Do We Need Midwives?

Odent Michel

Sujets

• Sciences et techniques
• Pregnancy
• Midwifery
• Evolution

Informations

• Publié par: Pinter & Martin Limited
• Date de parution: 01 janvier 0001
• Nombre de lectures: 0
• EAN13: 9781780662237
• Langue: English

Extrait

DO WE NEED MIDWIVES?
DO WE NEED MIDWIVES?
MICHEL ODENT
Do we need midwives?
First published in Great Britain by Pinter Martin Ltd 2015
2015 Michel Odent
Michel Odent has asserted his moral right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act of 1988.
All rights reserved.
ISBN 978-1-78066-220-6
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
This book is sold subject to the condition that it shall not, by way of trade and otherwise, be lent, resold, hired out, or otherwise circulated without the publisher s prior consent in any form or binding or cover other than that in which it is published and without a similar condition being imposed on the subsequent purchaser.
Set in Minion Printed and bound in the UK by Ashford Colour Press Ltd, Gosport, Hampshire
This book has been printed on paper that is sourced and harvested from sustainable forests and is FSC accredited.
Pinter Martin Ltd 6 Effra Parade London SW2 1PS www.pinterandmartin.com
CONTENTS
1 A ludicrous question
2 A sensible question
Pre-midwifery societies
Biased knowledge
The specifically human handicap
3 A useless question
Towards a new understanding of normality
Preliminary signs of a new normality
Pre-labour versus in-labour caesareans
What if ?
4 primalhealthresearch.com versus NIH
From knowledge to awareness
A useful tool
Concordant results
Genesis of non-communicable diseases
Enlarging our horizon
Limits to primal health research
5 The driving force
Epigenetics
Informational substances and their receptors
Evolutionary biology
Twenty-first-century bacteriology
6 Bridges between scientific perspectives
Autism
Obesity
Interdisciplinarity
7 Meanwhile
Timing of the operation
Immediate skin-to-skin contact
Entering the world of microbes
Ironies
8 Homo Ludens from a primal health research perspective
From Plato to Kerstin Uvn s Moberg
The primal health research perspective
9 At the edge of the precipice
A twentieth-century scientific discovery
Immediate practical implications
A transitory phase of our history?
10 The gaps between science and tradition
Countless examples
An unexpected way to learn about the crucial divergence
Another basic physiological concept
The still dominant paradigm
11 In pain thou shalt bring forth children
12 Will the symbiotic revolution take place?
Symbiosis as the antithesis of Domination
Reinventing Fire... and Birth
Flirting with utopia
13 What is the sex of angels?
Lesson from an analogy
After the paradigm shift
Addendum (To be read after July 2030): Can humanity survive medicine?
A premature question
Neutralised laws of natural selection
A vicious circle
Genetically modified human beings
Different orders of magnitude
References
Index
Special thanks to Liliana Lammers She gave the title of this book then I wrote the text.
CHAPTER ONE
A ludicrous question
Midwifery is among the oldest professions. It is one of the characteristics that set our species apart from other mammals: human females routinely seek assistance when they give birth. This is well known among primatologists, as well as in anthropological and medical circles. The specifically human mechanical difficulties are the bases for all sorts of interpretations. Countless articles and textbooks have reproduced the classical drawings by Adolph Schultz. 1 , 2 , 3 These drawings show the size of the neonatal skull in relation to the maternal pelvic outlet among spider monkeys, proboscis monkeys, macaques, gibbons, orang-utans, gorillas, common chimpanzees and Homo sapiens.
The well-accepted conclusions of the evolutionary perspective are easy to summarise: the socialisation of birth is an adaptation to mechanical difficulties. This is, in part, a result of the fact that the human infant emerges from the birth canal facing the opposite direction from the mother, hindering her ability to assist in its delivery. The presence of another individual who can receive the infant during delivery is, therefore, quasi-necessary. It is claimed that, as bipedalism evolved, natural selection favoured the behaviour of seeking assistance during birth. Seeking companionship was driven by fear, anxiety, pain and desire to conform to behavioural norms. It is also commonplace to claim that the evolutionary process has resulted in heightened emotional needs during labour, which leads women to seek companionship at this time: this suggests that the desire for supportive, familiar people at birth is deeply rooted in human evolutionary history.
The interpretations offered by comparative anatomy are supported by anthropological studies. It would take volumes to review all the perinatal beliefs and rituals reported in a great variety of cultures. As early as 1884, Labor Among Primitive Peoples , by George Engelmann, provided an impressive catalogue of beliefs and rituals occurring in hundreds of ethnic groups on all continents. 4 It seems acceptable to conclude from such studies that the socialisation of childbirth is universal.
The academic perspective is in perfect agreement with our cultural conditioning: we believe that a woman does not have the power to give birth by herself. Looking at the roots of the words is a way to illustrate our deep-rooted way of thinking. For example, the origin of the word obstetrics is obstetrix ( midwife in Latin), which literally means the woman staying in front of (from the verb obstare ). It implies that when a woman is giving birth somebody must be in front of her. Looking at how we talk about childbirth in daily conversations is another way to illustrate the dominant way of thinking. If we ask a young mother who delivered her baby, we are not expecting the answer: I gave birth .
Vocabulary that emerged during the second half of the twentieth century has reinforced our cultural conditioning. Among groups promoting natural childbirth certain terms became popular. A coach is a guide bringing her (his) expertise. The need for emotional support implies that to give birth a woman needs some energy brought by somebody else. In the medical literature the term labour management is widely used. The terms coaching and managing express the same way of thinking.
Since there is a perfect agreement between academics, tradition and contemporary culture, it is obviously ludicrous to raise a question such as: Do we need midwives?
CHAPTER 2
A sensible question
Will our question remain ludicrous after looking critically at these two common assumptions? We ll first ask whether the active participation of a birth attendant is really a universal human characteristic. Then we ll consider whether morphological and mechanical factors are really the main reasons for difficult births in our species.
When studying inherent human nature, we should always take into account the spectacular turning point in the history of mankind that started about 10,000 years ago. Before that time human beings took advantage of what nature could offer, obtaining their food from wild plants and animals. An increased level of social tolerance was an evolutionary advantage. It is notable that Homo sapiens gradually developed characteristics suggestive of a process of self-domestication , such as facial diminution (a decrease in size and prominence of the facial features). Then, suddenly, our ancestors began to domesticate plants and animals in places as diverse and as far apart from each other as the Tigris and Euphrates valleys in the Middle East, South Asia, Central Asia, and Central America. The advent of agriculture and animal husbandry - the Neolithic revolution - radically changed the dominant human lifestyle. Our ancestors were obliged to be less nomadic and more sedentary. The concept of territory took on unprecedented importance, along with other reasons for conflicts between human groups. The new basic strategy for survival was to dominate nature and dominate other human groups. It became an advantage to develop the huge human potential for aggression.
It is acceptable - although simplistic - to claim that there have been two eras in the history of Homo sapiens , separated by the Neolithic revolution. Yet today even the most authoritative academics may be imprisoned by their own conditioning, which has gradually developed during the comparatively short period following this revolution. The way human babies are born offers an opportunity to illustrate this cultural blindness. Considering what has been reported about childbirth in pre-literate and pre-agricultural societies challenges the assumption that midwifery is universal, and that seeking assistance when giving birth is a human characteristic.
Pre-midwifery societies
One of the most useful written documents about childbirth in pre-literate and pre-agricultural societies is the 2008 book by Daniel Everett, Don t Sleep, There Are Snakes . 1 One of the reasons why this document is valuable is that the author - a male missionary and a linguist - originally had no personal curiosity about childbirth. He reports what he learnt about life and language among the Pirah s, who live in the Brazilian Amazonian jungle by the Maici River. Neither the blurb presenting the book nor the numerous published endorsements mention what Everett wrote about the way Pirah women give birth. It is only in the middle of a chapter entitled Material Culture and the Absence of Rituals that precious information is incidentally provided. The report is authoritative, since Daniel Everett spent nearly 30 years of his life among the Pirah s.
The Pirah s have kept many characteristics of pre-agricultural (Paleolithic) societies. Preparing and planting fields of manioc is a new development, introduced by the American linguist Steve Sheldon, who preceded Daniel Everett in the study of the local language. The use of