French obstetrician Michel Odent has spent the last several decades trying to make the world think about the importance of birth. Odent’s mother was a nursery-school teacher with an interest in child development and the work of Maria Montessori. This exposed the young Odent to a world view that accepted the impact of early life experience on later life health and wellbeing.
Odent now leads the Centre for Primal Research based in London, which pulls together disparate areas of scholarship to focus on the key developmental period of conception to the end of the first year, and the way this period has later life consequences. Odent turns among others to ethologists, the scientists who look at behaviours across species, who were the first to understand that among mammals in general there is, immediately after birth, a short period of time that will never happen again, and that is important in mother–baby attachment. Odent uses their work to think about humans.
Konrad Lorenz was the zoologist who discovered imprinting; the first creature a goose sees after birth is the creature it will follow. Anyone who did biology at school in my day imprinted a chicken. I don’t know what happened to the chicken that followed me about. I hope I was kind to it but I just don’t recall. Odent paints a picture of birth in which the first hour is of key importance to both mother and child. He also draws attention to research that is linking birth experiences with a diminished capacity to love or self-love in later life, including autism, anorexia nervosa, adolescent suicide and drug addiction.
Odent says that every culture that has sought to control nature through aggression also interferes with childbirth. When he wants to know how safe he will be in any city of the world, he looks at the birth practices. He will be least safe, he says, in cultures that interfere most with birth and its natural rhythms. Odent mentions some ethnic groups in Benin, West Africa, in which women are forbidden from looking into the eyes of a newborn baby for the first twenty-four hours following birth so that ‘bad spirits’ cannot enter the baby’s body. ‘The greater the need to develop aggression and the ability to destroy life, the more intrusive the rituals and the cultural beliefs are in the period around birth.
In the seventies, Odent was an obstetrician at Pithiviers Hospital outside Paris. His own account of what he and the families and midwives created there reads as a description of birth care as it should be. Odent asked women who’d birthed to design the hospital’s birthing rooms. The care team, doctors and midwives working together, changed practice in response to what women wanted, as well as a combination of evidence and what they found worked. One by one, Pithiviers removed all of the standard protocols for hospital care – a great deal of screening during pregnancy, making women lie on a bed for labour and birth, Syntocinon to start or speed up labour, forceps for delivery, episiotomy, separating even very premature newborns from their mothers. It changed birth and changed families. Pithiviers was not a low-risk centre. It took all women. According to Odent, there were good outcomes for mothers and babies. And Pithiviers had not only low rates of intervention and low caesarean rates but also low rates of baby and mother death and injury. It seems so simple, so achievable, and yet it’s not.