The Final Push Countdown to Life: The Extraordinary Making of You

This is Harrison and he was born at 23 weeks, which is incredibly early.

And you just feel, you know, so much emotion,

looking at a baby that is this small, this young and this vulnerable.

He really shouldn't be here, he should be inside his mum.

Often born without fingernails and with their eyelids sealed shut,

these premature babies are fighting for their lives.

Inside their bodies, vital changes which should have happened

while in the womb still need to take place.

I'm not sure what he can see or how much sense

he can make of the world because the neurons in his brain are not

fully formed, his senses are not fully developed.

My older son was born premature and...

It is very moving, it takes me back,

because we were worried about him,

but he was early, but not as early as this young boy.

Many months will pass before some of these babies can leave hospital.

But the technology in this room will give them

the best chance of survival.

HORN BLARES

In this final episode, we journey from 24 weeks to 40 weeks...

SHE GROANS

..and the moment when we have to face the outside world

and survive on our own.

CAT YOWLS

We home in on the moment when bones harden...

..lungs mature...

..and our senses switch on,

flooding the brain with new impressions of the world.

Yet not everything will always go to plan.

Those last precious months may shape not just your long-term health

but your entire future.

HORN BLARES

To be a strong human, we need a strong skeleton.

An adult skeleton is made up of over 200 bones.

These give us shape and movement.

They protect our vital organs.

And muscles attached to the ribs enable our lungs to expand

and fill with life-giving air.

It is a strange thought that we all began without a single

bone in our body.

Our skeleton was made of supple cartilage.

But at 25 weeks, the pelvis,

our largest bone, is forming.

It is a very precise process.

If it is disrupted you will be floppy,

with little support or shape.

Nine-year-old Janelly was born without the ability to make bones.

Our bones are formed by special cells called osteoblasts.

They swarm around the skeleton,

replacing the soft cartilage with a hard calcium-based mineral.

But this process produces a damaging chemical

which stops our bones from hardening.

So the body has developed a response.

A gene is activated, creating a protein -

TNSALP -

which neutralises the damaging chemical.

This lets bone formation continue.

But in Janelly, this gene is faulty...

..so her supple cartilage never turned to strong bone...

..leaving her on the edge of survival.

Que quieres, hmm?

Que quieres?

But before they were forced to make that choice,

Janelly's doctors heard of a new drug being trialled in Australia.

Going to listen to you.

Yes, we are!

Suddenly, out of the blue, there was hope.

Dr Jill Simmons has been treating Janelly for the past seven years.

We had heard about the drug,

but it was very early in the clinical trial.

There was almost nothing known about it at this point

but at this point in Janelly's life, there was also no other option.

So, this is when she was at her worst.

Compare it to an X-ray of a normal 18-month-old child.

Well, Janelly's made grim viewing. It showed a severe lack of bones.

Normal bone development happens not just in the womb

but all the way through to our teenage years.

Janelly's doctors hoped that the new drug might stimulate her body

to start this bone formation.

After an agonising six-month wait, they X-rayed her.

What they saw was amazing.

The drug had replaced the missing protein

Janelly's body couldn't produce.

It was astonishing. Janelly had started to develop real bones.

I think when you look at the X-rays,

it's one of the most miraculous things

that I have ever seen as a doctor.

Here we were seeing bones grow from where

there had been no bones before and it was an incredible experience.

Te gusta, Janelly?

Nine-year-old Janelly's treatment is ongoing,

but doctors are confident that she will continue to improve

and live a long and happy life.

There is, of course, more to being human

than just flesh, blood and bone.

At the top of your body, the most complex organ of them all

is beginning to get organised.

At 27 weeks, our brain is already extremely active.

Cells transform into wonderful, complex structures,

reaching out to connect with each other.

Most of the brain's growth is now in the wiring.

Fatty sheaves are wrapped around the brain cells,

insulating them so they can send signals around your head.

You are making an estimated 100 billion new connections every single day

and you are beginning to lay the foundations

for one of the most important things in the future - your memory.

This is Joey.

He is one of a handful of people being actively studied

because of his extraordinary memory.

I can't quite explain it.

The memory is just there.

It is very clear, it's very quick and it is almost like I see

my life very chronologically, if that makes sense, like a movie.

If you give me a date, I can usually tell you something that

happened on that day or vice versa.

OK, well, it just so happens, obviously enough,

I have a few dates here.

If you don't mind, I'm going to try testing you now.

So, 31st of August 1997.

-Well, that was a Sunday.

-OK. OK, that's good.

I remember... So, that was the day that Princess Di passed away.

Absolutely right, yeah.

June 24, 2011.

I remember hearing the news that New York

had legalised same-sex marriage.

Absolutely, there you go.

-That was a Saturday.

-Yeah.

-Thursday. Tuesday.

-Yes.

And I remember that one very well - the OJ verdict.

I also lost my wallet, coincidentally.

Joey certainly has an exceptional memory

and it begs the question, do memories start way back in the womb?

To have memories, we need to have formed senses

and the very first to develop is hearing.

Old Mother Hubbard Went to the cupboard

To fetch her poor dog a bone.

But when she got there The cupboard was bare

And so the poor doggy had none.

No bigger than a grain of rice, this amazing coiled snail-like

structure, the cochlea, is the sensory organ for hearing.

She went to the bakers To buy him some bread

But when she came back, The poor dog was dead.

Sound waves cause fluid inside the cochlea to move...

..A motion that is picked up by 30,000 tiny hair cells.

At 28 weeks, sounds coming from the outside world should spark

these tiny hair cells into life...

..sending signals to our brain, which we interpret as sound.

And it is time for Kirsten to find out

if her unborn baby has arrived at this life-changing moment.

So, we can see the internal structure of the baby's brain.

There is the baby's little cheeky face looking at us.

It's amazing how much it has grown.

They are astonishing images, aren't they?

Do you talk to your baby at all?

Yeah, always first thing in the morning

and then my partner likes to blow raspberries all over my tummy.

-MICHAEL BLOWS A RASPBERRY

-Yeah, and I often get a kick with that.

-And then I sing as well, I like the Disney songs.

-OK.

-But I'm an awful singer.

-What sort of things?

-The Bare Necessities.

# The bare necessities... #

If you do that, it will definitely kick.

'I want to find out if Kirsten's baby can hear.

'So I have devised a simple test...'

So, my little bag of tricks.

'..and it involves making a lot of noise.'

I'm optimistic about the bell.

I think probably not...

WHISTLE TOOTS

To make sure that Kirsten can't subconsciously influence her

baby's responses, we are going to shut out the outside world.

Can you hear me? Is she responding?

No, she is not responding. That's good.

OK, one, two, three.

TOY SQUEAKS

-The baby put its hands over its face.

-Did it?

MICHAEL LAUGHS

So, yes, the baby seemed to go,

"No, I don't particularly like that one."

ULTRASOUND WHOOSHES

From the reaction to all the racket I'm making,

it seems this baby really can hear in the womb

and is already beginning to make sense of the world around it.

That was just like the baby heard the rattle, went, "What is this row?"

and then went back again.

But do we remember any of those sounds we hear in the womb?

Old Mother Hubbard Went to the cupboard

To fetch her poor doggy a bone.

But when she got there The cupboard was bare

And so the poor doggy had none.

Are we capable of forming early memories?

She went to the joiners To buy him a coffin

But when she came back

The poor dog was laughing.

-ECHOING VOICE:

-She took a clean dish To get him some tripe

But when she came back He was smoking a pipe.

She went to the fishmonger's...

In a study, a group of pregnant women were asked to read a rhyme

to their unborn babies every day for six weeks.

When she came back He was dancing a jig.

She went to the cobbler's To buy him some shoes

And when she came back He was reading the news.

They then stopped for a couple of weeks

before starting to read to them again.

She went to the hatter's To buy him a hat.

She went to the joiner's To buy him a coffin.

When she came back The poor dog was laughing.

And what they found is when you read them a rhyme that they were

now familiar with because they had heard it before,

the heart rate dropped.

They became nice and calm.

She went to the seamstress To buy him some linen

But when she came back...

When the mother read them a rhyme

they were not familiar with there was no response,

so that would suggest that the baby was remembering something.

Old Mother Hubbard Went to the cupboard

To fetch the poor dog a bone.

Now, what was surprising is that when even a stranger read the rhyme,

the baby responded by reducing the heart rate.

That suggests, to me at least, that somewhere,

lingering in the back of its mind,

was a memory of the stories that its mother had told it.

So, it seems even before birth, the brain can store memories.

But these memories will soon be lost.

No-one is capable of remembering anything about what their life

was like in the womb.

The brain cells that store memories long term simply don't exist yet.

But this is a time when our other senses ripen.

At 28 weeks, in the enclosed world of the womb...

..something truly amazing is happening.

We are starting to see.

Nestling deep in the South Pacific is this tiny atoll.

For your eyes, it is a feast of beauty.

Yet this place is known as Colour-Blind Island.

At the back of our eyes on the retina,

light-sensitive cells called rods and cones grow.

And our rods are so sensitive that in the darkness of the womb,

we can see...

..even if it is only in black and white.

But now the cone cells are being wired up...

..getting ready to colour our world.

Light-sensitive proteins will convert red, green and blue,

separate components of the light entering our eyes,

into nerve impulses.

These are sent to the brain and interpreted as a colour image.

But if these vital proteins misfunction,

you will live in a world like this...

..24/7, for the whole of your life.

It is not just about being unable to see colour -

without his cones working, in the daylight,

Herrol struggles with a painful burnt-out image.

What do you see here? Do you see any numbers?

Nothing.

Most people aren't really colour-blind but colour deficient.

A strongly colour-blind person may only be able to

distinguish 20 different hues...

..compared to the hundred or so that normal-sighted people can.

But sadly, 10% of the population of Pingelap are condemned

to live in a totally black and white world.

In 1780, tragedy struck.

Pingelap was all but wiped out by a typhoon.

As few as 20 people survived...

..one of whom was the king.

Now, the king went on to have many children,

but it seems that he himself was profoundly colour-blind

and he passed this characteristic on to his children.

THUNDER RUMBLES

BELL RINGS

THEY SING

The remoteness of the island and a religion that discourages marriage

to outsiders has, down the centuries, kept the gene pool very small.

Today, if both parents have the faulty gene...

..then their children are programmed in the womb

to be completely colour-blind.

By day, life is hard for the colour-blind.

But as the sun goes down...

..they gain an amazing advantage.

You and I have no chance of seeing what Herrol can see,

but our super-sensitive camera

reveals just how well he can see in the dark.

So, it could just be that the part of Herrol's brain that should

interpret the light from cone cells

is instead being used as extra processing power

for his monochrome night-vision.

In the middle of the night, long after the sun has gone,

Herrol and his friends are out hunting flying fish.

These fish are attracted to the flame and fly towards it

as if towards moonlight.

It is now that Herrol truly puts his disadvantage to good use.

During our time in the womb,

we go through the most incredible transformation...

..from a single cell to a baby that is able to make sense of its world.

A lot of what makes you who you are, from your height

to the colour of your skin, is of course down to the genes

you inherit from your parents.

But these are nothing like as inflexible as was once thought.

# How lucky can one guy be?

# I kissed her and she kissed me

# Like the fella once said... #

We are starting to discover that our genetic code is not fixed.

And extraordinarily, that even in the womb,

we are being shaped by the outside.

The world is already beginning to subtly influence you,

to programme your body, preparing for what is to come.

It may even be preparing us

for how we will respond to food later in life.

I used to eat fish and chips and Indian food.

Next over here is coffee time.

Lal and Freddie have very similar lives.

-Subway.

-Potato chips.

-Dunkin' Donuts.

-Sweet, sometimes salty.

They live in the same city, they do the same job.

They even eat the same food.

24 hours, everywhere is open, subway's running.

The restaurants are open, food is everywhere.

Even sometimes when you're not hungry, you eat the burger.

You eat the burger. After a while, you go to have a cup of coffee.

After a cup of coffee, you aren't hungry,

but you want to have some doughnut or some candy.

You never give a rest to your stomach, you keep eating

and keep eating, you know?

Yet Lal, unlike Freddie, has developed type 2 diabetes.

His body is no longer able to regulate the sugar in his blood.

When I find out I'm diabetic and my doctor tell me, I was big shock.

I was... Really, I thought I was going to die soon.

My doctor said nothing going to happen like this,

but you have to take care of yourself, you have to take

the medicine rest of your life, and watch what you're eating.

Two eggs, straight up, and bread without butter.

Can I try your Greek omelette? Can I get a coffee as well, please?

If it's left untreated, Lal's diabetes could cause severe

loss of sight and damage his arteries...

Thank you, this looks fabulous. Tuck in.

..potentially leading to heart failure or stroke.

-Three years ago I discovered that I was also a type 2 diabetic.

-OK.

So my blood sugar was way too high,

and we just found it by accident when the doctor was doing a blood test.

-Mmm.

-But when you look at me you don't

immediately think I look like somebody...

Many people when I tell them I'm diabetic, they say,

"You do not look like..." You know?

Type 2 diabetes develops when we are adults, it's caused by our

diet and lifestyles as well as our genes.

But do our chances of getting this disease also

depend on what our mother was eating before we were born?

Secretly, what I'm doing is looking at the pancakes.

HE LAUGHS

Could the reason why Lal has type 2 diabetes

and Freddie doesn't be traced back to the womb?

Well, they were both born in India

and there is no family history of diabetes,

but there is one crucial difference.

I was born and brought up in Mumbai, and it is very fast life.

20 million people.

I was born in Punjab. My village was small village.

And life was very simple.

Like millions of Indians, Lal's life is very different to

his mother and father's.

Theirs was a rural existence.

Life was totally different here and there.

And over there we were eating all the natural food.

Rice, some daal, some rotis.

Some vegetables. Over and over.

And we was very happy.

One theory is that if a mum's diet is low in fat, sugar

and calories, then her growing baby adapts to this.

It becomes incredibly efficient,

built to extract as much energy as it can from the little food available.

The problem comes when you end up living in a very different

environment to the one you were conceived in.

Ever since he left the village where he was conceived and grew up,

Lal's diet has been very different to his parents.

Much richer in fat, sugar and calories.

And unfortunately, it is not the sort of diet

that his body was programmed in the womb to expect.

If that theory is right,

then Lal was always more likely to become obese or develop diabetes.

He certainly fits the studies.

Freddie's mum, on the other hand, would have been eating a lot

more calories, living as she did in the busy city of Mumbai.

Fries with that. Number five, fries.

Today, his diet is not that different to hers.

Recently I've been eating Italian foods, pizzas, Spanish food.

The other day I had Brazilian food.

Freddie may have been programmed in the womb to expect

a high-calorie future.

We are living through the greatest migration in history.

As people like Lal move from small villages to big cities.

From poor countries to rich ones.

Freddie and Lal's stories certainly fit the theory.

Yet the actual process of how their mother's diet affected them

in the womb is unclear.

But there are clues.

I want to show you something which I think is utterly remarkable.

What you've got here are a special strain of mice that have been

bred so they are genetically identical.

And yet, when you look at them, they look utterly different.

So how is that possible?

The only difference is, the little brown mouse,

has mum was given special supplements during pregnancy.

These include things like folic acid and vitamin B12.

The result was that from the earliest stage,

when, just a few cells big, he was exposed to what are called methyl groups.

What these methyl groups do is they latch on to the DNA...

As a result, crucial genes are switched on and off,

a process called methylation, leading to a normal, healthy brown mouse.

But the mother of the mouse with the ginger coat

was not fed these supplements, and the genes remained unaltered.

The result is, not only is he bigger and fatter,

but he's also much more vulnerable to diseases like cancer and diabetes.

So I think that is remarkable.

Genetically identical mice who are fed exactly the same from birth,

and the only difference is what their mums were eating

while they were in the womb.

I think that diabetes is like the gift I have from America.

You see, all my sisters and my brothers,

they're living in India, none of them have diabetes.

But still, I love America.

Although we can't say for sure that Lal's diabetes is

the result of nutrition in the womb, the statistics

and the mice study strongly point in that direction.

And all around the world, the hunt is on for other forces which will

subtly change you in the womb,

and which will then go on affecting you for decades later.

17 years ago, this community was thrown into turmoil.

The people of Quebec in Canada were experiencing

the collapse of civilisation.

SIREN WAILS

Outside was very, very scary.

We didn't know what was happening, we don't have any radio,

so we don't have any news.

WIND HOWLS

We have no phone, no electricity, so we were alone, very, very alone.

We didn't see the light at the end of the tunnel.

It was like a warzone. Warzone.

They had been hit by a giant ice storm that left a trail of destruction.

But the landscape wasn't the only thing affected.

At the time, this boy was in the womb,

and his family became part of a unique experiment.

His mum Julie was in her last months of pregnancy with Vincent.

Julie was one of hundreds of expectant mothers

trapped by the ice storm, living under extreme stress.

It's long been wondered whether experiencing stress

during pregnancy could have a lasting effect on your unborn child.

There are very few studies in humans on prenatal stress.

It just would not be ethical to submit a pregnant woman to stress

to see what effects it has on the children.

But the ice storm gave Professor Suzanne King

a precious opportunity to find out.

I was wondering, "Are we going to have enough wood?

"Are we going to have enough food?

"We have no money!" Banks were closed, so what are we going to do?

You know what's happening, you're alone. You're alone.

Alone.

Professor King reasoned that the longer they were without power,

the more stressed the 176 pregnant mums in the survey would have become.

At first, I was OK.

But the morning came and, no electricity, and the evening

came in, no electricity, and the day after and the day after...

We were 22 days without electricity.

The question was -

would the effects of this stress be passed on to their unborn children?

That's the day Vincent was born.

He was 8lb 14oz.

Here he is about two weeks. Two weeks.

Professor King had to play

an extraordinarily long and patient game.

She took swabs of DNA from the children as they grew.

Here is Vincent with Santa Claus.

First at three years of age and then at various stages up until 15.

That's at four years old, and now at...

17.

IN FRENCH:

STEADY HEARTBEATS

When Professor King looked at her results...

..what she found was disturbing.

RAPID HEARTBEATS

HORN BLARES

Whoo! Go, go, go, go, Vincent!

SHE SCREAMS

The test on the children's DNA showed that crucial genes

had been switched on and off.

And the more days the expectant mum spent without electricity,

the bigger the effect on their unborn babies.

And the bigger the impact on their lives as they grew up.

So, for example, the greater the number of days without

electricity, the lower the IQ of the child, the lower

their language development, even the way they played was different.

Vincent, he had a lot of allergies to dairy food, nuts and seafood.

And Vincent had problems with language.

He's seen a therapist for that for about seven years.

Why is he allergic? Why?

Nobody in the family had food allergies.

Nobody have problem to speak.

A likely explanation is that the stress

the mothers were experiencing during the ice storm...

..caused cortisol to be released into their bloodstream.

-SHE SHOUTS ENCOURAGEMENT

-Go, go, go.

This hormone regulates the body's response to stress.

It can cross the placenta, into the baby's bloodstream,

and affect how it grows.

Whoo-hoo!

Whooo!

We still have a long way to go before we completely understand how the

outside world influences the way that we are built in the womb.

But Professor King's study showed for the first time that a stressful

environment affects our genes before we are born.

We are nearing the end.

All the vital organs have been built and tested.

Except one.

For our entire time in the womb, our lungs lay dormant,

flooded with liquid.

Strangely, we practice breathing in anticipation of our first

air-filled breath.

SHE INHALES DEEPLY

SHE EXHALES DEEPLY

The whole aim of the game is to be as relaxed as possible,

so no stress, no worry.

Getting into your own little world, disappearing really.

You kind of focus inward

and you get very in tune with what your heart rate is doing,

what your levels of oxygen are, whether you need to breathe or not.

Sam regularly pushes her lungs to their absolute limit.

She is a freediver.

She can explore the depths of this lake on one single breath...

for minutes at a time, without coming up for air.

It's very quiet, it's very peaceful, it can be very beautiful.

You haven't got your phone to think about, you haven't got any beeps

or distractions or people calling for you.

You're in a real moment of peace and serenity,

you tune in to that nothingness and enjoy that instead of everyday life.

Our lungs have been growing like branches of a tree,

and now, just weeks from birth,

a massive flood of growth hormone is about to

kick off a transformation that is essential to life after birth.

Thousands of tiny saccules blossom.

These are alveoli, the secret to breathing.

Unless they form properly,

we will struggle to absorb the oxygen we need to stay alive.

Oxygen that has to cross from the outside world into our bloodstream.

I may not be an athlete or indeed as young as Sam,

but I'm here to challenge her to a competition.

Put your hands, kind of push your belly button,

suck the air, try and suck it all the way down as far as you can.

I'm going to pit my bigger male lungs against her

smaller female lungs.

It's a rather basic test, but an effective one.

Who can hold their breath the longest?

So you want that last breath to be a really full breath,

because it's going to last you maybe 15,

20 times longer than it might do if you're wandering around up here.

-You think of breathing as quite a simple thing...

-Yeah.

Clearly, breathing is more sophisticated than...

As long as you breathe, that's the main thing!

Sam teaches freediving, which is

very surprising considering what happened early in her life.

You need to spit in it to stop it fogging up.

I was born six weeks premature back in 1972.

And at that stage, six weeks premature was quite severe.

It's still not that great today, but it was quite a big deal

in those days and it was quite scary for my parents apparently.

Being premature meant Sam's lungs couldn't develop

to their full potential.

She has far fewer alveoli than if she'd gone to full term.

In we go.

Keep hold of the rope and let your face go in,

and just try and stay there for as long as you can.

A few basic training tips from Sam and I'm good to go.

With safety divers on hand...

..should anything go wrong.

Surface to Neil, surface to Neil.

Do you have sight with both divers?

Woo!

That's about as much as I think I can handle.

She's still down there somewhere. I can't see her at all.

That is pretty amazing because she obviously was born premature,

her lungs, in theory, should be much less efficient than mine,

less alveoli.

I only managed about 40 seconds which is a pretty standard time

for holding your breath underwater.

But Sam has certainly demonstrated that she has overcome

the disadvantages she was born with.

She has trained herself to the point where

she can hold her breath underwater for five minutes.

If you don't really know how far you can go or how long you can stay,

then sometimes you might overstay your welcome.

If you get too excited or nervous than your heart starts racing

and then you need to come up, so you've got to be very in control

of your thought processes and, to some extent, your body.

Well done, how are your lungs? That was very good.

I must admit, I found it quite addictive.

Good. Maybe we'll see you again, then!

Sam is living proof that whatever the circumstances of your first breath,

you can overcome those early obstacles in life.

Though, having said that,

there's no doubt that how we develop in the womb profoundly

influences our body, our personality, in many ways our entire future

From our first breath, to our last.

After nine months of development, our bodies are ready.

We are now made up of more cells than there are stars in the galaxy.

We are just hours away from having to abandon Mum, go it alone.

It's the final push

WOMAN MOANS

In the womb, we get our life-giving oxygen from our mum.

Well done, well done, nearly there. Nearly there.

It crosses the placenta directly into our blood.

Now, in an instant, a monumental change takes place

Our lungs must switch from being an unused sack of liquid...

..to an organ filled with air.

Big push, Gaby. Big push.

Another big push, if you've still got a contraction, another big push.

-Take a breath in and another big push.

-Another big push.

Lovely, that's it. You're doing so well.

You can see the head.

-There we go.

-Oh, wow! There we are.

-Well done, Gaby.

Oh, my God, that was so good.

BABY GURGLES

As we take our first ever breath, our lungs start the lifelong job

of providing the oxygen we need to survive.

Oh, little baby.

One cut of the umbilical cord and you are separated from your mother.

You've made it.

Thank you very much.

And your life outside the womb begins.

-3.972. Which is 8lb 12.

-Wow.

MUSIC: One Life by James Morrison

It's a boy. 8lb 12oz.

# With so many choices I just Didn't know what to do now

# Won't let my soul slide away I'll do whatever it takes

# Cos this time's only borrowed

# I got one life One life

# One life and I'm gonna live it

# I got one life One life... #

Birth, of course, is just the beginning.

From now on, we will learn, grow, adapt.

Our lives will be immeasurably enriched by our relationships with other people.

But our life before birth will have left an indelible mark,

it will have laid the foundations

because in many ways these were the nine months that made us.

# I got one life, one life One life and I'm gonna live it

# I got one life, one life

# One life and I'm gonna live it right. #

The Open University has produced a poster exploring how the

process of human development in the womb affects health after birth

and long into adulthood.

To order your free copy, please call:

Or go to:

Follow links to the Open University.