Is the Participation of the Father at Birth Dangerous?
by Michel Odent, MD
© 1999 Midwifery Today, Inc. All Rights Reserved.
[Editor's note: This article first appeared in Midwifery Today Issue 51, Autumn 1999.]
A century ago, when most babies were born at home, such a question would
have been deemed irrelevant. At that time, everybody knew that childbirth
is "women's business." The husband was given a practical task,
such as spending hours boiling water, but he was not involved in the birth
itself.
Today, the same question is still deemed irrelevant, even stupid. At
the dawn of the 21st century, everybody knows about the importance of
the active role of the father in the "birth of a family" Most
women cannot even imagine giving birth without the participation of their
"partner." We have heard countless wonderful stories of "couples
giving birth." Fathers are welcome in the most conventional delivery
rooms.
If it is commonplace to dodge the real question, in spite of a conceptual
mutation, this means that the issues are complex. In order to interpret
such sudden and radical changes in concepts and behavior, one must put
them into their historical context. It is essential to recall that the
intriguing phenomenon we are studying began unexpectedly in most industrialized
countries in the 1960s. Then, a new generation of women felt the need
to be assisted by the baby's father when giving birth. They started to
express this new demand at the very time when births were more and more
concentrated in larger and larger hospitals. From a historical viewpoint
one cannot dissociate hospital birth and the participation of the baby's
father. This was also the time when the family had a tendency to become
smaller and commonly reduced to the nuclear family, so that in the daily
life of many women the baby's father was the only familiar person.
Furthermore the 1960s represent the time when the midwife became one
of the members of a large medical team (in the countries where she had
not completely disappeared). It is clear that the participation of the
father was as an adaptation to unprecedented situations: it had not happened
before in the history of mankind that women had to give birth in large
hospitals among strangers; the nuclear family was unknown in any other
culture and midwives had always been independent.
Those who have been active witnesses of such behavioral upheavals remember
how quickly theoreticians established new doctrines. For example I heard
around 1970 that the participation of the father will strengthen ties
between the couple and that we should expect a decrease in the rate of
divorces and separations. I also heard that the presence of the father,
as a familiar person, should make the birth easier and that we should
expect a decrease in the rate of caesarean sections.
The dawn of the 21 st century represents, thirty years later, the beginning
of another phase in the history of childbirth. The current turning point
is related to the fast development of "evidence based obstetrics"
and "evidence based midwifery." One of the first effects of
a scientific approach is to stimulate a new awareness of the importance
of environmental factors in the perinatal period. For example, we learned
from a series of prospective randomised controlled studies that an electronic
environment tends to make the birth more difficult and has no other effects
on statistics than to increase the rates of caesarean sections. Evidence
based obstetrics is instrumental in the preparation for the "post
electronic age" in childbirth.
The current crisis, induced by evidence based practices, represents
a unique opportunity to reconsider many theories and preconceived ideas
and to take an inventory of the questions we must raise. Where the participation
of the father at birth is concerned, we must raise at least three questions:
First question: Does the participation of the father aid or
hinder the birth? Those who are old enough to remember what a birth can be like when
there is nobody else around than an experienced, motherly and low profile midwife
are inclined to formulate the question that way. Our objective is not to provide
answers but to analyze the many reasons why it is such a complex issue.
There are many sorts of couples according to the duration of cohabitation, the
degree of intimacy, and so forth. There are many sons of men: some can keep a low
profile while their partner is in labor; others tend to behave like observers, or
like guides, whereas others are much more like protectors. At the very time when
the laboring woman needs to reduce the activity of her intellect (of her neocortex)
and "to go to another planet" many men cannot stop being rational. Some
look brave, but their release of high levels of adrenaline is contagious.
The double language of human beings appears as the main reason why the complexity
of such issues is underestimated. There is a frequent conflict between the verbal
language and the "body language" of pregnant women. With words, most modern
women are adamant that they need the participation of the baby's father while they
give birth; but on the day of the birth the same women can express exactly the opposite
in a nonverbal way. I remember a certain number of births that were going on slowly
up to the time when the father was unexpectedly obliged to get out (for example to
buy something urgently before the store is closed). As soon as the man left, the
laboring woman started to shout out, she went to the bathroom and the baby was born
after a short series of powerful and irresistible contractions (what I call a "fetus
ejection reflex").
When raising such a question one must also take into account the particularities
of the different stages of labor. It is often during the third stage that
many men have a sudden need for activity, at the very time when the mother
should have nothing else to do than to look at her baby's eyes and to
feel the contact with her baby's skin in a warm place. At this time any
distraction tends to inhibit the release of oxytocin and therefore interferes
with the delivery of the placenta.
Second question: Can the participation of the father at birth
influence the sexual life of the couple afterward?
Through such a question we introduce the complex issue of sexual attraction.
Sexual attraction is mysterious. Mystery has a role to play in inducing
and cultivating sexual attraction. Once there were mother goddesses. At
that time childbirth was enigmatic among the world of men. I had the opportunity
in the past to talk about the birth of their baby with women who were
themselves born at the end of the 19th century. They could not imagine
being watched by their husband when giving birth: "And what about
our sexual life afterward?" was their most common reaction.
Today I am amazed by the great number of couples who split off some
years after a wonderful birth according to the modern criteria. They remain
good friends but they are not sexual partners any longer. It is as if
the birth of the baby had reinforced their comradeship while sexual attraction
was fading away.
Third question: Can all men cope with the strong emotional reactions
they may have while participating in the birth?
I am not thinking of a woman watching the TV while giving birth with a drip and
an epidural, but of a woman relying on her own hormones. I would have never thought
of raising such a question as long as I had only the experience of hospital birth.
During the days following a hospital birth, nobody is wondering about the well being
of the father. When visiting a family two or three days after a homebirth, I almost
always found a happy and active mother taking care of her baby. I had a surprise
when asking about the father. More often than not I heard that the father was in
bed because he had a tummy ache, or a backache, or a flu, or a toothache, or simply
because he was "drained," as a mother told me. When referring to my experience
of homebirth, I am tempted to claim that male postnatal depression is more common
than female postnatal depression, although it is not recognized as so.
The concept of male postnatal depression is a reminder that many cultures
have rituals whose effects are to channel the emotional reactions of the
father. All these rituals belong to the framework of the couvade (anthropologists
use this term that originally means, in French, "hatching").
These rituals, whatever the local particularities, make the father busy
while his wife is giving birth. The last example of couvade was the man
spending long hours boiling water. I cannot help thinking of the case
of young modern men who spend a long time rebuilding a rented transportable
birthing pool: finally the baby is born before the pool is ready. Is it
a revival of the couvade?
My only objective is to justify a series of questions by suggesting
that the issues are much more complex than we commonly believe. It would
be premature to offer clear-cut answers. Questions should precede doctrines.
Michel Odent, MD founded the Primal Health Research Centre in London
and developed the maternity unit in Pithiviers, France where birthing pools are used.
He is the author of ten books published in nineteen languages. Two of them—Birth
Reborn and The Nature of Birth and Breastfeeding—were published
originally in the United States. His forthcoming book The
Scientification of Love will be published in November 1999.
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