Book review by Cristin Tighe, BirthWorks Trainer & CBE/CBD/CPD(BWI)
Birth Reborn book is a classic and keeper for any birth professional's bookshelf and for parents wanting inspiration and to feel confident in their ability to birth. Its timeless concepts are exceptionally valuable for birth workers and parents alike. BirthWorks International is honored to work closely with the author Dr. Michel Odent, to promote his Primal Health and current research, and to have his personal support for the value of BirthWorks Philosophy to childbirth and more.
Women Birth Most Successfully On Their Own
This book provides proof of women’s ability to birth successfully on their own without technological intervention. It is ironic that a man (the author) is the one to say that women should pay attention to the fact that birth is a natural process and women are capable of birthing well – “Michel Odent is trying to convince birth practitioners that staying on the pillar of technology will only cause more suffering in most cases” (p.5). Despite the seemingly incongruence that a man writes this book, it is a beautiful story of a place that fully supports women’s natural births and gives significant suggestions for each birth to be “…an opportunity for self-transformation.”
Pithiviers is a birth clinic in France, where Odent began working in 1962. He saw that their obstetrical practice consisted of “much more than mechanics and techniques” (p.5). He began to see birth as much more than a medical problem, but “in fact an integral part of sexual and emotional life” (p.6). Their view was not conventional, but saw time and patience as the most useful allies for birth progressing -- which allows active intervention to be used sparingly and only in special cases (p.5) -- and the medical team as “facilitators” and “back-up… to intervene as little as possible” (p.8).
Let Woman Safely Create the Birth Process - Consciousness & Human Dignity
Pithiviers has warm, cheerful, intimate, welcoming rooms, encourages the women to create the birth process for herself, allowing women to “shift to a deeper level of consciousness” (p.13), using instinct to labor spontaneously which is “connected to a particular hormonal balance” (p.14). Their way values the mothers’ integral role in birth and the importance of the infant being welcomed; restoring “dignity and humanity” to what they see as the safest approach to birth – giving mothers control.
Considering the time before birth, the clinic highlights the entire history of the woman, as well as her daily habits, as important to consider. They create support and community by having an introductory tour and meeting, discussing different positions and allowing breathing to be whatever comes naturally (vs. conventional psychoprophylaxis (Lamaze) controlling breath); how pain is real (but manageable); and the partner’s support. There is a sense of community at Pithiviers where there are weekly informal meetings teaching singing, sound and breathing and sometimes dancing, and weekly discussions on postnatal care, as well as a weekly yoga and maternity group. Additionally, they have outside activities such as swimming, or learning how to let go and conquer panic as it surfaces.
Birth is Not a Medical Problem to Be Solved
At Pithiviers, prenatal medical care does NOT treat pregnancy as illness requiring prescription, but uses only neutral, brief and rudimentary urine and blood tests (typically not doing ultrasound or amniocentesis). Also, their management of premature births does not include drugs inhibiting uterine contractions or cerclage (sewing cervix closed) (p.34-35). Helping women in labor begins with recognizing each woman and recognizing that each labor is different ~ so anything is possible (destroying the image of the pregnant woman as a patient). (p.40). They question the automatic use of drugs, ultrasound and other interventions as necessary. Instead, they create a serene, comfortable environment (quiet, warm, dark rooms) with minimal sensory stimulation, so a woman is urged “...to trust what she feels, move as she pleases, and take any position she finds spontaneously,” (p.41) particularly hands-and-knees and non-posterior positions for labor and squatting or facing partner (with hands around neck) for pushing. The woman can choose who is in the room, is encouraged to have a support woman/doula, and can drink, use baths and make sounds. Out of 800 women who gave birth there, only two chose to lie down, showing that when given choice, most women will choose upright positions.
Satisfy a Baby’s Fundamental Needs at the Very Start Impacts Its Whole Life
Odent discuss how the first hour of birth is key because “it may determine how children relate to their mothers, which in turn could affect how they will approach other people and the world around them” (p.61). There is not a clock in the rooms, and after birth they encourage skin-to-skin contact and let the placenta be born naturally. The mother bathes the baby early on, right there on the floor of the birth room, and then they encourage mom to hold the baby for suckling. They do everything to support breastfeeding and bonding, with the baby (and spouse as well) in the room all the time. One reason they encourage natural (vaginal) birth is endorphin levels are higher (which facilitates bonding, maybe later reducing baby blues). Also, babies' demands are quickly met with mom there, avoiding any situations that will not “… satisfy the fundamental needs of the baby.” (p.86).
Forget the Positivization of Birth - Just Trust the Process
Pithiviers is “anti-obstetric” as they do not buy into the “risk factor” idea that justifies “…the wholesale “medicalization” of the birth process to discredit all alternatives.” (p.94) They do not interfere - rarely break the water; do not induce with Pitocin (which seems to make contractions more extreme causing risk to the baby); and do not justify routine use of epidural, c-section (unless there is pre-eclampsia or a pregnancy beyond term), episiotomy, the dorsal position, or the use of forceps. They do use alternative methods like acupuncture or lumbar reflex therapy. The key is that they let the labor progress naturally unless vaginal birth seems impossible or dangerous. The “belief in the instinctual potential of human beings” and the “innate knowledge women bring to childbirth” is clear.
I believe that Pithiviers, as described, is a wonderful counterfactual example of typically accepted, medicalized hospital births that tend to disempower mothers by focusing on technological interventions. Letting women have spiritual, sexual, free births has better outcomes in this place, as their statistics on birth show! From the history of this inspired clinic in France, we take key lessons for understanding BirthWorks.