‘I am think­ing of the fu­ture of mankind’

The Guardian - Family - - Family - The Birth of Homo, The Marine Chim­panzee by Michel Odent (Pin­ter & Martin Ltd, £11.99). To or­der a copy for £10.19, go to guardian­book­shop.com or call 0330 333 6846.

Michel Odent has moved from be­ing the be­nign nat­u­ral birth pi­o­neer to a doom­sayer pre­dict­ing that cae­sarean sec­tions will in­crease autism spec­trum disor­ders and change hu­man­ity on an evo­lu­tion­ary level. Saskia Baron meets him

Michel Odent has spent his life chal­leng­ing the con­ven­tions of med­i­cal or­tho­doxy. Now in his 80s, the doc­tor who en­cour­aged women to ex­pe­ri­ence pain-free labour in warm pools of wa­ter and was the first to write about the im­por­tance of plac­ing new­born ba­bies to the breast has turned Cas­san­dra. His new book is a warn­ing that we face a grim fu­ture by our heed­less em­brace of med­i­cal tech­nol­ogy; that the very tech­niques used to save lives are also chang­ing the hu­man race on an evo­lu­tion­ary level.

The Birth of Homo, The Marine Chim­panzee the­o­rises that the way ba­bies are de­liv­ered could be one cause of in­creased num­bers of de­vel­op­men­tal disor­ders, psy­cho­log­i­cal prob­lems and ad­dic­tive be­hav­iours. He has in­ter­preted epi­demi­o­log­i­cal stud­ies that show that a high num­ber of chil­dren born by cae­sarean sec­tion or in­duc­tion go on to be di­ag­nosed with an autism spec­trum dis­or­der in sup­port of his the­o­ries.

It’s not sur­pris­ing that the man who trained as a sur­geon in France in the 50s and be­came a guru to the nat­u­ral birth move­ment when he pioneered birthing pools and skin-to-skin con­tact should have a pas­sion­ate in­ter­est in neona­tal health. Since re­tir­ing in 1985 from Pithiviers hospi­tal south of Paris where he rev­o­lu­tionised the labour ward, he’s spent his time writ­ing and lec­tur­ing around the world to mid­wives and doc­tors. Now based in Lon­don, he likes to de­scribe him­self as “an in­ter­dis­ci­pli­nary stu­dent of hu­man na­ture”. He is tire­less in his out­put, pro­duc­ing five books in the last 10 years alone. The in­spi­ra­tion for his latest book came to him a year ago while he was lec­tur­ing to an au­di­ence of mid­wives and swim­ming in­struc­tors who work with ba­bies. It draws on his in­ter­pre­ta­tion of re­cent dis­cov­er­ies in palaeon­tol­ogy, mi­cro­bi­ol­ogy and ge­net­ics and he is ea­ger to see how his ar­gu­ments are re­ceived.

He ex­plores the highly con­tentious aquatic ape the­ory at length – the the­ory that hu­man an­ces­tors de­scended from the trees via an aquatic evo­lu­tion­ary phase – par­tic­u­larly as it echoes his be­lief that some women in labour are in­nately drawn to im­mer­sion in wa­ter. He is also fas­ci­nated by cur­rent re­search into epi­ge­net­ics – the study of bi­o­log­i­cal mech­a­nisms that switch genes on and off – and stud­ies that in­ves­ti­gate how the ma­ter­nal mi­cro­biome – the mi­cro­scopic or­gan­isms, such as bac­te­ria, that in­habit the hu­man body – might af­fect a baby’s de­vel­op­ment in preg­nancy, de­liv­ery and in­fancy. He is most pas­sion­ate about ad­vanc­ing his the­ory that al­ter­ing the way women con­ceive and give birth is chang­ing hu­man­ity at an evo­lu­tion­ary level. Odent be­lieves that in­duc­tion us­ing ar­ti­fi­cial hor­mones, cae­sarean de­liv­er­ies and ad­vances in neona­tal medicine have led to more ba­bies be­ing born to moth­ers who might oth­er­wise have not sur­vived.

“One ef­fect of mod­ern ob­stet­rics is to neu­tralise the laws of nat­u­ral se­lec­tion – the laws that foiled us all [in the past]. We have neu­tralised those laws. It means that at the be­gin­ning of the 20th cen­tury, a woman who could not give birth nat­u­rally would die, whereas the one in the vil­lage who could give birth eas­ily would have 12 chil­dren. To­day, the num­ber of chil­dren one has de­pends on other fac­tors than the phys­i­cal ca­pac­ity to give birth.

“I mainly talk about ob­stet­rics, but we can also talk about con­cep­tion. If you can­not have a child, you can have med­i­calised con­cep­tion. So we have neu­tralised the laws of nat­u­ral se­lec­tion. It is one of the big­gest prob­lems for hu­man­ity to­day and peo­ple don’t re­alise that. Any math­e­ma­ti­cian, any statis­ti­cian in­ter­ested in this topic will find ways to cal­cu­late what will hap­pen – in my book I give sev­eral ex­am­ples.”

Odent cites the dis­cov­ery in the 70s that med­i­ca­tion could treat rhe­sus in­com­pat­i­bil­ity dis­ease that has since saved hun­dreds of thou­sands of lives. It’s made it pos­si­ble for par­ents who are rhe­sus in­com­pat­i­ble to have sev­eral ba­bies. He also cites re­search into breech births that has shown a ge­netic com­po­nent: “In the past, breech births were more dan­ger­ous than head first, but sud­denly with the ad­vent of mod­ern cae­sarean tech­niques, they are not more dan­ger­ous. So the peo­ple with the genes for breech birth (and it can come from the mother or the fa­ther) are able to have the same amount of ba­bies. This is a math­e­mat­i­cal fact.”

Where Odent moves on to far more con­tro­ver­sial ground is in his selec­tive in­ter­pre­ta­tion of two large lon­gi­tu­di­nal stud­ies into higher rates of cae­sare­ans and in­duc­tion among chil­dren later di­ag­nosed with autism spec­trum con­di­tions. These case-con­trol stud­ies used pop­u­la­tion-based data done in 2002 and 2004 and found an as­so­ci­a­tion with cae­sarean de­liv­er­ies and autism. Odent claims that the in­crease in preva­lence in cases of autis­tic spec­trum disor­ders can­not be as­cribed solely to in­creased aware­ness and changes in the def­i­ni­tion of autism. His con­cerns fo­cus on syn­thetic oxy­tocin used to in­duce labour, the in­creas­ing num­ber of cae­sare­ans and the en­vi­ron­men­tal con­di­tions in the womb. He sug­gests that some or all of these fac­tors may in some cases trig­ger a ge­netic pre­dis­po­si­tion to de­velop autism.

But cor­re­la­tion does not equal cau­sa­tion. A very dif­fer­ent in­ter­pre­ta­tion of the higher rates of autism among chil­dren born via in­ter­ven­tion comes

One ef­fect of mod­ern ob­stet­rics is to neu­tralise the laws of nat­u­ral se­lec­tion

from the Amer­i­can pae­di­a­tri­cian and autism spe­cial­ist Paul Wang: “A foetus with de­vel­op­men­tal is­sues may have low mus­cle tone that can in­ter­fere with mov­ing into proper po­si­tion for nat­u­ral de­liv­ery. In this and other ways, the foetus plays a cru­cial role in ini­ti­at­ing and ad­vanc­ing nat­u­ral labour.”

Oth­ers have pointed out that the higher rates may not be an in­di­ca­tion that birth in­ter­ven­tions have trig­gered autism but that the dif­fi­cul­ties as­so­ci­ated with autism – mo­tor plan­ning, hypo or hy­per sen­sory dif­fer­ences, com­mu­ni­ca­tion im­pair­ments – may make it dif­fi­cult for the al­ready autis­tic baby in the womb to en­gage in the birth process in the stan­dard way.

Dr Ca­role Buck­ley, the Royal Col­lege of General Prac­ti­tion­ers’ clin­i­cal rep­re­sen­ta­tive on autism, is dis­turbed by the hy­poth­e­sis: “There is no ev­i­dence to sup­port the claims in this book and it is ex­tremely un­help­ful of Dr Odent to make them. Sug­gest­ing that in­duc­ing labour or de­liv­er­ing a baby via cae­sarean may lead to autism is ir­re­spon­si­ble. It will only in­crease anx­i­ety and feel­ings of guilt or in­ad­e­quacy that women of­ten feel when they need in­ter­ven­tion to give birth to their ba­bies.”

Wor­ry­ing anx­ious par­ents is the last thing that Odent be­lieves is help­ful. “I put a caveat in my books – they are not for preg­nant women. I tell them not to read them. They are books for peo­ple who are in­ter­ested in the fu­ture of hu­man be­ings – prefer­ably ones with a sci­en­tific back­ground, peo­ple in­ter­ested in think­ing in terms of the fu­ture and the fu­ture of the species.”

This may seem a lit­tle disin­gen­u­ous when the book’s small publisher spe­cialises in birth and par­ent­ing guides. Try­ing to tease out of Odent whether he’s ar­gu­ing that would-be par­ents who have prob­lems with fer­til­ity or de­liv­ery should not em­brace med­i­cal tech­nol­ogy in case it in­creases the risk of autism, results in a de­fen­sive an­swer:

“I’m not think­ing that way – not in terms of opin­ion and judg­ing, I’m just ob­serv­ing. What I am say­ing is that peo­ple think in the short term, which is what we do in general – our ob­jec­tive is al­ways what can we do now? So if we say that ev­ery­one can have a baby, from a short-term per­spec­tive, that is pos­i­tive. But I am not talk­ing about the short term, I am think­ing of the fu­ture of mankind. There have been hu­man be­ings for mil­lions of years and how long can hu­man­ity sur­vive now? It’s prob­a­bly a neg­li­gi­ble num­ber of years in com­par­i­son with the past.”

Those who see autism and other de­vel­op­men­tal dis­abil­i­ties as dif­fer­ences to be ac­com­mo­dated and ac­cepted rather than some­thing to be pre­vented may well find the tone of his con­clud­ing chap­ter wor­ry­ing:

“We sug­gest that the neu­tral­i­sa­tion of the laws of nat­u­ral se­lec­tion by ob­stet­rics and other branches of re­pro­duc­tive medicine should be given a prom­i­nent place as an ap­par­ently ir­re­versible fac­tor: it tends to set for­ward the ‘Dooms­day clock’. It is ur­gent to re­alise the prob­a­ble and un­prece­dented evo­lu­tion­ary ef­fects of easy, fast and safe tech­niques of cae­sarean sec­tion.”

It’s a con­sid­er­able shift in Odent’s im­age from the be­nign nat­u­ral-birth pi­o­neer to the doom­sayer; it will be in­ter­est­ing to see how his ar­gu­ments are eval­u­ated.

▲ Michel Odent Pho­to­graph by Graeme Robert­son for the Guardian

Pho­to­graph by Vir­ginia Star

‘If you can­not have a child, you can have med­i­calised con­cep­tion,’ says Michel Odent

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