In a London Victorian terraced house I sat opposite one of the greatest minds of our time. Progressive and brilliant. Fearlessly challenging the conditioned cultural belief that “Women have not the power to give birth by themselves”. Dr. Michel Odent presents his theories founded on research and hard data. His suggestions are inspiring and his message is clear: “if we understood the importance of what a labouring woman needs it might dramatically change the history of childbirth”.
What an honour to hear his views in person. I could have easily said goodbye to my camera crew and sat for hours listening and theorising with this childbirth hero. It is with sincere pleasure that I host a few of his words in this issue.
When a first time mother enters into her own first labour, she is often walking blindly, having only heard stories of birth but never witnessed one. If we are able to encourage just one mother to believe that she is capable of giving birth naturally, without intervention, then we have succeeded.
Please enjoy this rare opportunity.
Starr Meneely, Editor-in-Chief of The Mother magazine
What Are The Challenges Women Face in Pregnancy and Childbirth?
I think to answer this question about challenges women have during pregnancy, we have to wonder first what are the basic needs of pregnant women? I realise through experience that pregnant women need to communicate with other pregnant women. They need to talk with pregnant women and young mothers with babies.
I realised this in a hospital in France where we introduced the concept of singing sessions for pregnant women. Women were invited, once a week, to sing together around a piano. Interestingly, after each session the women were happy to say “see you next week”. After singing they were talking about themselves and their babies. They were happy to meet other young mothers. I think it’s a basic need to talk about baby.
The emotional state of the mother is an important factor, influencing the growth and the development of a baby in the womb. We understand that ideally a pregnant woman needs to live in peace. She needs to be in a positive emotional state, to have joyful experiences. I go back to our singing sessions, We could see joyful faces. The emotional state of a pregnant woman is vital.
Today the emotional state of women is, to a great extent, influenced by new factors special to our society; the medicalisation of pregnancy. Pregnant women have
many prenatal visits, but prenatal care is a new concept. We observe that many pregnant women have difficulties living in peace because of this dominant style of prenatal care. The dominant style of prenatal care is testing … testing … testing, an incredible amount of tests. Testing the development of the baby, testing the health of the mother, trying to detect possible health problems in the mother. We are reaching a time when it is almost impossible to meet a ‘normal’ pregnant woman. It is difficult for a pregnant woman to live in peace because of this style of prenatal care.
When we talk about the life of pregnant women we have to consider all of these factors that are special to the 21st Century and that it is difficult for pregnant women to live in peace.
Describe Birth and Fear?
When we talk about childbirth often the word ‘fear’ appears as well. Fear of birth is an aspect of human nature. But what we have to understand, is that Nature found a way to overcome this fear of birth. The part of the brain called the neocortex, is highly developed among humans, so developed that we can understand that the fear of giving birth, and many other fears, are special to our species. During birth this part of our brain is supposed to stop working. Giving birth is the business of archaic, primitive brain structures.
The main handicap during the birth process among humans is the activity of the brain of the intellect – the neocortex. The brain associated with conditioning and cultural fears; fears of death, fear of giving birth. Stopping this activity, this ‘fear’, is exactly what makes birth possible in humans, by eliminating the cultural conditionals, particularly the fear of birth.
The basic need of a labouring woman is to be protected from anything that might stimulate the neocortex, the brain of the intellect. It means that, in practice, silence is a basic need. Language is the enemy when a woman is giving birth. Also, light, for example. Today we can explain the effect of light. Light inhibits the release of melatonin. One of the properties of melatonin is to reduce the activity of the neocortex.
To contrast the way we understand the birth process, when we think like physiologists, is to contrast the basis of our cultural conditioning – that a woman has not the power to give birth by herself. That a woman cannot give birth without some kind of interferences, help, or support.
How Important is the Birth Environment?
It’s important to emphasis at which point environmental factors are important when a woman is giving birth. In order to give birth you need to release a mixture of hormones, one of them is particularly important; oxytocin. But this hormone is a ‘shy’ hormone. Oxytocin is like a shy person that does not appear among strangers or observers. You also need to release this hormone is other situations, for example, to make love both partners have to release oxytocin. It is well known that in general you need privacy to make love. To give birth you also need to release this shy hormone. It is incredibly simple. It’s important to realise the importance of the environment. It is important that there are few people as possible around.
What is your Opinion on the Participation of the Father at Birth?
During the 21st Century when we talk about childbirth, we are obliged to refer to the particularities of childbirth in our cultural environment, in particular the participation of the father at birth. It is Important to recall that this is something absolutely new. Young generations must realise that the issue of the participation of the baby’s father at birth is special to our society. This started to become a popular request from mothers at the time when birth became more and more concentrated in huge hospitals, the beginning of the ‘institutionalisation of childbirth’. Historically speaking, we can associate the participation of the baby’s father at birth with the institutionalisation of childbirth.
It was also the time when the nuclear family became smaller, so that in the daily life of many modern women the baby’s father was the only familiar person. However, there was a question that was not asked during this time. When the baby’s father participates in birth, what kind of influence will this fact have on the sexual life of the couple. This is a difficult question, a question of sexual attraction. Sexual attraction is mysterious, and perhaps sexual attraction needs some kind of mystery. At that time the only people who raised this question were women from a previous generation. Women who had babies in 1920 at home. When they were told of this new behaviour of young couples in birth their reaction was “ I cannot imagine my husband watching me when I gave birth.”
At the present time I have special interest in another question that has not been raised. It is about the health and behaviour of the father in the days and weeks following baby’s birth. I am convinced there is male postpartum depression which is not recognised as such. Male depression is a hidden, covert depression. Men often have symptoms of depression just at the time following birth. This is just an example of the many questions, regarding the participation of fathers in birth, that have not been raised properly.
Regarding the effect on the birth itself, we assume that if the theoreticians of the 1970s, had had a better understanding of birth physiology, they would have anticipated that when a man loves his wife it will be normal for him to release stress hormones. A high level of adrenaline is contagious. It is transferred to the labouring woman and if she is producing adrenalin she cannot release oxytocin, the main hormone needed for giving birth. This is exactly what we need to understand today, when we speak like physiologists. You cannot help an evolutionary process. Birth is an evolutionary process and archaic, primitive brain structures need to be protected. This is why the issue of the participation of baby’s father at birth is very important at the present time, especially in our society. It is much more complex than we could have imagined.
In general we can say that the duration and difficulty in labour is proportional to the number of people around. We need scientific explanations, to discover what has always been known in many cultures. I know a Persian proverb which says “Two midwives and the baby’s head is crooked”, a Hungarian proverb says “When there are two midwives baby is lost”, and in Chile, traditionally they say “Too many hands kill the baby.” This has been well known in many societies. But now this is culturally almost unacceptable. When I talk about this with other professionals they only consider the obstacles saying that this situation is utopian. The question is “What about baby’s father?”
We are in a strange paradoxical situation where it is politically correct to say that we must reduce the rate of Caesarean section. But if you describe a birth situation that is as easy and fast as possible; to feel secure without feeling observed, to be protected from language and light, you are at the limit of what is politically correct. You have to flirt with utopia.
Does The way We are Born Have Life-long Consequences?
The possible long-term effects of how we are born is not a question of opinion. Today it is a question of hard data. I have to mention our database (primalhealthresearch.com) which specialises in studies that explore correlations between what happens at the beginning of our life and what happens later on. When I say the ‘beginning of life’ it’s what we call the ‘primal period’ which goes from conception until the first birthday, it includes the birth itself. What we can learn today for sure is that the way we are born has long-term consequences, and when we say long-term consequences, it is not just lifelong effects. Today we are starting to consider trans-generational effect of what happens at the beginning of life.
More and more studies suggest that the effect can go beyond lifelong effects. This can be interpreted in the light of emerging scientific disciplines like Epigenetics and also modern Bacteriology. We can understand now the hundreds of trillions of microbes that occupy the mother’s body can, to a certain extent transmit to the next generation.
What is also interesting, is that for some pathological conditions all studies give concordant results. An example, if you take the case of autism which is an important topic today. You find that whatever the country and whatever the research protocol, there are similarities in the result. It is that the period of birth is critical. In modern language we can say that it appears that the period of birth is critical for gene-environment interaction. There are genetic factors and environmental factors. The particular question is ‘when’ this interaction occurs. In our database we have enough information to say that it appears that the period of birth is critical.
Today there are also more and more studies that have, what might be considered, ‘mysterious’ results. Referring to what we call the microbiome revolution. In terms of bacteriology there is a real revolution with new techniques used by bacteriologists. We can present homo sapiens in an absolutely different way, it was impossible to do this five years ago. Today we can say that, among homo sapiens, there is a kind of ecosystem with a constant interaction between the hundreds of trillions of microbes that occupy the body; the gut, skin, mouth, and so on, and our genome. Today we realise that our health and our behaviour is to a great extent influenced by these hundreds of trillions of microbes.
It is acceptable today to say that the microbiome is established immediately after birth. To be born is to enter the world of microbe. When a baby is born he is germ free, an hour later billions and billions of microbes have colonised in his body. Originally these microbes come from the mother. The vaginal perineal route is full of microbes colonising immediately in the baby, often in a place familiar for the mother. The first microbes have an important role to play. Immediately after birth they programme and educate our immune system. This is important because the microbes that come from the mother are friendly for the baby, they are familiar microbes and maternal antibodies have easily crossed through the placenta.
From a bacteriological perspective, childbirth is a phase of human life that has been dramatically modified. Until recently all babies were born by the vaginal route in a familiar place. Today some babies are born by caesarean section in an operating theatre in a sterile environment. This is a terrible microbial deprivation. Babies need microbes immediately after birth. Many babies are also exposed to antibiotics which is another way to disturb the way how the microbiome is established.
We can understand now that disturbing the birth process, from a bacteriological perspective, is disturbing the way our immune system is programmed immediately birth. Theoretically we can anticipate more deregulation of the immune system. Today it is becoming easy to explain the importance in the way babies are born.
The one situation associated with a birth that is as easy and fast as possible, is when there’s nobody around the labouring woman apart from one experienced midwife or doula sitting in a corner knitting and that’s all, it’s simple. If this was better understood I think it might dramatically change the history of childbirth.