CHILDBIRTH AND THE EVOLUTION OF HOMO SAPIENS

Michel Odent is one of the world's foremost obstetricians who is also the founder of the Primal Health Research Centre (www.primalhealthresearch.com and www.wombecology.com). His work has been pioneering in many respects, and in these two books he reviews developments in childbirth practices and their implications for our collective future. It is easy to forget the revolution that has taken place during my lifetime, especially with respect to Caesareans. They used to constitute only 2% of births, but the latest figures in the US are up to 33% and rising. The procedure used to take an hour and required two units of blood, while it now takes 20 minutes with minimal blood loss. This means that in advanced countries it is likely that the Caesarean will become the predominant mode of delivery in the foreseeable future. In addition, there is research to suggest that labour is becoming more difficult. Few general readers would stop to consider the implications of this trend in moments of childbirth.

Foremost among the consequences is an interruption of the natural occurrence of oxytocin during a normal vaginal birth. It is an example of a physiological function that has suddenly become underused and is important in bonding between mother and baby. Michel explains that adrenaline and oxytocin are natural antagonists, and that it is important for the mother to be in a state of neocortical inhibition while she gives birth. This has the incidental advantage of reducing pain. It follows that too much hands-on interference in the birth process is likely to activate the mother's neocortex and favour adrenaline over oxytocin – as do bright lights. The ideal midwife is one who sits knitting in the corner in a supportive role.

Most societies in history have interfered with the birth process, and there has been a strong cultural conditioning to regard the microbe in terms of disease rather than supporting the development of the baby's immune system. In the 1970s, ecologists like Tinbergen and Lorenz developed the notion of a critical period surrounding birth when the infant should be in direct contact with the mother. An additional taboo was the danger of the colostrum, so that medical systems of care tended to isolate the baby from the mother in order to protect it from potential infection. We now know that it is crucial for the mother to be able to pass on her microbiome to the baby, and that breastfeeding is much easier if the baby has immediate bodily contact. As indicated above, the baby needs the mother in a specific psychological and physiological state. An amusing example of this was the woman who gave birth very easily after having a glass of champagne offered by her roommate who had given birth the day before. This had the ideal of inhibitory effect on the mother's neocortex.

Michel relates the cultural interference with the birth process to the rise of the human domination of Nature during the evolutionary process. It is arguable that this dominator mode has had historical advantages, but it is now becoming clear that this approach is unsustainable if we are to continue to live on a habitable planet and that the partnership mode suggested by Riane Eisler is now an evolutionary imperative. The emergence of such terms as symbiosis and Gaia theory is symptomatic of a change in direction. However, there is a further evolutionary consideration to take into account, namely that modern medicine is neutralising natural selection and potentially making us even more dependent on it.

Michel discusses research on patterns of immune response and disease relating to modes of childbirth. I already mentioned an interruption of the oxytocin process above, which means that the immune response of Caesarean babies is less robust than those born through the vaginal route. Another modern discovery is that the human gut is an ecosystem and that gut flora are responsible for about 80% of our immune system. There also appears to be a link between oxytocin dysregulation and depression. In addition, it is possible that this is also linked with rise of autism and the decline of empathy. Michel points out that there is a correlation between autism and Asperger's syndrome with mathematical talent; one study showed that the autistic group had significantly lower blood oxytocin levels than the normal group. It is these people who are more likely to become scientists with IQ predominating over EQ, left hemisphere thinking over right hemisphere thinking, head over heart. This can even translate into visions of the future where we become progressively cleverer but less empathetic - a dangerous prospect.

Michel concludes that we need a better understanding of the needs of the labouring mother and new born child and that contemporary scientific discoveries should overturn centuries of cultural conditioning so that we can create the ideal conditions for childbirth. These informative and research-based essays can help general readers get to grips with these critical issues and apply them to their own circumstances.