Could there be a common experience that divides women more than childbirth? No two labours are the same, yet each one is such a momentous event that, decades later, mothers - grandmothers - relish the telling and retelling of their stories. After all, we are the experts.

I confess, then, that when I go to meet Michel Odent, the controversial London-based French obstetrician, author, pioneer and agent provocateur, I am rather looking forward to dusting down my own hellish anecdotes of extreme birthing, NHS-style.

The 84-year-old has just written Do We Need Midwives? in which he avers that increased medicalisation means women are losing the ability to give birth, to the potential detriment of humankind.

Dr Odent has made it his life's work to test and push boundaries. His years in charge of a maternity unit in Paris and his subsequent establishment of the Primal Health Research Centre in London saw him introduce ground-breaking ideas that are now received wisdoms.


It was he who promoted the idea of water births and low-tech birthing suites, skin-to-skin contact after birth and the instigation of breast feeding within the first hour.

When he speaks, medics listen, even if the general public don't always like what he has to say. In recent years, he made headlines by suggesting fathers ought not to be present at births (they disturb the focus and emotional equilibrium the mother needs, he argues) and that women should not be given standardised drugs, as the long-term effects, he says, are unknown.

First fathers, then drugs, now midwives - what other essential element of most modern mothers' birthing experience would he do away with next?

"Take it from me, Michel, we do need midwives. Lots more of them!" I begin. "I should know; my first induction was so shocking and brutal and swift, without a midwife to be seen, that I developed post-traumatic stress and - "

Odent smilingly waves his hand at me to stop. Nonplussed, I take this as a cue to change tack.

"Well, Michel, second time round, I asked the hospital to assure me that there would be a midwife available when I went into labour and they said it was a guarantee they couldn't give, so I asked for an elective Caesarian but then - "

A charismatic, distinguished man, with a French accent as rich as ripe Camembert, he murmurs something that sounds suspiciously like agreement. This seems odd for a man who says we are jeopardising the species with too much perinatal intervention.

Giving his new book such a provocative title is, I begin to suspect, a ploy to ruffle feathers and draw in an audience not usually interested in obstetric policy. His contention, it emerges, is not that we should do away with midwives - rather, that we need them more than ever. In particular, to shield women from doctors who try to intervene in births, ensuring they have the space and peace to give birth naturally.


"When I ask 'Do we need midwives?', it is a real question," he says. "If all births are medicalised, what sort of a midwife will we need?"

The ideal scenario, says Odent, is for a woman to give birth in a dark, warm, quiet room, her sole companion a midwife, knitting. This, he argues, is a pragmatic rather than romanticised scene: "We only discovered in July 2014 that melatonin, the sleep hormone, has an important role to play in childbirth and it is destroyed by light, so dim surroundings are important," he says. "So too is the knitting aspect; repetitive activity reduces adrenaline, which, if present, has a subtle effect on the labouring mother."

The picture he paints is the antithesis of the average bright, busy, hectic labour ward. By his thinking, we are undermining a natural process, resulting in too many Caesarians, which have, in turn, resulted in what he calls an unwelcome "neutralisation of natural selection".

It's an alarming, borderline politically incorrect turn of phrase that conjures up disturbing images of straining mothers being abandoned on a bleak hillside to their breeched-birth fates.

"But I had to be induced twice!" I say. "I am clearly not fit for birthing purposes! And you don't approve of Caesarians. People like you would leave women like me to die."

"I am not against Caesarians. I have performed over 1,000 of them. But I am taking a long-term view of how increased medicalisation will affect humankind, and the rational result is that some day the most common way for humans to be born will be by Caesarian. We need to look ahead and understand the consequences."

Odent, a father of three, with three grandchildren, asks uncomfortable but necessary questions about what we do as a species and how it influences who we are.

"In previous centuries, women who were capable of giving birth had lots of children. Women who weren't died in labour," he says.

"Thanks to the miracles of modern medicine and reproductive science, most women who want two babies can have them. Similarly, women who once might have had a great many babies can now stop at two; this is wonderful for the women concerned but it logically has an overall impact."

The impact is by no means singular; babies born surgically in a sterile environment rather than through the microbe-rich birth canal do not have the same opportunity to build resistance to disease. Babies born by Caesarian are five times more likely to suffer allergies.

Mothers who have C-sections or are induced by drugs that mimic oxytocin, the "love hormone" that prompts sex and love and bonding and breastfeeding, do not produce their own, which has a knock-on effect on the way they bond with their infants.

Odent also believes there may be a link between the rise of Caesarians and an increase in rates of autism; autistic people produce less of the hormone.

"People are not genetically programmed to think long term," Odent says. "When a woman talks about this subject she focuses on her own body, her own baby, as you did. I'm talking about human evolution and people prefer not to look so far ahead."

Looking at the bigger picture, then, the facts appear to bear him out - women who gave birth between 2002 and 2008 took two and a half hours longer during the first stage of labour compared to those between 1959 to 1966.

In England in 2013-14, 26.2 per cent of births were by Caesarean section - double the rate recorded in 1990 - and 25 per cent of labours were induced by chemicals such as synthetic oxytocin.

Natural oxytocin, Odent believes, primes the mother and baby to fall in love with one another in the days after birth.

As there is evidence that the quality of this first attachment lays down patterns for all future relationships, there is an argument that human beings tamper with it at their own risk.

All around us, he says, we have evidence that we are in danger of losing what he calls our "capacity to love". By the process of evolution will our oxytocin systems then start failing? And if so, then what?

As he contemplates his 85th birthday next week, Odent is aware he has limited time in which to keep conveying his ideas.

And whether we're aware of it or not, we need thinkers like him to keep asking discomfiting questions on our behalf. The future not just of midwives, but of humanity itself, could lie in the answers.

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First fathers, then drugs, now midwives - what other essential element of most modern mothers' birthing experience would he do away with next?

Posted by Herald Life on Wednesday, June 24, 2015