Birth and Breastfeeding E-Book

Michel Odent

• Herausgeber: Clairview Books
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2012

Beschreibung

Humanity, argues Michel Odent, stands at a crossroads in the history of childbirth - and the direction we choose to take will have critical consequences. Until recently a woman could not have had a baby without releasing a complex cocktail of 'love hormones'. In many societies today, most women give birth without relying on the release of such a flow of hormones. Some give birth via caesarean section, while others use drugs that not only block the release of these natural substances, but do not have their beneficial behavioural effects. 'This unprecedented situation must be considered in terms of civilization', says Odent, and gives us urgent new reasons to rediscover the basic needs of women in labour. At a time when pleas for the 'humanization' of childbirth are fashionable, the author suggests, rather, that we should first accept our 'mammalian' condition and give priority to the woman's need for privacy and to feel secure. The activity of the intellect, the use of language, and many cultural beliefs and rituals - which are all special to humans - are handicaps in the period surrounding birth. Says Odent: 'To give birth to her baby, the mother needs privacy. She needs to feel unobserved. The newborn baby needs the skin of the mother, the smell of the mother, her breast. These are all needs that we hold in common with the other mammals, but which humans have learned to neglect, to ignore or even deny." Expectant parents, midwives, doulas, childbirth educators, those involved in public health, and all those interested in the future of humanity, will find this a provocative and visionary book.

Leseprobe

MICHEL ODENT was born in 1930. Originally qualified as a surgeon, he is popularly known as the obstetrician who introduced the concepts of birthing pools and homelike birthing rooms. His ongoing influential work in childbirth and health research has featured in TV documentaries such as the BBC’s Birth Reborn, and in authoritative medical journals. After his hospital career, Odent practised home-birth and founded the Primal Health Research Centre in London, which focuses on the long-term consequences of early experiences. The Primal Health Research data bank (www.birthworks.org/primalhealth) features material which indicates that health is shaped during the primal period (from conception until the first birthday), and that the way we are born affects our sociability, aggression and capacity to love. He has also developed a preconceptional programme (the ‘accordion method’) to minimize the effects of intrauterine and milk pollution by synthetic fat-soluble chemicals. Odent’s other principal research interest is the non-specific, long-term effect on health of early multiple vaccinations. He is the author of dozens of scientific papers and 11 books published in 21 languages, including Primal Health and The Farmer and the Obstetrician.

By the same author:

Entering the World

Birth Reborn

Zinc and Health (co-author)

Water and Sexuality

Primal Health

We Are All Water Babies (co-author)

The Scientification of Love

The Farmer and the Obstetrician

(not in English)

Genèse de L’homme Écologique

Les Acides Gras Essentiels

BIRTH AND BREASTFEEDING

REDISCOVERING THE NEEDS OF WOMEN IN PREGNANCY AND CHILDBIRTH

MICHEL ODENT, MD

Clairview Books Hillside House, The Square Forest Row, East Sussex RH18 5ES

www.clairviewbooks.com

Published by Clairview 2012

First published by Bergin & Garvey, Greenwood Publishing Group, Inc., USA, in 1992

This edition © Michel Odent 2003

Michel Odent asserts the moral right to be identified as the author of this work

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying or otherwise, without the prior permission of the publishers

A catalogue record for this book is available from the British Library

ISBN 978 1 905570 41 6

Cover design by Andrew Morgan Typeset by DP Photosetting, Aylesbury, Bucks.

Contents

Preface

Introduction to the First English Edition

1 Our Mammalian Roots

Different ways to discover our mammalian roots. The case of a little girl from North Dakota

2 At the Dawn of the Post-Electronic Age

Studies demonstrating the negative side effects of electronic foetal monitoring. Their historical importance

3 The Hospital of the Future

How to give priority to the need for privacy in the hospitals and birthing centres of the post-electronic age

4 On Another Planet

The human environment in the birthplace. Protection of privacy

5 The Foetus Ejection Reflex

Let us save from oblivion Niles Newton’s phrase regarding the birth of non-human mammals

6 Cats

Some diversion for those who need to recover after a rather technical chapter

7 The Old and the New

Human beings are condemned to live with two brains, the old brain and the new brain. This is the main chapter of the book

8 Colostrum and Civilization

Every culture has its own way of altering the well-being of the newborn baby and, directly or indirectly, the early contact with its mother. What are the evolutionary advantages of these almost universal attitudes? Genesis of the ecological sense

9 From Holland to Malawi

The points in common between a highly educated Dutch midwife and an illiterate and innumerate Malawi traditional birth attendant

10 Photos and Videos

An epidemic we should be aware of. The invasive camera

11 Freud as a Midwife

Just as Freud made his breakthrough when he discarded authoritarian hypnosis and started to sit unseen in a corner, in the same way the low-profile midwives are the real experts where the physiology of the birth process is concerned. The research by John Kennell and Marshall Klaus about the doula

12 The Hormone of Love

An inkling about the hormonal basis of what we commonly call ‘love’

13 Breastfeeding and Family Structures

The duration of breastfeeding and family structures are two inseparable topics

14 Lullaby Time

The rediscovery of the specifically human lullaby

Postscript

Notes

Select Bibliography

Preface

Why a New Edition?

This book was originally published in French (1990), and soon after in English with the title The Nature of Birth and Breastfeeding. Our goal was to answer two questions.

• Why must we prepare for the ‘post-electronic age’ of childbirth?

• How should we prepare for this new phase of the history?

THE HOWS

In 2003, the hows are no different from what they were at the beginning of the previous decade. That is why the original text is reproduced without any significant alteration. The point is to rediscover the basic needs of women in labour. After thousands of years of culturally controlled childbirth it will be a real rediscovery. That is why we need to go back to the roots. We must rely on the perspective of scientists who study body functions, the physiologists.

From the perspective of physiologists, one can draw a simple conclusion. It is that the best way to make the birth as easy as possible is to follow a rule of thumb: where labour, delivery and birth are concerned, what is specifically human must be eliminated, while the mammalian needs must be met.

The first step should be to exclude the aftermath of all the beliefs (inseparable from rituals) that have disturbed for thousands of years the period surrounding birth in all known cultural milieus. The belief that colostrum is harmful is a typical example (let us emphasize that this thick substance the baby may find in the breast immediately after birth is precious according to modern science). Such beliefs conferred an evolutionary advantage as long as the basic strategy for survival of most human groups was to dominate nature, to dominate other human groups, and therefore to develop the human potential for aggression.

Eliminating what is specifically human also implies, during labour, that the part of the brain most highly developed in our species (i.e. the brain of the intellect) must allow itself to become subordinate. In more scientific terms, let us say that a reduction in the activity of the neocortex (the ‘new brain’) is the most important aspect of birth physiology. All inhibitions during the birth process originate in the neocortex. That is why the spectacular development of this new brain is our specific handicap in childbirth. When the activity of the neocortex is reduced, the labouring woman is as if ‘on another planet’, cutting herself off from our world. She can become almost as instinctive as other mammals. This leads us to understand the labouring woman needs to be protected against any sort of stimulation of the brain of the intellect. Language, which is specifically human, is one of its most powerful stimulants. As for the need for privacy and the need to feel secure, both are basic mammalian needs in the period surrounding birth.

I am amazed by the countless pleas I see for the humanization of childbirth. Today childbirth needs to be ‘mammalianized’. In a sense, it needs to be de-humanized.

THE WHYS

The reasons to reconsider the way babies are born are more obvious than ever at the dawn of the new millennium. They are also easier to explain. They are now calling for immediate attention.

Immediate reasons

At the time of the first edition, there were immediate reasons to suggest that the electronic age of birthing was drawing to a close and that we had to prepare for the advent of a new phase of history. A series of authoritative studies had compared the effects on statistics of two ways to check the baby’s heartbeat during labour: either ‘now and then’, in an intermittent way, or continuously, by recording the rhythm of the heartbeat on a graph via an electronic machine. All studies confirmed that the only constant and significant effects of electronic foetal monitoring during labour was to increase the rates of Caesarean sections, without influencing the number of babies alive and healthy at birth.

Many obstetricians had difficulties abandoning this powerful way to observe and to control the birth process, which was the very symbol of industrialized childbirth. In some countries they had a tendency to simply ignore the scientific data. In other countries they had a tendency to abandon the use of the electronic monitor during labour at least for ‘low risk’ cases. However, in many hospitals, it became routine to record a 20-minute graph on admission. Recently, a large Irish study involving more than 8000 women1 showed the only detectable effects of this 20-minute graph are to increase the use of electronic monitoring during the whole labour and also to increase the number of babies from whom a scalp blood sample is taken before being born. It does not improve the birth outcome. The next step might be to confirm previous studies suggesting electronic foetal monitoring is useless or harmful in ‘high-risk cases’ as well.

Other symbols of industrialization

Electronic foetal monitoring is not the only symbol of twentieth-century obstetrics that has been shaken by recent scientific data. Routine ultrasound scanning in pregnancy has become the symbol of modern prenatal care. It has also been its most expensive component. A series of studies compared the effects on birth outcomes of routine ultrasound screening versus the selective use of scans. One of these trials, published in the New England Journal of Medicine, involved more than 15,000 pregnant women.2 The last sentence of the article is unequivocal: ‘Whatever the explanation proposed for its lack of effect, the findings of this study clearly indicate that ultrasound screening does not improve perinatal outcome in current US practice.’ Around the same time, an article in the British Medical Journal3 assembled data from four other comparable trials. The authors concluded: ‘Routine ultrasound scanning does not improve the outcome of pregnancy in terms of an increased number of live births or of reduced perinatal morbidity. Routine ultrasound scanning may be effective and useful as a screening for malformation. Its use for this purpose, however, should be made explicit and take into account the risk of false positive diagnosis in addition to ethical issues.’

It is possible that, in the future, a new generation of studies (in the framework of primal health research) will cast doubts on the absolute safety of repeated exposure to ultrasound during foetal life. One of the effects of the selective use is to reduce dramatically the number of scans, particularly in the vulnerable phase of early pregnancy.

Even in a high-risk population of pregnant women, ultrasound scans are not as useful as commonly believed. The results of several studies suggest that the detection of foetal growth retardation via scans does not improve outcome despite increased medical surveillance.4‘5 It has been demonstrated that ultrasound measurements are not more accurate than clinical examination to identify high birth weight babies.6 This led to the memorable title of an editorial of the British Journal of Obstetrics and Gynaecology: ‘Guess the weight of the baby’.

In general, an accumulation of scientific data published since the first edition leads to a reconsideration of the very concept of ‘routine’, a key component of the concept of industrialization.7 Let us take as an example the routine measure of haemoglobin concentration (the amount of red blood-cell pigment). There is a widespread belief this test can effectively detect anaemia and iron deficiency in pregnancy. In fact, this test cannot diagnose iron deficiency because the blood volume of pregnant women is supposed to increase dramatically, so the haemoglobin concentration indicates first the degree of blood dilution, an effect of placental activity. This was confirmed by a large British study, involving more than 150,000 pregnancies.8 The regrettable consequence of routine evaluation of haemoglobin concentration is that, all over the world, millions of pregnant women are wrongly told they are anaemic and are given iron supplements. There is a tendency both to overlook the side effects of iron (constipation, diarrhoea, heartburn, etc.) and to forget that iron inhibits the absorption of important growth factors such as zinc. Furthermore, iron is an oxidative substance that can exacerbate the production of free radicals and might even increase the risk of pre-eclampsia.9

Another routine screening practised in certain countries is for so-called gestational diabetes. If the amount of glucose in the blood is considered too high after absorption of sugar, the ‘glucose tolerance test’ is positive. This diagnosis is useless because it merely leads to simple recommendations that should be given to all pregnant women, such as: avoid pure sugar (including soft drinks, sodas, etc.) choose complex carbohydrates (pasta, bread, rice, etc.) and have a sufficient amount of physical exercise. A large study, at the level of the Canadian population, demonstrated the only effect of routine glucose tolerance screening was to inform 2.7% of pregnant women that they have gestational diabetes.10 The diagnosis did not change birth outcomes. Even the routine measurement of blood pressure in pregnancy may be reconsidered. Its original purpose was to detect the preliminary signs of pre-eclampsia, particularly at the end of a first pregnancy. But an isolated increased blood pressure, without any protein in the urine, is associated with good birth outcomes.11,12,13,14 The prerequisite, to diagnose pre-eclampsia, is the presence of a certain amount of protein in the urine. It is actually more useful to rely on the repeated use of the special strips for ‘urinalysis’ one can buy in any pharmacy. Measuring blood pressure is thus not essential.

Today, when we refer to the advent of the post-electronic age, we are thinking of the phase of the history of childbirth when all the symbols of industrialized obstetrics are reconsidered. Although we have now at our disposal numerous and powerful hard data that should be able to shake these symbols, we must not underestimate the strong obstacles to a new awareness. We must take into account that an army of doctors have been trained during the electronic age and are the prisoners of the only model they know about. This is the case, for example, of most anaesthesiologists specialized in obstetrics, who are the experts in epidural anaesthesia during labour. I spent a day at one of their conferences, and I understood how attached many of them are to the main characteristics of industrialized childbirth: concentration in large hospitals; routine use of tests and treatments; presence of the father; and even electronic foetal monitoring.

Long-term considerations

Since the publication of the first edition, there has been an accumulation of hard data confirming the life-long consequences of the prenatal environment and also of the way we are born. In other words, the branch of epidemiology we call ‘Primal Health Research’15 developed dramatically. It developed at such a pace that around 1997 we found it necessary to establish and to continuously update the Primal Health Research Data Bank on the Web (www.birthworks.org/primalhealth). It is available for all to use. Today the data bank contains hundreds of abstracts of articles published in authoritative scientific and medical journals. All of them are about correlations between what happened during the ‘primal period’ (from conception until the first birthday) and what will happen later on in life in terms of health and behaviour. It is not easy to detect such articles because they do not fit into the current classifications. This is the main reason to bring them together.

From an overview of the data bank it appears immediately that, in all fields of medicine, there have been studies revealing correlations between an adult disease and what happened when the mother was pregnant. It is even possible to conclude that our health is to a great extent shaped in the womb. There are in particular many studies confirming the emotional states of pregnant women may have life-long effects on their children. This leads to the conclusion that the first duty of health professionals should be to deal tactfully with the emotional state of pregnant women. This is not easy in the framework of industrialized childbirth, which implies a certain style of prenatal care, constantly focusing on potential problems. Let us say that antenatal visits often have a ‘nocebo effect’. There is a nocebo effect whenever health professionals do more harm than good by interfering with the imagination and the belief system of the person for whom they are providing care.