What do we have to learn from other birthing mammals that can help the labouring woman? Michel Odent makes the case for de-humanising childbirth.
At the end of her first pregnancy, Claire was living in a hostel. One day she decided that the bathrooms and the corridors were dirty. She felt an urgent need to clean them. When she walked out of the building, she had to sweep the pavement. The next day her labour started.
Against all odds, Iona decided to stay at home for the birth of her first baby. She called me one afternoon as contractions forewarned her of the beginning of labour. Even before knocking at the door, I was intrigued by the noise of a vacuum cleaner. Between contractions, Iona was hoovering. During contractions, she was leaning on the back of a chair. Afterwards, I asked her if she usually did the cleaning in the middle of the afternoon. ‘What? No!’ she said. ‘I don’t know what made me do that today’.
Such behaviour either goes unnoticed or is misunderstood by anyone ignorant of our mammalian condition. The nesting instinct is by no means exclusive to birds and insects that build nests. It is the behaviour that drives an animal to prepare the space where it will welcome its offspring. There are even some mammals, such as the dormouse, who actually build nests.
Striking similarities: after thousands of years of culturally controlled childbirth and a century of industrialised childbirth, it seems difficult to rediscover the basic needs of labouring women. It is commonplace to go astray by raising negative questions such as how to reduce the rates of C-section? The primary question should be: how can we deviate as little as possible from the physiological model? The key is to listen to those who are familiar with the nesting instinct of non-human mammals; this is the case, for example, with vets.
In the age of the Web, everyone has easy access to expert advice about the birth of highly domesticated mammals like dogs. By chance, I found the site of a veterinary hospital (www.shakervet.com/servicesC.htm). It is significant that the most detailed pieces of advice are about preparation for whelping... It reads, “Prior to whelping, it is important to prepare a secure location for the bitch to whelp. When secure, a bitch will tend to relax and be less likely to have a difficult birth. This is best accomplished by preparing a whelping box approximately 24"x 24" for a small dog and 40"x 40" for a large dog. It should have high walls on 3 sides to provide security and keep out drafts. One side should be low, about 8” to allow the bitch to get in and out...” After such a description of the nest, focusing on precise details regarding its size, the second group of recommendations is about how to make the nest familiar: “It is very important to get the dog used to the whelping box 1-2 weeks prior to whelping. A good way to accomplish this is to place the box in the room that will be used at whelping and feed the dog in the box. This will help to reduce anxiety at whelping time”.
When reading such advice online or having personal conversations with veterinarians, I cannot help thinking of the striking similarities with the preoccupations that guided me in the 1970’s when I was in charge of the maternity unit of the Pithiviers hospital in France. My main objective was to improve the birth environment in order to facilitate the physiological processes. This is why the midwives, a group of mothers and I decided to transform one of the conventional delivery rooms into a small homelike birthing room… a small square nest. This room has subsequently been imitated in different maternity hospitals. Most of our visitors did not realise the importance of the size of the room, which should be as small as possible. They did not understand the reality and the nature of the nesting instinct.
Another of our aims was to enable the mother-to-be to become accustomed with the birthing place. It is obviously easier to satisfy the need for privacy in a familiar place. It is not enough to have had a guided tour of the facilities and to be told the whereabouts of the midwives’ desk, the birthing room or the TV room. In order to become really familiar with a place you have to be there often and keep going there to do something. And it is better if you are doing something pleasant. Those concerned with giving priority to the need for privacy must think about the sorts of activities adapted to pregnant women. The important thing is to ask questions. A variety of answers will be found according to the time, the premises, the kind of population being served as well as the personality of the people in charge of the centre. We found an answer that was perfectly adapted to our maternity unit. Once a week, the pregnant women and the staff would be given the opportunity to meet and sing around the piano. What could be easier, or more pleasant? It was not expensive. You can buy twelve secondhand pianos for the price of one electronic fetal monitor!
Should we de-humanize childbirth?
There is no doubt that childbirth is at a turning point. It has never happened in any other society that most women could have babies without releasing a flow of love hormones. The future of our civilisation is at stake.
In order to rediscover the basic needs of labouring women we might express a simple rule of thumb: where labour, delivery and birth are concerned, what is specifically human must be eliminated and the mammalian needs must be met. The first step should be to get rid of the aftermath of all the beliefs (inseparable from rituals) that have disturbed for millennia the physiological processes in all known cultural milieus. The belief that colostrum is harmful is a typical example. Such beliefs conferred an evolutionary advantage when the basic strategy for survival of most human groups was to dominate nature and to dominate other human groups. It was an advantage to develop the human potential for aggression. Today, humanity urgently needs to invent new strategies for survival. In order to develop respect for Mother Earth and to unify our global village, the priority is to develop the capacity to love rather than the potential for aggression. So those beliefs and rituals which disturb the physiological processes are losing their evolutionary advantage.
Let us add that there is a part of the brain that is highly developed among humans only. We might call it the thinking brain, the rational brain or if we use the language of anatomists and physiologists we must call it the neocortex. It is in the neocortex that all inhibitions originate during the birth process. That is why the spectacular development of the neocortex is the specific human handicap in childbirth. That is why a reduction in the activity of the neocortex is the most important aspect of birth physiology. When the activity of her neocortex is reduced the labouring woman is as if ‘on another planet’, cutting herself off from our world. She dares to do what she would not do in her daily social life. She dares to scream or to swear, for example. She can find herself in the most unexpected posture. She can become almost as instinctive as other mammals. This leads us to understand that the labouring woman needs to be protected against any sort of stimulation of her neocortex. Language, which is specifically human, is one of the most powerful stimulants of that part of the brain that is highly developed in our species. One of the most important qualities of a midwife is her capacity to remain silent and to use as little verbal communication as possible. Not feeling observed and feeling secure both tend to reduce cortical activity: they are basic needs during the birth of mammals in general, and humans in particular.
I am amazed by the countless pleas I see for the humanisation of childbirth. Today the priority is to ‘mammalianise’ childbirth. In a sense it is to de-humanise childbirth.
The time has come to learn from the legendary mother who gave birth to a man whose mission was to promote love. Her baby was born outside the human community, in a stable... among mammals.
Michel Odent is familiarly known as the obstetrician who introduced the concept of birthing pools and home-like birthing rooms. He developed the maternity unit at Pithiviers Hospital in France in the 1960’s and 1970’s. After his hospital career he practised home birth. As a researcher he founded the Primal Health Research Centre in London, which focuses upon the long term consequences of early experiences. An overview of the Primal Health Research data bank (www.birthworks.org/primalhealth) clearly indicates that health is shaped during the primal period (from conception until the first birthday). It also suggests that the way we are born has long term consequences in terms of sociability and aggressiveness or, otherwise speaking, capacity to love.
Michel has developed a pre-conceptional program (the ‘accordion method’) in order to minimise the effects of intrauterine and milk pollution by synthetic fat soluble chemicals such as dioxins, PCBs, etc. His other research interests are the non-specific long term effects on health of early multiple vaccinations.
Photo by PNW Production
First published in issue 1 of JUNO. Accurate at the time this issue went to print.