MIDIRS Essence > January 2010 > Midwifery News

Oxytocin as the 'shy hormone' - by Michel Odent

Originally posted on Jan 2010

Since the discovery of oxytocin by Henry Dale a century ago we have acquired an accumulation of data about the mechanical and behavioural effects of this hormone.

The time has come now to improve our understanding of its release. It has been demonstrated since the middle of the 20th century that the release of oxytocin among non-human mammals is highly dependent on environmental factors during the milk ejection reflex (Whittleston 1951) and during the fetus ejection reflex as well (Newborn et al 1966). There is a lack of studies evaluating the importance of such effects among humans. However, by combining animal observation, animal experiments, and clinical observation, we can already summarise what we know by claiming that oxytocin is ‘the shy hormone’. It is like a shy person who does not appear in the presence of strangers or observers.

The concept of ‘shy hormone’ is well understood in certain situations but not in others. For example it has been noticed by anthropologists such as Malinowski (Malinowski 1929) that even in societies where genital sexuality is comparatively free, couples isolate themselves to make love, as if they knew that there is no sexual intercourse without the release of a shy hormone. This is also understood to a certain extent during breastfeeding. Women who have difficulties breastfeeding may be advised to isolate themselves in a small dark room with all the doors closed as a way to facilitate the milk ejection reflex.

Where childbirth is concerned, we can first notice that all non-human mammals have a strategy not to feel observed when giving birth, as if they knew that they have to release a shy hormone. A sufficient number of anthropological documents suggest that in pre-literate and pre-agricultural societies, women used to isolate themselves to give birth—going to the bush (Schiefenhovel 1978, Eaton et al 1988), or to a special hut (Klein 2003), for example. It seems that usually, when a woman was giving birth in such societies, her own mother, an aunt, or another experienced mother in the neighbourhood was around, protecting the environment against the presence of a wandering animal or a wandering man. This is probably the root of midwifery.

Then, over thousands of years childbirth gradually became more and more socialised. The midwife often became a guide who dared to interfere using language. She became the one controlling the event, and also the agent of the cultural milieu transmitting beliefs and rituals, using a great diversity of procedures, including invasive procedures such as manual dilation of the cervix, compression of the abdomen, or traditional herbs. An important step in the socialisation of childbirth occurred when women started to give birth in the place where they were spending their day-to-day life: home birth is comparatively recent in our history.

It is notable that although childbirth had been socialised for thousands of years, women always tended to protect the birthing place from the presence of men, particularly medical men as if they knew that oxytocin is more shy in a male than in a female environment. Despite thousands of years of culturally-controlled childbirth during which the basic mammalian needs of labouring women and of newborn babies were increasingly denied and even ignored, and in spite of the indirect influence of male medical men, women have given birth in predominantly female environments—until the middle of the 20th century. Around 1950, in the case of home birth, childbirth was still ‘women’s business’. The doctor—usually a general practitioner—was called at the last minute to use forceps or witness a disaster. The husband was either in the pub, or the café, or he was given a task such as boiling water for hours. At that time, even in the case of a hospital birth, the environment remained eminently female. The ‘knitting midwife’ was the central person in the maternity unit (Odent 2003). There was a very small number of specialised doctors who were almost invisible, appearing suddenly if the midwife called them for a forceps delivery, and disappearing as quickly as possible after the birth. In the maternity unit where I was an ‘externe’, in 1953, I did not dare enter a room where there was a woman in labour. I could only appear during the second stage, because I was supposed to learn the use of forceps. Of course, at that time, nobody could even imagine that the baby’s father might be allowed into the maternity unit.

It was just after the middle of the 20th century that the atmosphere started to be ‘masculinised’. The number of specialised doctors increased at lightening speed, and almost all were men. Around 1970 some women occasionally made a new demand (as a way of adapting to the ‘industrialisation of childbirth’) for the participation of the baby’s father at birth. It became almost overnight a doctrine supported by theories: the participation of the baby’s father at birth became within some years an undisputed ‘rule’. At the same time, sophisticated electronic machines invaded the delivery room, high technology being a male symbol. There was such indifference to the gradual masculinisation of the birth environment that there were no serious discussions when midwifery schools started to accept male pupils. The almost total masculinisation of birth had been achieved. It can be seen as a consequence of a deep-rooted lack of understanding of the basic needs of birthing women and newborn babies. Accentuating this trend, the spectacular technical advances associated with the masculinisation of the environment reinforced a lack of interest in learning from the physiological perspective.

In addition, an unprecedented and sophisticated form of cultural control of childbirth suddenly appeared in the 1950s in the form of theories. It became fashionable to teach women how to give birth, and particularly how to breathe during labour and delivery. New actors entered the birth territory: helpers, guides, ‘coaches’. The socialisation of childbirth – and therefore the lack of understanding of the role of a ‘shy hormone’ - had entered a new phase in its long history.

Still more recently, the wrong messages transmitted by the ‘natural childbirth’ movements have been strengthened by a real epidemic of videos. The power of such visual messages is enormous. In most cases a labouring woman is shown surrounded by two or three persons (including a man), watching her (and, of course, there is a camera). These births are presented as ‘natural’ because the scene occurs at home, or because the mother is on hands and knees, or because she is in a birthing pool. But the environment is as unnatural as possible. The message transmitted by these powerful pictures is: ‘you cannot give birth without the participation of persons who bring their expertise (coaching, management, etc.) or their energy (support, etc). Not only have we forgotten that oxytocin is a shy hormone, but furthermore we are sending the opposite message.

In such a context it seems at first sight unrealistic – even utopian – to reverse thousands of years of cultural conditioning and to promote a new generation of studies about the particularities of oxytocin release. However optimism is permitted when considering the power modern scientific perspectives have to reverse deep rooted cultural conditioning. One of the main scientific discoveries of the second half of the 20th century offers an eloquent example. We had to wait until the 1970s to discover that a newborn human baby needs its mother. For thousands of years newborn babies were more or less separated from their mothers and breastfeeding was delayed. Cultural milieus were interfering mostly via beliefs (eg that colostrum is harmful), which were associated with rituals (eg rushing to cut the cord). When I was a medical student in a maternity unit in 1953, I never heard of a mother asking permission to keep her newborn baby in her arms. Everybody knew that a newborn baby routinely needs ‘care’ by a third person. Suddenly, in the 1970s, there were randomized controlled trials of the effects of skin-to-skin contact immediately after birth. Such studies were inspired by the concept of critical periods for mother baby attachment introduced by ethologists studying non-human mammals. At the same time there was a new generation of research regarding the behavioural effects of hormones fluctuating in the perinatal periods. There were also more studies on the composition of early colostrum, while we were learning about the capacity a neonate has to find the breast in the hour following birth (Odent 1977). From immunologic and bacteriological perspectives we learnt that germs transmitted by the mother should ideally be the first to colonize the baby’s body. Even if it will take time to digest such knowledge and to accept all the implications, one can claim today that, thanks to the fast development of several scientific disciplines, the basic needs of a human neonate have been discovered in the twentieth century.

Since such important scientific discoveries about the basic needs of newborn babies have been possible, we dare to claim that now a discovery of the basic needs of labouring women is not utopian in spite of similar difficulties. We can anticipate that in depth studies of physiological concepts such as catecholamines – oxytocin antagonism and neocortical inhibitions will be particularly instrumental. We can expect more studies of the environmental factors that can influence the release of oxytocin – the ‘shy hormone’.

About Michel Odent

For several decades Michel Odent has been instrumental in influencing the history of childbirth and health research.

As a practitioner he developed the maternity unit at Pithiviers Hospital in France in the 1960s and '70s and he is familiarly known as the obstetrician who introduced the concept of birthing pools and home-like birthing rooms. His approach has been featured in eminent medical journals such as Lancet, and in TV documentaries such as the BBC film Birth Reborn.

As a researcher he founded the Primal Health Research Center in London (UK), which focuses upon the long-term consequences of early experiences.

Michel Odent has also developed a preconceptional program (the "accordion method") in order to minimize the effects of intrauterine and milk pollution by synthetic fat soluble chemicals such as dioxins, PCBs, etc. His other research interests are the non-specific long term effects on health of early multiple vaccinations.

Author of approximately 50 scientific papers, Odent has 11 books published in 21 languages to his name. Visit www.michelodent.com for further details.

References

Eaton SB, Shostak M, Konner M (1988). The paleolithic prescription: a program of diet and exercise and a design for living. New York: Harper & Row.

Klein M (2003). From birth hut to garden of Eden. Midwifery Today. 66: 24-6.

Malinowski B (1929). The sexual life of savages. London: Routledge & Sons

Newton N, Foshee D, Newton M (1966). Experimental inhibition of labor through environmental disturbance. Obstet Gynecol 27(3):371-7.

Odent M (1977). The early expression of the rooting reflex. In: Proceedings of the 5th International Congress of Psychosomatic Obstetrics and Gynaecology, Rome 1977. London: Academic Press: 1117-9.

Odent M (2004). Knitting midwives for drugless childbirth? MidwiferyToday 71: 21-2.

Schiefenhovel W (1978). Childbirth among the Eipos, New Guinea. Film presented at the Congress of Ethnomedicine. Gottingen, Germany.

Whittleston WG (1951). Studies on milk ejection in the dairy cow. The New Zealand Journal of Science and Technology 32(5):1-19.

Michel Odent | Photo credit: Michel Odent

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