato.

The project exists to educate the public on how life has gotten better, and they do that by providing free empirical data on long-term developments and trends. Chelsea’s writing has been published in the Wall Street Journal, USA Today, Newsweek, Forbes, all over the place. And, she was named to Forbes’ 30 Under 30 list. I can’t even remember being under 30, but Chelsea was under 30, at least in 2018, in the category of Law and Policy. She is super smart, and I’m really thrilled to have her on today. Thanks for coming on, Chelsea.

Chelsea Follett:

Thank you so much, Julie, for having me and for that kind introduction and your kind words about the website. We are on Facebook, Twitter, Instagram, YouTube  — we’re very active.

Julie:

Great, great, great. Okay, so the reason you’re on, and I didn’t really mention this in the intro, is that you wrote a story, an article, I think it was in the Washington Examiner, is that correct?

Chelsea:

That’s correct. I was still on maternity leave when I wrote that article, that was almost two years ago. And wow, reading it brought back a lot of not-so-pleasant memories, it was a very dramatic birth experience. But I am so grateful that —

Julie:

Well, before you go on, I wanted to sort of tee this up a little bit because I blurted out that you’d written this article. But this article was called “Human Progress Saved My Baby,” and in it, Chelsea talks about her own — I really cannot stand the phrase — birth story … Because mine were more like birth dumpster fires. I never really had a sweet story that seems so calm and lovely. And neither did you, really, I would say after reading this article. Again, I’m sorry to interrupt you, but I wanted to let people know that this article, again, “Human Progress Saved My Baby” is worth a read. It’s amazing, but it’s tense. So, tell us the story itself and then also tell me why you wanted to write about it.

Chelsea:

Sure. So, it’s definitely the most personal article I have ever written, or op-ed. My daughter is almost two now, she is the joy of my life and I can’t imagine life without her, and I am so grateful that we live in an era where technology was able to save her life during her birth, as the title of that op-ed that you read gives away, that is what the article is about. We’re also in an era where lifesaving technologies are becoming more and more widespread globally. And that’s just wonderful, because no mother should ever have to lose a child, and it’s becoming rarer and rarer, especially in the developed world. So, Chrissy Teigen, whose case you just mentioned, fortunately that is not a very common experience here. Hopefully it will continue to become less common.

But to catch you up on the story, I didn’t include all of the details in that article, I’ll actually give you a few more details about what was going on. They do a lot of monitoring today when you’re pregnant, fortunately. And they found that her growth rate, my daughter’s growth rate, was not on track. She had something called intrauterine growth restriction, or IUGR. So, they decided to induce and it was a fairly long, unpleasant labor. And then when the article picks up, they found that her heart rate was not doing well with each contraction. So, we did have an emergency C-section. And when that was over, they found that she had her umbilical cord wrapped around her neck four times, so that’s what was causing her to not be able to descend with the contractions. That’s also what was causing her to not be able to get as much nutrition, which is what was causing the growth restriction. That’s why she was so tiny.

She’s doing great now, she’s very rambunctious. Now, she’s actually over the 90th percentile for height for her age and she’s doing very well. So, I’m just so grateful that the technology was there to allow her to be born.

Julie:

Yeah. And that’s the thing that’s so scary. Well, first of all, for those who don’t know, I also had to have an emergency C-section. If it’s either a case of you having a baby and everything went great and you never had to have an emergency C-section or younger people who are listening who haven’t yet been through this, emergency C-sections are tense because it’s very rushed, at least mine was. So, that’s nerve wracking. Did you feel it among the doctors and nurses? There’s this sort of rushed feeling and nervousness to get this baby out. Correct?

Chelsea:

Absolutely. It was terrifying, it was the most difficult thing I’ve ever gone through physically. Also, the recovery was not easy. But we got a baby out of it, so I’m very grateful that the technology was in place to allow for that.

Julie:

Yeah. And the thing is, in your article too, you go through some of the statistics of how much better maternal and infant mortality are and how fewer of these incidents there are, thank God. But the cord wrapping around a baby’s neck, that’s … I mean, I don’t want to speak because I’m not a doctor, and I didn’t actually look for the data on this. But I think that’s one of the reasons there’s still stillbirths. Many times they can’t see this and they can’t necessarily tell. So, like you said, that monitoring of the heart, the indications of the growth, these are all things to point to that. But they still are limited in what they can see inside the womb. So, these advances in technology is what’s preventing, I would say, a lot more stillbirths. Is that correct?

Chelsea:

That is absolutely correct. And as that technology improves, we should expect to see these rates continue to decline. But unfortunately, there is still a huge gap in access to these technologies. If you look at the rates of stillbirth in rich versus poor countries, you see that actually 98% of the world’s stillbirths take place in low- or middle-income countries. Only 2% of the world’s stillbirths are in high-income countries. So, that technology being in place, having the infrastructure and wealth in your society that you can access it, that makes a huge difference.

Julie:

Yeah. Yeah, absolutely. And I think I want to talk to you a little bit too about how you feel about home birth. This is something that makes me very nervous. I have a friend who almost lost her child due to a home birth. And in that case, it definitely could’ve been and probably was due to a midwife not handling the situation properly. They got her to the hospital and she delivered and it was fine, but it was really touch and go. And the doctor said, “This really might not have ended well.” But talk to me about your feelings on home birth because again, I personally … Home births have a higher rate of resulting in either injury or death of the child. And it worries me a little bit about that. But we were talking earlier about how there are requirements; for instance, midwives have to be able to have a plan to get you to the hospital. So, give me your sense on home birth. It’s a popular trend now, and when I hear stories like this, it worries me about people not having the medical professionals there.

Chelsea:

Right. So, around the world, home births are still very common, especially in poor countries. That can often be the norm in many communities, but we are seeing positive trends there as well. We’re seeing more and more births attended by skilled health staff, even if those births aren’t in hospitals. It’s now over 85% of births around the world that are attended by nurses or doctors or other skilled health staff. In developed countries like the United States, almost everyone opts, of course, to give birth in hospitals. You say that it’s a popular trend to give birth at home, but it’s actually a very small minority of women who opt to do that.

And I’m probably a bit more libertarian than you on this topic in that I think that people can assess their own risk tolerance. And if that’s something that a young, healthy woman wants to do, to give birth at home near a hospital with a plan in place to get there, with a Certified Nurse Midwife — and that’s such a small minority of women who choose to do that — but I think they should have the freedom to choose to do that, if that’s what they want. But almost everyone who has the ability to give birth in a hospital, who has access to that, chooses to do that. And I think that’s because most women do recognize that the technologies available in hospitals can be life-saving and the standard of medical care that you can get in a hospital is life-saving.

So, allowing more women around the world to have the option to give birth in a hospital, which again, for many people in many communities is not an option, that could have a huge effect in terms of saving mothers’ and infants’ lives. There was an article earlier this year of UNICEF warning that lack of hospital access due to lockdowns from the pandemic could actually cause a huge rise in child mortality. Because hospitals, they really just do have access to so many things that can save lives. I mean, there’s this sort of fallacy, I think, that whatever is natural is good, and whatever is artificial or modern is bad. But of course, we know that the natural rate of stillbirth, the natural rate of death in childhood, and the natural rate of maternal mortality is extremely high, and it’s only with technology and medical interventions that you can have a very low rate of infants and mothers dying.

Julie:

Yeah, well viruses are natural, and they’ve killed a number of people here. Coronavirus has killed a number of people in the United States. So, I hope some people … I agree with you on that fallacy of believing everything that’s natural [is good]. I mean, there’s plenty of … botulism is natural too and you shouldn’t really be … That is one of the most frustrating fallacies out there. Another natural thing is quinoa, I’m not interested in eating quinoa either. It doesn’t taste good. So look, it’s not all good, and I think the more that we tackle that fallacy, the better. But I do think that … I actually agree with you, I think that people should … I don’t think that I’m sort of less libertarian on this, I do think that people should have the choice. And I like how you framed that, of saying people should look at their risks and make decisions that are based on are they a healthy younger person having a child? Then they probably … This isn’t as risky a decision.

But I will say what frustrates me, and you brought up this sort of fallacy of natural and synthetic. That’s part of the problem, is that I think in order to make the decisions, I think the best way to do that is to make an informed decision. I think in pregnancy, there’s so much misinformation out there, and there’s so much pressure, and there’s so much guilt, and there’s so much shaming. And I don’t want to sort of go off on … I don’t want to whine about things on this. But I do think one of the … I mentioned in my intro, there’s a new study out about drinking coffee when pregnant. And [inaudible 00:14:58] wrote a piece last week over at [inaudible 00:15:01] — and I blogged on this just a little bit — about this issue, this new study out that basically says that if you … This is wild. If you are pregnant or even thinking about becoming pregnant, you should entirely stop drinking coffee. Have you seen this study? Did you see this study out?

Chelsea:

I’m not familiar with the study, but that is both unrealistic and it goes against the vast majority of studies that I’ve read on this topic. Obviously, the relationship between caffeine and pregnancy outcomes has been studied very extensively, and the vast majority of evidence says that a reasonable amount, like one cup of coffee a day, has no effect on your ability to conceive or to have a healthy child and no relationship to adverse outcomes. So, that’s very surprising to me that this study would say the opposite. But it may also be a case of the media presenting a study in a way that will maximize clicks, so that may not be what the study itself says. I’m not familiar with the actual study, but that often is the case.

Julie:

Yeah. Well, this study was published in the British Medical Journal, so right there when you … Let’s just pretend we’re both sitting here, we’re pregnant, we’re scanning the news in the morning. Because I will tell you that this … You are absolutely right, this new study generated thousands of …  I shouldn’t say thousands [of clicks], but I’m sure it did. But around the world, these sort of hyperbolic headlines saying you’re going to kill your kid if you have that cappuccino [generate clicks]. So, you’ve got the media sort of in hysterics, and they love this. Like you said, it generates clicks. And to media outlets, that’s what matters.

But this was published in the British Medical Journal, the BMJ is a very respected medical journal. And it was conducted by professor Jack E. James. It turns out though, that Doctor James has written two books and has sort of presented himself lately as sort of an anti-caffeine activist. Okay? These are things you don’t learn. You have to research it. You read the article in the Daily Mail, you don’t know that Professor James is an anti-caffeine activist, and you don’t know that he’s written two very lengthy books about the dangers of caffeine. But you do once you do the research. But as a pregnant woman you read this and you go, “Oh gosh, I’m doing terrible harm to my baby.”

What’s great though, and again I blogged about this last week, is … And Lenor also mentions this, that 20 public health officials, which were mainly women — I think there was one man among this list of 20 public health officials — wrote a letter to the British Medical Journal. It actually said, “We believe the review and its recommendations should be interpreted with extreme caution.” And I think for those of us who sort of follow the scientific world, that’s basically saying, “Toss this out.” The letter that they write goes into details about why this isn’t a … And it’s not, this study has a lot of holes in it and it really, really shouldn’t have passed muster. In fact, I don’t think that it should’ve even been published in the British Medical Journal. But the point is that the damage has been done.

I can sit here and say, “Hey, guess what guys? There’s a lot of doubt for this study.” But for the average person who’s just scrolling through headlines in the morning, they’re going to see this and it’s going to scare them. Stress is another issue that pregnant women have to worry about. So, what frustrates me is this sort of constant drumbeat that you’re doing harm to your child, that I think really makes being pregnant unpleasant. Was that something that you really dealt with? I mean, you are a smart person, you follow this stuff, you sort of know that certainly pregnancy in the United States is safer than anywhere else. But is this something that you dealt with when you were pregnant?

Chelsea:

Absolutely. I think that no matter how well-informed you are, you kind of can’t help it because there is just so much alarmism around pregnancy and birth and parenting. It can be really hard not to give into that fear. Again, this speaks to that strange hatred of modernity and modern conveniences like coffee, that is just illogical. You also sent me an article about a woman who thought that she was able to conceive a child because she basically stopped touching plastic and she started buying organic groceries. She switched to something she called chemical-free toothpaste, which is ridiculous because everything is made of chemicals. The human body is made of chemicals. It’s like saying that she wrote a sentence without any letters in it, it’s not possible.

But it speaks to this widespread ignorance of, and suspicion of, modernity and science and again, that strange belief that whatever is natural is good and anything artificial is bad. Because I think she probably meant to write ‘all-natural’ toothpaste. But of course, just because something is natural does not mean it’s good for you. In the area where I live, in the park where we often walk through, we’re always very careful to keep our daughter away from these really striking berries on bright pink stems that grow everywhere here called pokeberries. And a single one of them is poisonous enough to actually kill a small child, it’s terrifying. But they’re completely natural. So, if all you care about is eating what’s natural, you could eat these very poisonous berries. Nature is filled with plenty of toxic and poisonous things, and there are plenty of manmade things that are harmless. A normal amount of coffee has no adverse effects on pregnancy. They can now grow meat in a lab in a Petri dish and it’s perfectly safe to consume. It’s been tested to death and it’s safe, but it’s not natural.

Julie:

Right, right, right. Just to catch the listeners up, so I had sent Chelsea a blog that actually my friend Kelsey Bolar had sent me. Kelsey is at IWF, she does a lot of work on the comms side and she also writes on a number of issues. But she had sent me this. She has just had a child as well, so she sent me this blog called … Oh, let’s see, do I have it written down here? ‘Southern Curls and Pearls Blog.’ Okay? And this is what Chelsea was just referring to. This blog is apparently … And I don’t really read this stuff, so I was really appreciative that Kelsey sent this to me. And this is going to get confusing, by the way, because it’s Chelsea and Kelsey. So, let me see if I can keep this straight here.

Anyway, so Kelsey sent me this blog and apparently, it’s very popular. She [the blogger] has 1.1 million followers on Instagram. Now, you could tell me someone has five followers on Instagram. I’m a moron on this stuff, I guess, but I’ve been told that’s a lot. She’s very popular. And what’s so depressing is that she said that this was her most requested blog post in the 10 years since she’s been a blogger. And I’ll tell you why that’s depressing. Chelsea kind of touched on this, that she talks about how … She calls it pregnancy Q and A, where she shared her story on trying to conceive. Okay?

I don’t want to bore anyone with this, but this is kind of fascinating. She has this long story where she does not give any specifics. She says, “After receiving some negative results from a doctor’s visit,” so she, I guess ostensibly, she and her husband got tested. Again, she does not say what those tests are. She says they got these tests about a year into our journey, which means trying to conceive. “The doctor said we’d probably have to resort to IVF to get pregnant.” Okay, so she says, “For the next four months,” so before doing that she said, “For the next four months, [she and her husband] prioritized our health.” She says they “went on a journey to eat as healthy as possible and cut out as many toxins as we could.” And to do that, they ate organic. Chelsea and I can both talk about that. She ditched her Teflon pots and pans and, “Threw out all of the plastic in our kitchen.”

Chelsea sort of touched on this stuff, this idea of tossing out toxins. And she said, “Going chemical-free in my toothpaste.” But even when she talks about equating healthier with organic food, there are tons of studies on this issue. But my favorite is … and Chelsea I’m sure you know this study out of Stanford University that found no significant nutritional difference between organic and conventional food. Both conventional … And when I say conventional, that is using synthetic pesticides. Now, the thing that a lot of people don’t know is organic farmers also use pesticides. But they use what’s called … What do they call it, Chelsea? Is it like natural pesticides, non-synthetic pesticides? But in many cases, the synthetic pesticides are safer and leave less of a residue.

So, this idea that eating organic is just automatically healthy is a fallacy, and it also leads to spending more at the grocery store. And there’s other things; she talks about throwing out all of her plastics. I mean, unless you’re actually eating the plastic container that you put your leftovers in, you don’t actually need to toss your plastic out. You’re not harming yourself if you eat food that comes in a plastic container. This is the kind of thing though… And again, this was related to pregnancy. Because of course, she says, “After this four month time of eating only organic and tossing out our plastic, we got pregnant.” The message being conveyed there is if you don’t get pregnant … Because again, she doesn’t tell the reader what her tests were. So, we don’t know what was wrong with her. So, it tells every woman who’s dealing with infertility that you’re not working hard enough. Did you clean your cabinets out of plastic? Did you switch entirely to organic? Did you prioritize your health? Did you stop drinking coffee?

I mean, I think these are the kinds of things that really make it hard on women, and especially women who are struggling to get pregnant. Sort of not really a question at the end of that, Chelsea, but I think you would agree with that.

Chelsea:

I agree completely. I think that all of this misinformation and alarmism and hysteria does have a real cost. Because stress … You touched on this earlier, stress is something that we know is actually associated with a lot of adverse outcomes. Being under high stress is actually associated with having a harder time conceiving a child and with worse outcomes for pregnancy. So, stressing out women unnecessarily by making them worry that they’re not able to become pregnant because their toothpaste isn’t organic, that could actually be making things actively worse.

Julie:

Yeah. I actually … I don’t ever really say that I had fertility issues because I really didn’t, but I had miscarriages. And sometimes it is a fertility … I mean, you’ve got to be careful with the words you use here. But there are problems of women conceiving but then not being able to carry the pregnancy to term. And it’s all kind of complicated because that’s not really a fertility issue, that’s a sort of a ‘hanging onto it’ issue. But I remember during those times where the doctor would say, “You just need to calm down.” You know that emoji with the head explosion? That’s hard. It is hard to calm down.

Chelsea:

It is.

Julie: 

It is hard to calm down when you’re in a situation where you’re trying very hard to have children and things aren’t going well. And you have the tragedy, we talked about Chrissy Teigen. I thought what she wrote was just gutting, and it reminded me a lot how I felt. So, to add on this layer of … It was interesting Chelsea, I was in a doctor’s office, I had to get some test work done. And there was a September issue of InStyle. So, like anyone does, I was sitting around reading this, and there was an article with Kristen Wiig from Saturday Night Live. She has 9-month-old twins now, they’re probably 12 months old now, and they were born via surrogate. And she had a very interesting … She said some really interesting things in her interview talking about how they tried IVF for three years, she and her partner. She said it was a very long road, it was emotionally and spiritually exhausting. She said, “It was a very difficult time in my life, I wasn’t myself.”

And there’s this one line that just struck me. She talks about once the surrogate is pregnant and they’re at the doctor’s office, and she and her partner and the surrogate are there all together for a checkup, and they feel the baby kick for the first time. And she said, “I was over the moon feeling them kick.” And then she says, “But then I would get in my head and ask myself all these questions like, ‘Why couldn’t I do this?’” And it’s so sad. That’s just so sad because I think when you have blogs … And I don’t mean to beat up on that blogger, I think she was well-meaning. But there is this sense of, you think about Kristen Wiig doubting herself and constantly questioning herself, and for those women who don’t have the money to go the surrogacy route or the IVF route. And let me tell you, that is an expensive … I never had IVF, but it’s very expensive, very time consuming. You’re having hormones pumped into you, it’s very emotional.

So, I think you’ve got a situation here where then you have in your head that, “Oh, maybe I didn’t prioritize my health.” Or, “Maybe I’m using plastic containers or Teflon.” Or, “Maybe there’s too many pesticides on my …” This is the kind of stuff that makes it just … It makes pregnancy, it makes the journey, it makes everything associated with it very hard, and I wish there was less of that. I really wish that there was less of that kind of noise around pregnancy.

Chelsea:

Definitely. It’s unnecessary and it’s illogical. So many women blame themselves, but especially with first trimester miscarriages, it’s usually due to a chromosomal issue or something that you can’t control. It’s, in any case, definitely not because of your brand of toothpaste. It’s very rarely due to anything external. So, the culture that has women constantly blaming themselves and being afraid that their every decision to eat a non-organic piece of food could be harming their child, I think, is what’s toxic. And it’s very illogical. GMOs for example, are one of the targets often of hate from the anti-modernity crowd. The old method of creating new breeds of wheat and other foods that we eat before modern genetic modification was to just sort of randomly scramble the genes all at once until you got a usable product. And many organic food products were created that way. GMOs are much more specific because they’re changing a single gene at a time. So, it can’t possibly be less safe.

Julie:

But you’re leaving out the best part, Chelsea, which is they would blast it. It was truly like a sci-fi. It was like a sci-fi movie. They would blast it with … Wouldn’t they blast it with radioactivity? They would just … It was like the stuff of a 1950s sci-fi movie. Because they didn’t really know what monster was going to come out of this. They would just blast it and then hope they got something. I’m terrible to put you on the spot like this because I should know this, but what are some of the things that we got out of that? Different colored cauliflower? I can’t remember. There are some odd things that came out of that scrambling of genes. Do you know offhand?

Chelsea:

I don’t have it off the top of my head. I know one of the top strands of wheat came out of that — I think it was wheat. A lot of very popular organic foods did — a lot of foods that people who hate GMOs have no problem with, came out of this, as you say, very sci-fi sort of method of blasting things with radioactivity. And by the way, saying radioactivity, that’s not to dismiss this method. They’re not unsafe. Neither are GMO foods. It just sounds very unnatural. And again, that gets to this strange fallacy that somehow everything natural is good and everything artificial or modern is bad, which especially in the case of pregnancy — where the natural rate of death in childbirth and the natural rate of stillbirth and childhood death is so high — that’s a very dangerous fallacy to subscribe to.

Julie:

Yeah, yeah, yeah. It really is. I really love talking about this issue, and I could talk about it for hours more. And I do think that it’s one thing that’s funny, and I know I need to wrap this up, but one thing that’s funny is we’ve been talking about pregnancy and getting pregnant and the risks involved. But your baby is now an active, healthy [child] — I love the word rambunctious. I think that is definitely a word that needs to be used more, it’s not used nearly enough. The word rambunctious is so … It elicits such a cute image in my mind. She’s happy. You said she’s two, correct?

Chelsea:

She’s almost two. She’ll turn two at the end of this year and she is, my gosh, constantly running around our townhouse, up and down the stairs, she always wants to be outside running through the park and exploring. She’s learning new words each day, and just seeing her grow and explore is truly the highlight and joy of my life. I’m so, so grateful — I know I keep saying this — I’m just so grateful to have her in my life, and I can’t imagine if I had gone through that pregnancy and birth in an era without modern medical technology or in an area of the world without access to it, how my life would be.

Julie:

Well, I’m so glad you came on. Again, I’m sure you’ve heard this before, the days are long but the years are short. And that is definitely where I am right now because my youngest is 10, and it feels like it has flown by. And it has, it really has. And it does, it does for everyone. I’m not the only one who uses that phrase. So, enjoy this time. And again, I think it’s so important your message about … And your article. Again, I really encourage people to read Chelsea’s article. I think it’s important in an era where people sort of stick their nose up at things automation. Factories are wonderful. I don’t know why factories are now a … You say the word factorization or automation or factories and it’s like a pejorative.

I mean, this stuff … Automation helped humans get away from injuries, from heavy lifting, from painful, painful lives, working lives at the very least. And really painful all the time. There are many things about modernity that we, who live in modern times and benefit from modern times, sort of roll our eyes. But these are wonderful things. And modern medicine has allowed more babies to be born and has allowed women to enjoy their children and avoid the tragedy that was quite common only 100 years ago when you look at child mortality rates and maternal mortality rates — pretty horrifying. So, I think this is a really important article that you wrote. Thanks for coming on and talking to me about this.

Chelsea:

Thank you, Julie.

Julie:

As listeners to this podcast know, I usually end the podcast by talking [about] something in the past to give people perspective on, really, just how crappy life was in the past. I mean, we sort of live in an age where there’s Downton Abbey or there’s another sort of PBS costume drama where everyone looks so healthy and their teeth are straight. Their teeth aren’t just straight, they’re veneered, they’re Hollywood veneered. And they look like they smell good and their clothing is all clean. Even when there’s tragedy, it’s done in such a beautiful way. It’s filmed beautifully, and there’s rarely anything unpleasant about the scene. But that was not what it was like. And I wanted to read actually a little bit from Chelsea’s piece because she gets into some of the data that we didn’t get into, and I think it’s kind of important.

She says, “The specifics of my daughter’s situation may have been unusual, but her survival is an example of a broader trend. Thanks to medical advances, the global rate of stillbirth per 1,000 births has fallen from 24 in the year 2000 to 18 in 2015, with decreases seen in all regions of the world. In my daughter’s case, for example, those advances included external monitoring of the fetal heart rate during labor and a cesarean delivery. Not only has there been progress in reducing stillbirths, but more and more children survive to see their first birthday. The global infant mortality rate per 1,000 live births fell from 65 in 1990 to less than 30 in 2017, according to the World Bank.”

She goes on to talk about, “As extreme poverty becomes more rare and as living standards rise and as small changes in sanitation and nutrition exert a dramatic effect on infant health, more babies live.” And I think one thing we forget is that extreme poverty is very rare today. In 1820, 94% of the world population lived in extreme poverty. We’re talking about people starving to death, people not having shelter, literally walking around without proper clothing. This is extreme poverty. And think about that: in 1820, 94% of the world lived in extreme poverty. By 1990, so over 100 years later, that number was 34.8%. In 2015, that was just 9%. When the world’s living standards rise, when people become wealthier, when they have more money to spend, for instance, on healthcare, and when countries have more money to spend on, for instance, medical care and medical research, everyone’s lives improve.

I’m really thrilled that we got to talk about this today. I think it’s an important subject. And as Chelsea and as the Human Progress Project continually tries to remind us, our lives are improving every day. 

Thanks everyone for being here for another episode of the Bespoke Parenting Hour. If you enjoyed this episode or like the podcast in general, please leave a rating or review on iTunes. This helps ensure that the podcast reaches as many listeners as possible. If you haven’t subscribed to the Bespoke Parenting Hour on iTunes, Spotify, Google Play or wherever you get your podcasts, please do so, so you won’t miss an episode. Don’t forget to share this episode and let your friends know that they can get Bespoke episodes on their favorite podcast app. From all of us here at the Independent Women’s Forum, thanks for listening.

Today marks the third installment in a series of articles by HumanProgress.org called Centers of Progress. Where does progress happen? The story of civilization is in many ways the story of the city. It is the city that has helped to create and define the modern world. This bi-weekly column will give a short overview of urban centers that were the sites of pivotal advances in culture, economics, politics, technology, etc.

Our third Center of Progress is Mohenjo-Daro, a city in today’s Pakistan that pioneered new standards of urban sanitation. The city is thought to have been constructed circa 2500 BC, although the site has been inhabited since around 3500 BC. Mohenjo-Daro was the largest urban center of the ancient Indus Valley civilization, covering nearly 500 acres, and one of the world’s earliest major cities.

The people of the Indus Valley civilization invented new water supply and sanitation devices that were the first of their kind. They included piping and a complex sewage system. Tunnels under Mohenjo-Daro carried the city’s waste to a nearby estuary. Almost all of the city’s houses had indoor baths and latrines with drains, and the city also showed its dedication to cleanliness with a large public bathhouse used for ritual bathing. National Geographic has opined that their civilization enjoyed the “ancient world’s best plumbing,” in some ways surpassing even the plumbing system that the Roman civilization would later create.

Ever since humanity gave up hunting and gathering to live in permanent settlements, our species has faced health challenges related to hygiene and the proper disposal of waste. Since the advent of cities, humanity has been vulnerable to rapidly spreading illnesses, because disease propagates more easily in concentrated populations. That is particularly true without adequate sanitation, and water-borne illnesses—such as cholera, diarrhea, dysentery, hepatitis A, typhoid, and various gastrointestinal diseases—were once a common cause of death.

Advances in sanitation have allowed people to live near one another in cities with less risk to their health than in the past. In particular, safe disposal of effluent to spare the water supply from contamination has proved to be a truly game-changing innovation. It has been argued that plumbers are the unsung heroes of civilization.

Today, Mohenjo-Daro is a striking archaeological site in the Sindh province of Pakistan. The site’s name means “Mound of the Dead” in Sindhi. Only part of the ancient city has been excavated and much of it remains hidden. Mohenjo-Daro has been designated as a UNESCO World Heritage site. Located on the right bank of the Indus River, Mohenjo-Daro is the most impressive of the ruined cities remaining from the Indus Valley Civilization. Mohenjo-Daro’s surviving structures are made of bricks fashioned from red sand, clay, and stones, lending the ruins a ruddy hue.

The Indus Valley civilization arose in the floodplains of the Indus and Sarasvati rivers in what is now northwest India and Pakistan, around 5000 years ago. The rivers flooded twice a year in a predictable manner, making the land fertile and allowing the Indus people to farm everything from cotton to dates to support their growing population.

Their prosperity also flowed from conflict avoidance and from their vast trade networks. They established one of the first long-distance trade relationships in the world by exchanging goods with the Mesopotamians located nearly two thousand miles to the west, as early as 3000 BC. Indus exports included spices such as clove heads, luxury goods like carnelian beads artfully etched with acid, and possibly even livestock such as water buffaloes. Their imports from the Mesopotamians included textiles and various artistic motifs and legends⁠—including aspects of the legend that would come to be known as the Epic of Gilgamesh⁠. The Indus people also had what is thought to be a written language, now called the Indus Script, which has yet to be deciphered by scholars.

If you could have visited Mohenjo-Daro in its heyday, you would have seen an orderly city of dense, multistoried homes with flat roofs fashioned out of uniformly sized bricks, standing along a grid of perpendicular streets. The grander houses had up to twelve rooms. You would have seen people gathering water, in decorated pottery jugs, from the numerous public wells and chatting, perhaps discussing art. Archeological evidence suggests that Mohenjo-Daro’s residents enjoyed art forms ranging from metal sculpture to dance. You may have observed children playing games, including games with dice, which many historians believe that the Indus people invented.

The city’s population may have peaked at around 40,000 people, similar to the population of Annapolis, Maryland, today. The men probably wore a cloth around their waist, perhaps gathered in a way that resembles modern dhoti pants, while the women wore longer skirts or robes. Wealthy people of both sexes wore jewelry with ivory, lapis, carnelian, and gold beads, as well as elaborate hairstyles and headdresses.

Walking through the city, you would have observed that Mohenjo-Daro had no grand temples, palaces, monuments or royal tombs. The society of Mohenjo-Daro seems to have been far less hierarchical than the cities of the Mesopotamians with whom the former traded. The people in Mohenjo-Daro may have had no king or, if they had one, he had only little authority. The lack of any royal structures certainly suggests the absence of a powerful ruler, although it remains unknown what kind of system governed the city.

Instead of a palace, the largest structure in the city was an immense, elevated public bathhouse. The Great Bath of Mohenjo-Daro measured almost 900 square feet, with a maximum depth of around 8 feet. It was constructed of fine brickwork, with a pool floor made of three layers: sawed brick set in gypsum mortar, then bitumen sealer, followed by another layer of sawed brick and gypsum mortar.

The status of the bathhouse as the city’s biggest and most prominent structure suggests that the people of Mohenjo-Daro highly valued cleanliness. Their entire ideology may have been based on cleanliness, according to historian Gregory Possehl of the University of Pennsylvania.

The bathhouse may have been a sacred place, and scholars believe that it was likely used for ritual bathing. The people did not need to use the bathhouse for everyday washing, because the houses of the city each had what was then a remarkable, groundbreaking feature: practically every home in the city, from the largest to the humblest, had a washroom.

These rooms were typically small, and square or rectangular in shape. In each washroom, the brick pavement floor was carefully built to slope toward a corner containing a simple latrine and drain, as well as a drained washing area. The slanted floors helped to ensure proper drainage, and the bricks were set tightly together to prevent leaking. Around each drain-hole the bricks were so meticulously rubbed down and fitted together that the joints were nearly invisible. In some cases, the bricks were overlaid on a bed of pottery debris to further bolster the floor’s resistance to leaks.

Homes with washrooms on upper floors were fitted with vertical terracotta pipes that carried effluent down to the street-level. The pipes of fired clay were joined together with tar to make them watertight. The Indus were the first people to have indoor plumbing, perhaps as early as 3000 BC. The pipes were positioned so that wastewater flowed down into the drain ditches that ran along every avenue in the city, and then into underground tunnels. Thanks to the invention of drain ditches, the cleanliness of the city’s streets was remarkable for the ancient world.

As the city’s population grew and the amount of waste it processed increased, the people kept their drain ditches functional by raising the brick walls alongside the former—to prevent effluent overflow into the streets. Archeological evidence suggests that the walls grew gradually in size to meet the city’s needs. The ditches and connected underground sewage tunnels carried waste away from the city, protecting its well-water supply from contamination.

Just like modern washrooms, the washrooms of Mohenjo-Daro were used for multiple personal hygiene activities, including bathing. Surviving artifacts suggest that the Indus poured pottery jugs of water over themselves to shower, and utilized clay scrapers similar to Greco-Roman strigils to cleanse themselves. In these rooms they also used pottery rasp tools to remove cuticles and shape their nails. Some washroom ruins contain what may be oil residue, suggesting that the washroom was also where Mohenjo-Daro’s residents moisturized their skin with oils.

Some traditions appear to be timeless. For example, evidence suggests that Mohenjo-Daro’s children played with bath toys just like today’s children. Instead of rubber ducks and plastic boats, their toy figurines were made of pottery. “[T]o judge from the number of pottery models that have been found in the drains, it would seem that the childish habit of taking play-things into the bath has persisted for thousands of years,” according to the British archeologist Ernest Mackay, who led the excavation of Mohenjo-Daro in the 1920s and 1930s.

Children were arguably the greatest beneficiaries of Mohenjo-Daro’s dedication to hygiene, although the city’s washrooms and sewage system were essential to the health of all of its people. While it can be hard to remember for those of us lucky enough to be able to take modern sanitation for granted, standards of hygiene throughout most of human history have been appalling. Associated illnesses were responsible for high rates of mortality, especially among children.

Mohenjo-Daro’s advanced plumbing serves as a reminder that progress is not steady or linear. Many people who lived thousands of years later coped with conditions far less hygienic than those enjoyed by Mohenjo-Daro’s people in the 3rd millennium BC.

It was not until the 19th century that urban sanitation became widespread. Those advances, along with the discovery of the germ theory of disease, are the primary reasons for the dramatic rise in human life expectancy, according to Nobel Prize–winning economist Angus Deaton. While more people now enjoy proper sanitation than at any other time in history, even today, in poor areas of the world, far too many people contend with inadequate sanitation and accompanying diseases.

Mohenjo-Daro is thought to have been gradually abandoned almost four thousand years ago, when the Indus river shifted its course and farmers could no longer rely upon it to irrigate their crops. Today, Mohenjo-Daro is best-known as the largest remnant of the enigmatic Indus Valley civilization. Because the Indus people’s writing system is currently unreadable, many aspects of that civilization remain a mystery. The religion and seemingly kingless government system of Mohenjo-Daro are unknown, as are the reasons for the Indus Valley civilization’s ultimate demise.

For developing plumbing and wastewater management, Mohenjo-Daro has earned its place as our third Center of Progress. Without washrooms and sewage systems, our lives would be far shorter and less hygienic.

Between 1960 and 2015, world population increased by 142 per cent, rising from 3.035 billion to 7.35 billion. During that time, average income per capita adjusted for inflation increased by 177 per cent, rising from $3,680 to $10,194. Moreover, after 56 years of human use and exploration, the vast majority of the commodities tracked by the World Bank are cheaper than they used to be – either absolutely or relative to income. That was not supposed to have happened.

According to conventional wisdom, population growth was to be a harbinger of poverty and famine. Yet, human beings, unlike other animals, innovate their way out of scarcity by increasing the supply of natural resources or developing substitutes for overused resources. Human ingenuity, in other words, is “the ultimate resource” that makes all other resources more plentiful.

Earlier this year, the World Bank updated its Pink Sheet, which tracks the prices of 72 commodities going back (in most cases) to 1960. I have eliminated some repetitive datasets and some datasets that contained data for only very short periods of time. I was left with 42 commodity prices, which are included in the chart below.

As can be seen, out of the 42 distinct commodity prices measured by the World Bank, 19 have declined in absolute terms. In other words, adjusted for inflation, they were cheaper in 2016 than in 1960. Twenty-three commodities have increased in price over the last 56 years. However, of those 23 commodities, only three (crude oil, gold and silver) appreciated more than income. In a vast majority of cases, therefore, commodities became cheaper either absolutely or relatively.

Figure 1: Worldwide Commodity Prices, Population and Income, 1960-2016

It is often assumed that population growth must inevitably result in the exhaustion of natural resources, environmental destruction and even mass starvation. Take, for example, The Limits to Growth report, which was published by the Club of Rome in 1972.  Based on MIT computer projections, the report looked at the interplay between industrial development, population growth, malnutrition, the availability of nonrenewable resources and the quality of the environment. It concluded:

 “If present growth trends in world population, industrialization, pollution, food production, and resource depletion continue unchanged, the limits to growth on this planet will be reached sometime within the next 100 years… The most probable result will be a rather sudden and uncontrollable decline in both population and industrial capacity… Given present resource consumption rates and the projected increase in these rates, the great majority of currently nonrenewable resources will be extremely expensive 100 years from now.”

It has been 45 years since the publication of The Limits to Growth. So far, the dire predictions of the Club of Rome have not come to pass. On the contrary, we have seen an overall decline of commodity prices relative to income – in spite of a growing global population.

Can this happy trend continue for another 55 years and beyond? To get a glimpse of the future, we must first understand the concept of scarcity.

Scarcity or “the gap between limited – that is, scarce – resources and theoretically limitless wants”, is best ascertained by looking at prices. A scarce commodity goes up in price, while a plentiful commodity becomes cheaper. That was the premise of a famous bet between Stanford University Professor Paul Ehrlich and University of Maryland Professor Julian Simon. Ehrlich shared the gloomy predictions of the Club of Rome.

In his best-selling 1968 book The Population Bomb, Ehrlich reasoned that over-population would lead to exhaustion of natural resources and mega-famines. “The battle to feed all of humanity is over. In the 1970s hundreds of millions of people will starve to death in spite of any crash programs embarked upon now. At this late date nothing can prevent a substantial increase in the world death rate,” he wrote.

Simon, in contrast, was much more optimistic. In his 1981 book The Ultimate Resource, Simon used empirical data to show that humanity has always gotten around the problem of scarcity by increasing the supply of natural resources or developing substitutes for overused resources. Human ingenuity, he argued, was “the ultimate resource” that would make all other resources more plentiful.

In 1980, the two thinkers agreed to put their ideas to a test. As Ronald Bailey wrote in his 2015 book The End of Doom: Environmental Renewal in the 2lst Century:

 “In October 1980, Ehrlich and Simon drew up a futures contract obligating Simon to sell Ehrlich the same quantities that could be purchased for $1,000 of five metals (copper, chromium, nickel, tin, and tungsten) ten years later at inflation-adjusted 1980 prices. If the combined prices rose above $1,000, Simon would pay the difference. If they fell below $1,000, Ehrlich would pay Simon the difference. Ehrlich mailed Simon a check for $576.07 in October 1990. There was no note in the letter. The price of the basket of metals chosen by Ehrlich and his cohorts had fallen by more than 50 percent. The cornucopian Simon won.”

Simon’s critics, Ehrlich included, have since argued that Simon got lucky. Had his bet with Ehrlich taken place over a different decade, the outcome might have been different. Between 2001 and 2008, for example, the world had experienced an unprecedented economic expansion that dramatically increased the price of commodities.

True, but Simon’s thesis does not have to account for price fluctuations that are heavily influenced by the ups and downs of the global economy as well as disruptive government policies (e.g., oil crises in 1973 and 1979). Rather, Simon posited that as a particular resource becomes scarcer, its price will increase and that will incentivize people to discover more of the resource, ration it, recycle it, or develop a substitute.

Commodity prices, academic research suggests, move in so-called “super-cycles,” lasting between 30 and 40 years. During periods of high economic growth, demand for commodities increases. When that happens, commodities go up in price. It is during this period that high commodity prices encourage the discovery of new supplies and the invention of new technologies. Once economic growth slows down, prices of “now copiously supplied commodities fall”.

Accordingly, the current commodity cycle seems to have peaked in 2008. In June 2008, for example, the price of West Texas Intermediate crude oil peaked at $154 per barrel. By January 2016 it stood at $29 (both figures are in inflation adjusted 2016 US dollars). The once-high price of oil has led to hydraulic fracturing, which has revolutionized the oil industry. Today, “fracking” continues to enable us to access previously inaccessible oil reserves in record volumes. In fact, humanity is yet to run out of a single “non-renewable” resource.

Unfortunately, many people, including Paul Ehrlich, and many organizations, including the Club of Rome, believe that the answer to scarcity is to limit consumption of natural resources. In reality, consumption limits are unpopular and difficult to enforce. More often than not, their effects fall hardest on the most vulnerable. A switch from fossil fuels to “renewable” sources of energy, for example, has increased the price of gas and electricity in many European countries to such extent that a new term – energy poverty – had to be coined.

According to the German magazine Der Spiegel, “Germany’s aggressive and reckless expansion of wind and solar power has come with a hefty price tag for consumers, and the costs often fall disproportionately on the poor.”  In democracies, such policies are, in the long run, unsustainable. More important is the fact that they are unnecessary, because real solutions to future scarcity are more likely to come from innovation and technological change.

I do not mean to trivialize the challenges that humanity faces or imply that we will be able to solve all of the problems ahead. Instead, I want to suggest that human brain, the ultimate resource, is capable of solving complex challenges. We have done so with disease, hunger and extreme poverty, which have all fallen to historical lows, and we can do so with respect to the use of natural resources as well.