Michel Odent and fathers at the birth

April 16, 2008 at 1:36 pm | In Family, Homebirth, Midwifery, Musings | 24 Comments
Tags: Michel Odent

Michel Odent has long been an obstetrician who I admired for his desire to resist the medicalisation of childbirth where not necessary but today I read an article where he speaks out against Fathers being present at the birth of their child. I have to admit that when I read the introduction I was horrified, I needed my husband during my labours, or did I? I started musing. What did he do? Well, he irritated me by coming out with little platitudes and attempting to massage my rigid abdomen but when he retreated to a chair and began to read a magazine I was hurt and so accused him of not wanting the baby and told him to go, he didn’t. He was handy though for a hand to squeeze during contractions and someone to keep my flannel cool and damp and place on my forehead and, most importantly, he was my advocate. He was there to deflect the offers of an epidural which, if he hadn’t been reminding me of my insistence that I didn’t want one, I would have accepted during two of the births. The midwives were well-meaning, they could tell from baby’s position and the slow progress of labour that these were not going to be easy labours and births, but had I not had Hubby there to remind me of my reason for resisting epidurals I’m certain that one birth would definitely have been a forceps and the other a caesarian birth. Did this need to be Hubby though? If I had a midwife throughout pregnancy and birth who knew me I’m sure that she would have been as effective an advocate and probably less likely to iritate me! Monsieur Odent talks about the adverse effects partners may have on a labour -

“First, a labouring woman needs to be protected against any stimulation of the thinking part of her brain – the neocortex – for labour to proceed with any degree of ease.

This part of the brain needs to take a back seat and allow the primal “unthinking” part of the brain connected to basic vital functions to take over.

A woman in labour needs to be in a private world where she doesn’t have to think or talk.”

I agree with this sentiment. At a home birth most community midwives will take a back-seat until they are required. We will sit there, quietly, reassuring and supporting when necessary but generally allowing the woman to concentrate on her labour. In an environment where the woman is able to follow her instincts she will try to avoid prying eyes, even if it is just by retreating behind a sofa, or shutting herself in the bathroom, or like me in a hugely medicalised scenario, by putting a flannel over her face to disassociate herself from any distractions. We are after all, basically animals. Anyone who has ever been privy to a cat having her kittens will know that she has prepared herself a safe, warm, dark place to give birth. No being the centre of attention in the middle of an unfamiliar room, surrounded by chattering people, especially strangers, with all the lights on, but that is what we expect the majority of women to do and then we wonder why so many labours require assistance from synthetic, hormonal augmentation to progress.

Odent then continues with the effect that witnessing their partner give birth can have on men -

“Over the years, I have seen something akin to post-natal depression in many men who have been present at the birth.

In its mild form, men often take to their bed in the week following the birth, complaining of everything from a stomach ache or migraine to a 24-hour bug”.

I hadn’t made the connection, but he could be on to something here. Thinking about many of the families I have cared for following the birth it does seem that quite a high number of the fathers do develop illnesses in the first few days at home with baby. The mean side of me had always put it down to them feeling put-out about the lack of attention from their partners, is it possible that it could be an expression of depression, a post-traumatic stress reaction? No answers at the moment but I shall start paying attention to how many of the men who found the birth traumatic then come down with ‘man-flu’, or something similar.

He discusses another adverse result of the partner being present at the birth, marital breakdown. I have only ever known one example of a partner being affected in that way by witnessing his child being born, that was a friend of ours. His wife had experienced a long labour, which culminated in a failed ventouse, forceps birth and a third degree tear. For some unknown reason the obstetrician had felt it wise to show him the extent of the damage before it was repaired and as a result he was unable to make love to his wife for nearly a year following the birth. I can understand this, before a tear, and especially an episiotomy has been sutured it does all look pretty horrific, the first time I saw a perineum prior to stitching I likened it to a mass of steak and kidney. It is not necessary though for the partner to see this, at this time there is plenty more going on, they have just had a new baby for heavens sake.

I decided to consult Hubby on the whole issue of Dads being there for childbirth. He is pleased that he was there, ‘wouldn’t have missed it for the world. I got you in that state, I should be there to help you through it.’ He obviously hasn’t suffered any ill effects from either witnessing me in pain, or the physical and verbal abuse that I put him through during the labours. He is very down to earth though. He knew that no amount of chanting nursery rhymes or deep breathing was going to stop this being extremely painful experience. He understood that when I told the staff to ‘put me down. You wouldn’t let an animal suffer like this’ I was not really dying, that this is not abnormal behaviour during labour. He was not traumatised, he was elated at seeing his children being born. Me? Well I knew that he appreciated what I had endured to produce our family. That he knew when he was ‘wetting the baby’s head’ that I had not just been languishing comfortably in serene surroundings. That when I came home and found sitting down super uncomfortable that I was not playing for sympathy. That, for something that large to exit, and then to require quite that long to put everything back together I definitely would be experiencing more than passing discomfort! So, if I could turn back the clock would I want him there? Yes.

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“high number of the fathers do develop illnesses in the first few days at home with baby”

This is interesting. Your post traumatic stress disorder sounds logical. I wonder, too, if there is a subconscious reaction to experiencing how much they were unable to help, how excluded they were to the process (in the sense that they could leave the room and most partners wouldn’t notice any difference and it would not impact the physiological aspect of the birth process).

My husband stayed at the opposite end of the apartment during my homebirth in June and brought our then 4yo son in for stage 2 labour. He was so much more at ease with everything this time around and life was so much more normal after the birth.

I’ll have to think on this one more.

Comment by mamaloo — April 16, 2008 #

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mamaloo – The feeling of helplessness for the Father is one of the subjects I discuss in my parentcraft classes as I have experienced how panicked, and then verbally aggressive, some partners become, particularly in ‘transition’, when their other half is often pleading for help and losing the plot entirely. I try to give them a role for if that happens, possibly the only time I talk about a structured breathing technique, that way they feel useful and, it stops them shouting at the midwife!
What did your little boy feel about seeing his brother born?

Comment by midwifemuse — April 16, 2008 #

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I can’t imagine wanting anyone else with me during the two most challenging days of my life. I married him because he’s my partner and friend. He certainly was my support during our two births. Of course, it helped that my husband had been present at the births of his previous 4 children as well! He was calm (seemingly, at least) and definitely was my advocate, asking questions that I’d whispered to him and reminding me that everything was OK.
My hero!

Comment by Nicola — April 16, 2008 #

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A long time lurker, time to post a comment. My husband was great in my labour. I was rubbish at the breathing thing so he made me copy his breathing, had he not done that I would have spent half of it hyperventilating. He has also said that he found watching our daugher emerge amazing and didn’t find it traumatic but does put this down to the fact that I was very quiet in labour and spent 2nd stage grunting into a pillow so he couldn’t hear anything. He thinks if I had been more vocal about my pain he would have found it distressing. He didn’t get man-flu! He was also a great advocate, I knew I didn’t want an epidural and when I asked for one reminded me of this and suggested i tried a bit longer without one. Great move as I was in 2nd stage 15 mins later and did my whole chemically (syntocinon) induced labour without an epidural which i am told is a great achievement so I feel very proud of myself.

Comment by freddie — April 16, 2008 #

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@midwifemuse – My son was so excited to see his brother born! He loved it. I prepared him with photos and going through the sounds I was likely to make, so a birthing woman and her parts weren’t a shock to him. As the baby crowned he said, in a high pitched, excited voice: “it’s a head, Dad! A head!” and then, as the head and shoulders were delivered, he exclaimed, “it’s a real live human!” and promptly jumped up on the bed to touch the newly born baby and snuggle with me. That was truly the best moment of my life.

@Nicola – I’d never discourage men from being with their wives because it’s obvious that some guys are really in tune with what’s going on and can be fantastic labour supports. As a doula, I try to make it OK for men to choose their role and change it as they are confronted with the new experience of childbirth. We never truly know how we’ll handle things and I help fathers and their partners realise that not all men (or female partners) want to be in on the action and that’s OK.

Comment by mamaloo — April 16, 2008 #

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My husband was worse than useless – he kept saying ‘are you alright?’ – well, of course I wasn’t!! But I would never have denied him the chance to have been at the birth of his children.

BUT!! I have been midwife at the most appalling instrumental and operative births and its no surprise if men are traumatized after them. I have been, and I am the health professional!

I sometimes wonder if we push men in attending births when they haven’t wanted to – we have gone to the other extreme of where we were in the 60′/70’s. But in the end, it should be down to each individual woman and her partner.

Comment by Sarah Stewart — April 16, 2008 #

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Completely off topic!

FYI:

Online seminar for midwives: What does professional activity have to do with midwifery competence?

Details:
http://sarah-stewart.blogspot.com/2008/04/online-seminar-for-midwives-what-does.html

Comment by Sarah Stewart — April 17, 2008 #

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I think it depends on the man (some will help and cope brilliantly and others will not) and the birth (which obviously can’t be completely predicted before hand). I don’t think it’s right to deny a father the chance to be present at the birth of his child, or on the other hand, to actively encourage a man to be present, so much so that he feels he has to.
My husband wasn’t present for the birth of our son, much to my disappointment and terror (our son was born in a Brasilian public hospital where only medical professionals are allowed to accompany you and, the chances are you have never met or spoken to the people supporting you through the birth). This was possibly a good thing as had he been there, I probably would’ve spent more time worrying about him, and his reactions and feelings, than I would have worrying about getting the baby out.

Comment by Vic — April 17, 2008 #

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Nicola – Your husband sounds like the perfect birth partner, an advocate and support. It helped that you had trust in him, you knew that he had experieneced birth before and so you didn’t feel that you had to be concerned about him.

Comment by midwifemuse — April 17, 2008 #

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Freddie – In my response to Mamaloo I talked about structured breathing and getting the partners to use it when their partner panicked, your supportive, sensible other half, did just the right thing for you, in my classes I call it ‘taking control’ and I do believe that it helps the husbands as well. Synto and no epidural, you and he must have been a wonderful team. Thank you for commenting!

Comment by midwifemuse — April 17, 2008 #

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Sarah – At those instrumental deliveries sometimes I spend as much time worrying about and attempting to distract the Dad as I do supporting the woman. Then then those partners that you look up at, generally just as the head is crowning, and they have turned a strange grey colour and you have to call assistance to help them recover! I would never persuade a partner to be there if he has any doubts about his ability to cope with it, counterproductive for the woman.
P.S Have read your entry so know about the wiki link…..I think!

Comment by midwifemuse — April 17, 2008 #

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Vic – You say it as it should be. If you had any more babies would Yuri be there, or would he be doing the just as important job of looking after your son?

Comment by midwifemuse — April 17, 2008 #

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Having read Michel Odent but AFTER the birth of my first child, I turned him out at the second. It felt right for both of us. He is specialist in emergency medicine and that fact makes him the lousiest birth partner imaginable…
I feel that Odent is quite right on stressing the need of privacy during childbirth. The first birth had to be a sectio because in bright daylight of an April afternoon there were six people gathered around my bed, staring at the haps between my spred legs and wondering why there wasn’t any progress… Not very hard to guess why, is it? And the most nervous and anxious of them was my husband with all the disastrous cases of his emergency-career in mind…

Comment by pienzchen — April 17, 2008 #

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I absolutely needed my partner to be there, even though he didn’t do very much and in retrospect, I would have wished for him to be more proactive. When in early labour at home I couldn’t bear him not being with me every minute. In the hospital, he was a great advocate and did the talking with the midwife for me when I didn’t want to speak anymore. Between them they tried their best to stick to the birth plan. It was easier getting irritated at him rather than the midwife who after all was a total stranger. He also was able to articulate my objection to a c-section when I could only incoherently refuse in a screaming fit to sign the consent form. This gave us the crucial 10 minutes delay which at least allowed baby to come down sufficiently for a forceps delivery. In advance I had given him the option of leaving when it came to operative delivery (I don’t think I would want to be there if I was the partner), particularly c-section, but he stayed and didn’t go green, which I think was really brave of him, and made the moment our daughter was handed to us so so special. So although he couldn’t exactly help with the labour, I wouldn’t want to have done it without him. I had a very supportive midwife who did all she could to follow my birth plan but I’d never met her before, so it was good to have a face there who I knew. It also meant that the midwife was able to leave us alone in the birth pool room for the first 4 hours in hospital, freeing her time to get on with women further on in their labours. Had I known the midwife who’d deliver my baby before and had the opportunity to make sure she knew my priorities for birth, his role wouldn’t have been quite so crucial. Above all though, he wanted to be there. Next time around if there is one, I think I could do without him but with a doula, but he might not want to miss this very special time.

Comment by cartside — April 17, 2008 #

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pienzchen – As a midwife I’m really unhappy when partners are medics, they get really stressed out and, as you said, it affects their partner. Amy on homebirthdebate.blogspot.com has got something to say about catecholamines, she doesn’t agree that stress/fear affect labour!

Comment by midwifemuse — April 17, 2008 #

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Cartside – An advocate is what you need and your partner sounds as if he was brilliant. The thing to have is someone you trust, partner, friend, mother or doula, or a midwife that you know. Doula’s do seem to be gaining in popularity, a reflection of how lacking maternity services are do you think?

Comment by midwifemuse — April 17, 2008 #

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Well, to a certain extent yes, but I also have to say had I known my midwife before and had had a chance to discuss my birth preferences, fear of a c-section and epidural, she would have been the person I needed (although I still would have wanted hubby to be there too). But you don’t know and you don’t want to be with a total stranger in such a situation. I was also lucky in that the midwife observed stage of my labour was from 9am – 4pm and I had the same midwife start to finish. Don’t know how I would have felt about a change of staff in the final stages.

Strangely in my health centre in Glasgow, although there was a team of midwives, I only ever saw one midwife in antenatal appointments (and more often than her, I saw a GP) and didn’t get to know the whole team as promised (the idea being that you don’t meet the midwife who delivers your baby first time in hospital).

Incidentally, in Germany you can “employ” a midwife – i.e. you pay a certain amount to choose the NHS equivalent midwife who will be delivering the baby. A very popular practice. Not the same as independent midwives (as they are employed by the hospital and the fee is much more affordable). Almost all my German friends did this, but you have to be very organised as you need to “interview” midwives early on in pregnancy to make sure they can accommodate you. It’s not private, but an interesting practice when resources provided by general Health Insurance (no NHS in Germany) services aren’t resourced to allow such a service. Sorry for long comments, it’s a very interesting topic!

Comment by cartside — April 17, 2008 #

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Cartside – We operate ‘team midwifery’ but we each have our own G.P’s surgery that we cover, so women generally only meet one of us also my G.P’s only see pregnant women twice during their pregnancies.
Interesting system in Germany, sounds quite similar to New Zealand. Friend of mine is midwife in NZ and initially she thought system was good but problems re. the funding arose if the woman required transfer to consultant care, extra investigations etc. I wonder how women choose their midwife, what qualities they look for, expect alot is decided by recommendation.

Comment by midwifemuse — April 17, 2008 #

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I think my first birth changed my husband’s view of me sexually — at least for a while. It was a planned home birth, and I had a 2nd-degree tear. Because of the way I tore and the lighting in the room, my husband had to hold a flashlight so that the midwife could see what she was doing. But I am still glad he was there; and he missed our second son’s birth entirely, which I deeply regret.

Kathy

Comment by Kathy — April 18, 2008 #

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Kathy – I would have hated that, Hubby standing there, able to see what it looked like. I feel sorry for both of you because I’m sure he didn’t really want to have to pay attention to the midwife’s task but to keep the site lit he had to look. I have one of those lights that is on your forehead so I can usually just get on. If I don’t use it I still don’t get the other half to hold it as there are always 2 midwives at a homebirth.

Comment by midwifemuse — April 18, 2008 #

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Well, she did have one of those “miner’s lamps”, and she had a doula/midwife assistant too. I can’t remember right now why it was necessary for him to be there too — I think because of the way I tore, the assistant had to help her and couldn’t hold the light, and I don’t know why the headlamp wasn’t good enough (perhaps the batteries were too low?). He was pretty cool about it all, but I wonder if the change in sex-related things I noticed was due to that. Or it could just be that “life happened” — tired with a baby waking up throughout the night, etc. He’s said that seeing me like that didn’t negatively affect him, but I wonder….

Comment by Kathy — April 18, 2008 #

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Kathy – I suppose it must affect men initially anyway, just being cautious about causing damage possibly? I used to have an angle-poise lamp, wonderful, but then Health and Safety told me I shouldn’t be plugging any of my own equipment into a patient’s electrical supply in case it caused a problem.

Comment by midwifemuse — April 18, 2008 #

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For what it’s worth, a friend contacted Dr. Odent about this article directly, and he says he was misquoted. So while it’s an interesting discussion starter, it’s not representative of Dr. Odent’s opinions, more the reporter’s.

Comment by Laureen — April 24, 2008 #

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Laureen – Interesting comment in view of the discussion on ‘Fetal distress’. Will Dr Odent refute the article publically?

Comment by midwifemuse — April 24, 2008 #

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