In 1964 a young obstetrician in France could, just, get away with an outrageous experiment. Offered samples by a friend of a new mind-altering drug, Michel Odent tried administering tiny quantities to women in labour. The results were spectacular. “Women would get completely crazy, shout in the corridors, pull out the intravenous needle, scare the midwife . . . but the baby was born right away.”
But because such behaviour was “unacceptable in a hospital setting” Odent quietly discontinued the experiment and didn’t talk about it — understandably, considering that the drug in question, GHB, is now notorious in the context of “date-rape”. It facilitates the release of the mysterious hormone oxytocin and in the case of these women (were they told of the experiment?) stripped away the layers of cultural inhibitions which separated them from their supposedly quick-birthing distant ancestors.
As befits the Maurice Chevalier of midwifery, Odent suggests in his new book, Do We Need Midwives? (Pinter and Martin, £11.99), which may well be his swansong, that champagne can speed up labour because it contains GHB.
Ever since that very Sixties experience, Odent has been trying to explain to us that human society is the enemy of childbirth, because we can’t help messing about with it. Only by suppressing the “thinking brain”, the neo-cortex, can women hope to reclaim the ability of their distant ancestors to birth quickly and easily. Very simple societies let women labour on their own, with an experienced companion waiting some distance away, but we do the exact opposite.
Then, often, we find out we were totally wrong. Only recently have we learned that babies physically need to be with their mothers straight after birth, not whisked off to a nursery. We used to shave and evacuate women, and scrub their nipples, before they could touch their babies; then we discovered that babies needed those microbes after all. (And the National Institute for Clinical Excellence has only just twigged that our decades-old practice of clamping and cutting the umbilical cord within seconds of birth has deprived millions of babies of up to 30 per cent of their natural blood volume.)
Even adjusting for age, height and weight, women take three hours longer on average to birth than they did 60 years ago. More women who aren’t very good at birthing pass on their lack of ability to their daughters, thanks to the success of caesareans, so the proportion of women in society who literally cannot birth without help is also growing. At the same time we move further and further away from the ability to experience what Odent terms, inelegantly, the “fetal ejection reflex”.
Are we really losing the ability to birth, as Odent believes? As I found when I studied with him a decade ago, Odent’s long-term thinking is not always practicable in the short term. An American medical malpractice lawyer recently admitted to me that one drug, Pitocin (known in the UK as Syntocinon) brought him more business than any other single factor in maternity care because it is implicated in so many cases of brain damage at birth. But Odent, frustratingly, is more interested in digging up highly inconclusive studies which allege a distant association between caesareans, Syntocinon/Pitocin and autism — a condition whose definition is still being rewritten — than in looking at the very immediate problem of brain-damaged babies whose mothers were induced.
To many women’s ears, Odent’s ideal birthing scenario sounds awful: a woman labouring alone (no midwife, or the midwife only very discreetly present, and definitely no male partner) in a darkened room. Once she has gone over her time limit, it’s time for the knife. If the woman can’t birth with the “fetal ejection reflex” then, he reasons, a caesarean is a better choice than prolonging her agony with other interventions.
Hmm. All by herself in a dark broom cupboard with the threat of major abdominal surgery hanging over her — you tell her, Dr Odent. We’re right behind you: well behind.