Perspectives

Nature Versus Nurture Photo of tree © Pawel Gaul; illustration © istock Collection / both from thinkstockphotos.com

MARY C. BRUCKER

S Mary C. Brucker, PhD, CNM, FACNM, is an assistant professor, adjunct, at Georgetown University in Washington, DC, and she is the editor of Nursing for Women’s Health. DOI:10.1111/1751-486X.12103

http://nwh.awhonn.org

Sometimes I’m amazed by how much we don’t know. Even my smartphone apps can’t seem to find where Jimmy Hoffa is buried (even though I guess New Jersey is leading the list), or how to reliably choose the shortest line at the grocery store, or a credible way to predict when a woman will go into spontaneous labor. Even forecasting prognosis for a woman with ovarian cancer is an estimate at best. So it isn’t a surprise that we’re still debating nature and nurture. I first remember hearing the phrase in a college survey course at a time when I naively thought it (and most other questions) could be definitively answered. Yet there’s no clear answer except to say that both are important and both are evolving. In this issue of Nursing for Women’s Health there are articles on genetics (nature) and the horrors of human trafficking (nurture).

Chemotherapeutics are increasingly being prescribed based on genetics of the cancer. Genetic screening tests, such as for the BRCA gene, are being used by women to make personal health care decisions. If you went to school when Mendelian genetics prevailed, get used to concepts such as mitochondrial DNA or imprinting/ parent of origin genetic transfer. Discussion already exists about whether or not to perform genetic analysis on every newborn to dictate health care decisions over the lifespan. However, we can’t ignore the influences of the environment. This January a chemical leak in West Virginia resulted in polluted water and even after the initial cleaning, it was recommended that pregnant women (and the elderly) restrict their intake to bottled water because it

© 2014, AWHONN

97

Perspectives

Perhaps the best practice for nurses is to encourage healthful habits and to keep up-todate on emerging evidence on genetics, as new implications for practice are found

was unknown if even low levels of the chemicals could be dangerous for those populations. Certainly teratogenic effects are important, but ubiquitous violence, racial inequities and poverty also inevitably influence a person’s health and life, in addition to hurricanes, tornadoes and explosions of a nearby fertilizer plants. I also realize that sometimes nature and nurture overlap. Genetics may make a person more vulnerable to developing a disease but it takes an environmental insult for the condition to emerge. In any case, there’s no simple answer to nature versus nurture—the best answer seems to be “it depends.” So I expect more information will continue to emerge. But perhaps the best practice for nurses is to encourage healthful habits and to keep up-to-date on emerging evidence on genetics, as new implications for practice are found.

I like the approach a friend of mine takes, which includes both nature and nurture. She’s a midwife who says she always encourages healthful habits for pregnant women for the good of the woman, her fetus and if the fetus is female, her grandchildren, because that offspring’s maternal genetic material is found in the oocytes contained in the fetus’s body. NWH

Photo © JupiterImages / thinkstockphotos.com

Do you have a story to share? Maybe it’s funny. Maybe it’s sad. Whatever it is, it just might resonate with other Nursing for Women’s Health readers. So consider submitting a personal essay of 1,500 words or less to our regular back-page feature “Reflections on Women’s Health.” To view our author guidelines or to submit an essay, visit http://www.editorialmanager.com/nwh and click on “Instructions for Authors.”

Reflections

98

Nursing for Women’s Health

on Women’s Health

Volume 18

Issue 2