Photo by Trevor Cole

Is Labor a Complication of Socialized Birth?

Editor’s note: This article first appeared in Midwifery Today , Issue 128, Winter 2018.

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It may be useful to recall that the word labor is originally suggestive of a difficult, arduous, or painful effort. It may be useful also to recall that the socialization of childbirth started recently—about 10,000 years ago—as an aspect of the domination of nature, at the same time as the domestication of plants and animals, in the framework of the “Neolithic revolution.” To provide preliminary answers to our question, we’ll combine what we can learn from three situations: childbirth among teenagers who had concealed their pregnancy, Paleolithic births, and anecdotes of authentic “fetus ejection reflexes” among modern women.

Unsocialized Births

People of my generation are likely to have heard of teenagers who, after concealing or ignoring their pregnancy, just went to the loo and gave birth. After thousands of years of socialized birth, such anecdotes provide food for thought. In all cases the mothers were young. They had snapped their fingers at the rules established by the cultural milieu. They had not read anything about childbirth. Furthermore, the babies were born in complete privacy.

Such stories are precious because they are now exceptionally rare. We must keep in mind that the prerequisite for an authentic “unsocialized” birth is weak cultural conditioning. In the context of the twenty-first century, it still happens that occasionally, and often by chance, women are alone when giving birth. However, the power of the conditioning leads us to classify these births as socialized. There are several ways to interpret recent and fast changes in the dominant conditioning. One of them is to keep in mind that the world illiteracy rate halved during the past 50 years, with progress toward gender parity. This tendency has been spectacular in parts of the world such as southern Asia and sub-Saharan Africa. The extreme current rarity of unsocialized birth is also related to easy access to modern methods of contraception. At a critical period in the history of socialized births we must dare to learn from such anecdotes that were not exceptionally rare until the middle of the twentieth century.

Paleolithic Births

One of the most useful written documents about childbirth in pre-literate and pre-agricultural societies is the book by Daniel L. Everett, Don’t Sleep, There Are Snakes: Life and Language in the Amazonian Jungle (2009). The author—a missionary and a linguist—spent nearly 30 years of his life among the Pirahãs, who live in the Amazonian Brazilian jungle by the Maici River. Neither the blurb presenting the book nor the numerous published endorsements mention what Everett wrote about the way women give birth in that ethnic group. Only in the middle of a chapter titled “Material culture and the absence of rituals” is that precious information incidentally provided.

The Pirahãs have kept many characteristics of Paleolithic societies, since preparing and planting fields of manioc started during the twentieth century. The use of imported machetes is also recent. In such a context one must read with attention what Everett wrote about childbirth. A woman usually gives birth by herself, and there is no special place to be in labor. It depends on the season. In the dry season, when there are beaches along the Maici, a common form of childbirth is for the woman to go alone into the river up to her waist, then squat down and give birth, so that the baby is born directly into the river. Not only is there no concept of a birth attendant but, furthermore, the attraction of laboring women toward water is confirmed as a widespread human behavior. This is probably the only written document about an ethnic group in which babies are occasionally born in water.

There are obvious common points between the report by Everett and what Marjorie Shostak and her husband, Melvin Konner, wrote about the “solitary and unaided births” among the African hunter-and-gatherer !Kung San, who live in the Kalahari desert (Eaton, Shostak, and Konner 1988).

Having spent nearly two years with the !Kung around 1970, Marjorie Shostak, as a woman, became intimate with some local women, particularly Nisa, who gave birth to four babies in the 1930s and 1940s at a time when the local people were still living as their ancestors had done before them—gathering wild plant foods and hunting wild animals in their semi-arid environment (Shostak 1990). Although Nisa was aware of a new tendency to socialize the event, she always managed to avoid the presence of other people:

“I have always refused to give birth with anyone there. I have always wanted to go alone. Because, although people try to help you by holding and touching your stomach, they make it hurt more. I did not want them to kill me with any more pain. That’s why I always went by myself.”(209)

In 1978, at a conference of “ethno-obstetrics” in Gottingen, Germany, I had the opportunity to watch the films by Wulf Schiefenhovel (from Max Planck Institute) among the Eipos, who live in the highlands of New Guinea. The Eipos were not perfectly representative of a pre-agricultural ethnic group, since they had gardens and pigs. However, they still had Paleolithic characteristics. The births were not socialized and, in the films made by Wulf and his wife, women are seen giving birth in the bush, without any assistance.

We’ll emphasize that these documents are precious pieces of information about lifestyle in Paleolithic groups living on three different continents. The similarities are striking. They confirm that the socialization of childbirth started with the Neolithic revolution.

The Fetus Ejection Reflex

In the 1960s, the American scientist Niles Newton looked at the effects of environmental factors on the birth of mice. By focusing on the importance of cortical inhibition, even among non-human mammals, she was studying parturition as a chapter of brain physiology (Newton, Foshee, and Newton 1967). She used the term fetus ejection reflex.

In the 1980s, I suggested that an authentic fetus ejection reflex is also possible among humans, but is usually repressed by neocortical activity. With the support of Niles Newton, I wrote that saving this term from oblivion would be a key to facilitating a radically new understanding of the particularities of human parturition (Odent 1987; Newton 1987). I had observed that, in exceptionally rare situations, women can occasionally experience such a reflex, characterized by a birth after a short series of irresistible and powerful contractions without any room for voluntary movements. When a typical reflex occurs, there is an obvious elimination of neocortical control: women seem to be “on another planet;” talking nonsense; behaving in a way usually considered unacceptable regarding civilised women; finding themselves in the most unexpected, bizarre, often mammalian bending forward or quadrupedal postures. The reflex does not always start at the same phase of descent of the fetal-presenting part.

It is easy to explain why the concept of fetus ejection reflex is not understood after thousands of years of socialization of childbirth. It is precisely when delivery seems to be imminent that the birth attendant tends to become even more intrusive. The fetus ejection reflex can be preceded by sudden, explosive expression of a fear with a frequent reference to death (Odent 1991). Any attempt to reassure with words can interrupt the progress toward the fetus ejection reflex (Odent 2000). In the particular context of a preliterate and pre-agricultural society of New Guinea, Wulf Schiefenhovel could discreetly film women giving birth in the bush, without any assistance, through authentic fetus ejection reflexes similar to those some modern women can occasionally experience in ideal situations. In general, any interference tends to bring the laboring woman “back down to Earth” and tends to transform the fetus ejection reflex into a second stage of labor, which involves voluntary movements.

Today, there is no simple recipe to overcome thousands of years of cultural conditioning. However, I can describe an environment that is compatible with an authentic fetus ejection reflex, even in the case of highly civilized modern women. The reflex is more likely to occur in a small dark room at a comfortable ambient temperature, with nobody around, apart from one low-profile and silent mother figure sitting in a corner.

The popularization of the concept of fetus ejection reflex, as a consequence of a renewed understanding of birth physiology, would be a critical step toward a certain degree of desocialization of childbirth. Can we present authentic midwifery as the art of protecting an environment compatible with a fetus ejection reflex?

The point is to realize that, where childbirth is concerned, we have reached the limits of the domination of Nature. We must analyze the consequences of a deep-rooted lack of understanding of the physiological processes that led to a new phase in the history of socialized birth, with the masculinization and the medicalization of the event. In the age of cheap synthetic oxytocin and safe c-sections, the number of women—at a global scale—who give birth thanks to the release of what is now considered a cocktail of love hormones is insignificant. What is the future of a humanity born without hormones of love?

Can we imagine such a paradigm upheaval that the need for privacy is recognized? The ball is in the court of the utopists.

References:

Eaton, S Boyd, et al. 1988. The Paleolithic Prescription . New York: Harper and Row.

. New York: Harper and Row. Everett, Daniel L. 2009. Don’t Sleep, There Are Snakes: Life and Language in the Amazonian Jungle . New York: Vintage Books.

. New York: Vintage Books. Newton, N. 1987. “The fetus ejection reflex revisited.” Birth 14: 106–08.

14: 106–08. Newton, N, D Foshee, and M Newton. 1967. “Experimental inhibition of labor through environmental disturbance.” Obstet Gynecol 3: 371–77.

3: 371–77. Odent, M. 1987. “The fetus ejection reflex.” Birth 14: 104–05.

14: 104–05. ———. 1991. “Fear of death during labour.” J Reproductive and Infant Psychology 9(1): 43–47.

9(1): 43–47. ———. 2000. “The second stage as a disruption of the fetus ejection reflex.” Midwifery Today 55: 12.

55: 12. Shostak, Marjorie. 1990. Nisa: The Life and Words of a !Kung Woman . London: Earthscan.