Almgren M, Schlinzig T, Gomez-Cabrero D, Gunnar A, Sundin M, Johansson S, Norman M, Ekström TJ Cesarean delivery and hematopoietic stem cell epigenetics in the newborn infant: implications for future health?. Am J Obstet Gynecol. 2014; S0002-9378:(14)00465-7

Childbirth and the future of homo sapiens

02 October 2014
Volume 22 · Issue 10

Childbirth and the future of homo sapiens

Michel Odent's ‘Childbirth and the future of Homo Sapiens’ (2013) aims to promote and inform discussion and debate around the changing views of childbirth around the world. Odent's views have always tended to polarise opinion among professionals and the public, and this book operates in the same way. Strong assertions are made about the links between autism spectrum disorders and anorexia nervosa, which are based on Dr Odent's own research, and are not generally supported in the wider medical field.

Many of the claims made in the book are in direct opposition to modern midwifery practice in the UK, and prompt further reading and reflection. For instance, the concepts of encouraging labouring women to mobilise as much as possible and to maintain an intake of energy-rich food and drink are directly challenged within the book, as resulting in raised adrenaline levels and possibly causing fetal compromise. As an advocate of woman-led care provision, the challenges that Dr Odent presents within the book encouraged me to read further and examine my own evidence-base for the advice which I offer to women.

The wider focus of the book is an examination of the thesis that the way in which we manage labour and birth is directly affecting the ongoing evolution of humans as a species. Dr Odent's background lies in medicine and surgical training, and as such, his views on evolutionary theory, while an interesting starting point for further reading and discussion, may not provide a rigorously tested expert opinion on the extent to which birth conditions can directly affect the direction of evolutionary progress. Despite the limitations of Dr Odent's professional background, his ideas in this book are at the forefront of current research. A newly published study (Almgren, 2014) appears to show that caesarean birth directly affects neonatal DNA, and as such this book may form an accessible starting point for anyone interested in epigenetics and the effect which midwifery and obstetric interventions may have on the wellbeing and legacy of the neonates we care for.

The format of the book is a large number of short chapters, which have the benefit of being easily accessible to anyone who wishes to read the book, professional or layperson. The chapters and their themes tend to read more as opinion pieces than as rigorous academic research. Many of the conclusions are based on a logic which Dr Odent is able to clearly articulate, but there is a feeling throughout the book that he has sought research to support his theories, rather than drawing conclusions based on the data available. Any reader should be forewarned that some of these theories are based more in the esoteric than the clinical, and encompass topics including philosophy, theology, and spiritualism. There is clearly a need to be aware of this range of influences when considering women's birthing experiences and holistic care provision; however, Dr Odent does not adequately frame the relevance of his thoughts in these areas with reference to the scientific context of evolutionary change as regards birth, which is the central theme of this book.

As a fan of Dr Odent's work around waterbirth, maternal power, and the role of midwifery-led birthing units, it is jarring to find so many questionable conclusions in a book of his. It is true that without challenges to mainstream, accepted practice, there would never be change towards a more positive model of antenatal and labour care; however, these challenges need to be rooted in sound evidence and ongoing debate. Michel Odent has been central in challenging the status quo in the past, but this book serves more as a series of thoughts and suggestions from an inquisitive and experienced mind. As such, it is a fascinating read and an excellent starting point for the conversation.