Michel Odent, MD, has been in charge of the surgical unit and the maternity unit at the Pithiviers (France) state hospital (1962-1985). During many years he has been the only doctor in charge of about 1000 births a year. He is the founder of the Primal Health Research Centre (London). He is the author of the first article in the medical literature about the initiation of lactation during the hour following birth (1977), of the first article about the use of birthing pools (Lancet 1983), and of the first article applying the ‘Gate Control Theory of Pain’ to obstetrics (1975). He created the Primal Health Research database. He has been a member of the Professional Advisory Board of La Leche League International for about 40 years. His latest book is titled “The Future of Homo” (World Scientific 2019)

Michel Odent is Visiting Professor at the Odessa National Medical University and Doctor Honoris Causa of the University of Brasilia.

In this episode, we talked about:

• “Can information bombardment make us blind?” Michel talked about the fact that we have too much information but miss the links between topics

• Originally he wanted to write about physiological birth, but he realised the need for the period of transition to prepare for birth

• Pregnancy is often shortened by inducing birth or performing pre-labour caesarean section before the mother and baby have given the signal for the onset of birth

• What are the long-term consequences of eliminating this period? There isn’t yet enough long-term studies

• Noticeable memory issues in later pregnancy, lack of interest in present situation and wanting to be less social 

• Studying brain functions with MRI, show that parts of the grey matter are shrinking during the days following birth, particularly the parts involved in socialisation

• The concentration of the hormone melatonin is reduced following birth. Melatonin reduces neo-cortical activity and is the hormone related to sleep and darkness. Melatonin works with oxytocin during the birth process

• “At the end of pregnancy, a woman needs to live in peace. Don’t interfere with the short phase of physiological birth preparation”

• “It’s ironic that today we need sophisticated scientific methods for such simple conclusions”

• There’s a need for research about the period of transition before birth

• “In unprecedented times, we need to phrase the question appropriately. We’re in an age of questions”

• “Why don’t we understand birth physiology?”Michel proposes that there are 2 reasons: 10 000 years ago, in neolithic times, our ancestors started to dominate nature e.g. by domestication of animals. Childbirth has become domesticated and socialised. Before this time, women used to isolate themselves to give birth. Cultural beliefs and rituals, passed down generation to generation, have interfered with birth. For example, there was a delayed onset of breastfeeding because of a belief that colostrum (the first form of milk) is not good for the baby . In actual fact, human lactation is meant to start from the first hour of birth. Religion has also played a part in involvement in birth

• The more recent reason that he proposes is the recurrent question: “why is human birth difficult”?, which is answered by mechanical reasons. The question should instead be asked “why do some women occasionally give birth so easily and quickly that they don’t know they are in labour?”

• Have mechanical factors such as the size and shape of the pelvis been overemphasised?

• “What makes human beings special? Our brain, specifically the neocortex”

• The activity of the neocortex can inhibit some physiological functions, known as neocortical inhibition. For example, the sense of smell is more powerful after drinking a glass of wine, because the activity of the neocortex is reduced

• Necortical inhibition impacts the process of birth. “Giving birth is not the business of the logical brain! Giving birth is the business of the primitive/ archaic brain structure”

• Women in labour can perceive smells that others can’t: this is a good sign of reduced neocortical activity

• Making sounds, adopting mammalian postures 

• “What a woman in labour needs is simple: she needs to be protected. Don’t stimulate the neocortex of a woman in labour. Don’t talk, keep lighting low, don’t draw attention to her”

• Light stimulates neocortical activity 

• The idea that a woman needs to be coached through birth is unacceptable in the current scientific context. We need to stop talking about coaching/ guiding/ helping/ management and instead talk about protection

• Today, babies are not born with great diversity of familiar microbes from the mother’s body

• As for other areas, we have reached the limits of the domination of nature and are at a precipice to take another direction

• Pre-labour caesarean birth:  the baby has not given the signal for the initiation of labor, releasing surfactant (a substance in the lungs) . The baby has not been exposed to maternal and foetal stress hormones that are necessary in the birth process (not all stress in birth is bad). Also, the sense of smell for the baby is not yet mature

• Michel categorises the two kinds of birth: with labour and without labour, instead of vaginal and caesarean

• The physiological state of the birth attendant, especially adrenaline, is important

• Michel was first involved in births in 1953, 67 years ago!

• Repetitive tasks such as knitting (that was often done by midwives), lowers adrenaline

Resources:

New book: ‘The Future of Homo’

Paramana Doula course with Michel Odent and Liliana Lammers

Primal Health Research database

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