A chat with Michel Odent.

By Sian Hannagan
Mar 2014

It is 9.30pm at night and my day is almost finished. It is wintry cold, and it is snowing outside. On the other end of the line, Michel Odent is just beginning his day and it is spring. But for the next 30 minutes we get to talk together about birth and the future of humankind. We’ve played phone tag getting to this point, but when he answers the phone Michel is warm and friendly. We only have half an hour, but Michel takes his time to answer our questions in full.

Michel Odent MD

Michel Odent has just released his latest book “Childbirth and the Future of Homo Sapiens”- a book written for people who are “interested in future of homo sapiens but have no special interest in childbirth” In fact, according to Odent, this book is for everyone except pregnant women, whose time is precious. “They should be watching the moon, singing to their unborn babies in the womb and nurturing the life within them,” Odent says. This book is about birth but not as we know it, it’s about why birth matters to all of humanity, it’s about how we birth affects the human race.  From Odent’s perspective, our understanding of how birth should occur is flawed, and within our herstory, this lack of understanding and the perpetuation of a misaligned birth culture has led to one of the biggest changes of our future. According to Odent, “We are at the bottom of the abyss” because, in his words, our current birth system is a result of 1000 years of conditioning where women are told that they cannot give birth. As a result, birth has been completely removed from how it occurs naturally, and it has been removed from women, essentially. So why does this all matter? A natural part of evolution is adaptation, if we have the technology to birth apart from our physiology then why not use it? “It should be our aim to create the right situation for as many people as possible on this planet to give birth to babies and placentas thanks to a flow of love hormones. Such an objective implies that the basic needs of women are rediscovered. Is this utopian?”

 Michel Odent – Childbirth and the Future of Homo sapiens

So, what happens in a world where women can’t give birth without intervention? Do the physiological systems we have in place to birth well, stop functioning via the process of evolution? For example, oxytocin, one of the most powerful hormones, responsible for love, socialisation, orgasm, birth, and breastfeeding is being use less and less in our intervention heavy birth culture. With the use of artificial oxytocin (syntocinon or pitocin), IVF and low breastfeeding rates it is now possible to be conceived, borne, birthed, and nurtured without any natural oxytocin transfer, so, by the process of evolution will our oxytocin systems then start failing? Have they already? What would a world without oxytocin look like? Odent has a few ideas, and it doesn’t look good, “without oxytocin we could expect disregulation (of our oxytocin system) and a reduced desire to survive” he states. This is because oxytocin is the key hormone in all facets of procreation, from love and sex to bonding and nurture. You can hear the passion in his words when he says “We don’t ‘need’ this physiological system. And therefore, it will become weaker.” Women are losing their capacity to give birth, losing their capacity to breastfeed” a future without oxytocin looks bleak.

“Since the Neolithic revolution, cultural milieus have interfered with the birth process and have undoubtedly transformed Homo sapiens. Human groups we know about have transmitted countless perinatal beliefs and rituals from generation to generation, the effects of which are to amplify the difficulty of childbirth, to separate mothers from newborn babies and to delay the initiation of breastfeeding.”

Michel Odent – Childbirth and the Future of Homo sapiens

So how do we pull apart this Gordian knot? I asked Odent what his thoughts were on this. In a utopian world, he would like to see the prerequisite for becoming a midwife, to have a positive birth experience. This seems like such a simple thing, but the way birth is currently viewed and perpetuated means that positive birth experiences are so rare that they are seen as unusual and even fringe. There is a reason that Odent uses the word ‘utopian’ because we have to acknowledge that current birth culture does not allow for such a luxury. But there is no question that having midwives who believe in positive birthing and trust the innate capabilities of a woman’s body to birth would make a difference. Instead of making decisions from fear, we could make decisions from a place of power. Odent has stated that these are radical ideas and currently, they are culturally unacceptable. But we need to challenge what is culturally unacceptable and move towards what is physiologically normal.  Michel Odent has in the past suggested that the job of a midwife is not to assist in birth, but to sit back and let birth happen, he paints the picture of an ideal birth happening in a comfortable space with a midwife sitting in the corner knitting and a mother birthing, for the most part unassisted. He has even controversially suggested that fathers in the birth space are not a great idea as they may distract the mother and cause her to engage the neocortical part of her brain, which shuts down the primal birthing process. These statements have brought conflict to the birth space in the past, but they are not without some justification.

New Zealand is often held up as a paragon of birth to the rest of the world, this is because we have a robust midwifery system that works via the domino (Domiciliary In and Out) system, where women have a dedicated midwife working from within the community to provide their lead maternity care. In contrast to this, other countries often have an obstetric model and midwives are considered outsiders in the birth environment.  So, what is Odent’s take on this? New Zealand has a good midwifery system, but we still have a relatively high intervention rate. Our caesarean section rate was at 24.9% in 2010 with some tertiary hospitals getting as high as 36%. New Zealand also has a robust natural birthing community who are active in promoting birth choice. Odent has noted that this is somewhat of a paradox, because in many countries where there is an obstetric model and little to no midwifery, there can be a very low caesarean rate. Countries such as France, Japan, and Scandinavia bear this out. So why then is NZ, with a robust midwifery system going through such an increase of caesarean section rate? That is the paradox, according to Odent, “this is the phase for questioning and analysis”. Without knowing why these paradoxes occur we cannot move forwards. “We need awareness, of all the mistakes transmitted during the past decade. Particularly by the natural childbirth movement”. Perhaps this is a time for some self-reflection. Or do we put forward that we have a strong natural birth movements as a result of our higher intervention rates, as a challenge to the status quo. It’s hard to know for sure. Either way, Odent is raising the hard questions that need answers. Odent confesses that this book may not answer these questions, but the questions it asks are important and while the future of the human race may be an obsession for many political and anthropological commentators, questions about how we birth, one of the key vectors for human population, which affects our whole human direction, are not being asked by the right people.

Rates of intervention in New Zealand.

The National Womens’ Health 2010 report states that our intervention rates are considered high, it goes on to state that any procedure undertaken unnecessarily represents a risk to mother and baby, as well as diverting resources that can be used elsewhere. Currently New Zealand’s epidural rates sits at approximately 24.9% of birthing women. Induction rates is at 19.8%, and augmentation is at 28.6% of birthing women. Our caesarean rate is 23.6% of birthing women. These figures have been taken from our 2010 report on maternity. 2013 is yet to be published.

Birth by Caesarean section. Image kindly gifted by Lulu Baird

Looking at historical figures we can see that National Caesarean section rates for New Zealand have been climbing steadily.

1980: 9% of total births were by caesarean section

1990: 15% of total births were by caesarean section

2008: 24.3% of total births were by caesarean section

2010: 24.9% of total births were by caesarean section

Factors that increase risk of intervention include maternal age, maternal weight, gestational diabetes, or pre-eclampsia (related to diet) and ethnicity. European women are twice as likely to have elective caesarean as women of other ethnicities. Pre-labour emergency caesarean and induction of labour increase with increasing BMI. The elective caesarean rate is highest among women attending a private obstetrician and lowest among those attending an independent midwife. Women under the care of medical clinic have a 1.4-fold increased rate of induction of labour compared to community women and women under diabetes clinic have a 2.2-fold increased rate. Place of birth: A New Zealand study published in 2011 indicates that place of birth does have an impact on outcomes. Women planning to give birth in secondary and tertiary hospitals had a higher risk of caesarean section, assisted modes of birth, and intrapartum interventions than similar women planning to give birth at home and in primary units. The key understanding here is not where they ended up birthing, but where they planned to birth. This means that transfers and resulting interventions are not included in figures for the tertiary and secondary units. Which means we get a more realistic picture on the positive influence of women planning a home birth or birth centre birth.

According to the study, the risk of emergency caesarean section for women planning to give birth in a tertiary unit was 4.62 times that of a woman planning to give birth in a primary unit. Newborns of women planning to give birth in secondary and tertiary hospitals also had a higher risk of admission to a neonatal intensive care unit than women planning to give birth in a primary unit. Davis et al, Planned Place of Birth in New Zealand: Does it Affect Mode of Birth and Intervention Rates Among Low-Risk Women? 2011

While rates in NZ are obviously rising, it is not clearly understood by which mechanism this is occurring. Of the 15,250 women who had a caesarean section in 2010, just over half had an emergency caesarean section (54.9% of all caesarean section births). The rate of emergency caesarean sections began to decline after 2006, but it is still the most common type of caesarean. The elective caesarean section rate increased from 7.6% in 2001 to 10.7% of all women giving birth in 2010. Report on Maternity 2012 Ministry of health in 2010 almost one in five women (19.8%) were induced and an epidural was administered to almost one in four women (24.9%). The national rate of episiotomies was 12.5 per 100 vaginal deliveries. Almost a third (28.6%) of all women not having an elective caesarean section required an augmentation.

Image of a caesarean section taking place – supplied by Lulu Baird

The world health Organisation previously had a target rate of no more than 15% of all births by caesarean section. They have since withdrawn this recommendation in June 2010 stating that what matters most is that all women who need a caesarean section would receive one. Michel discusses this in his book, stating that setting targets for caesarians may result in highly medicated and instrumental births. The important question is, how do we ensure that women who genuinely need a caesarean section receive one, whilst ensuring that women who don’t, aren’t put in the position of accepting an unnecessarian.  This is a difficult line to toe with levels of education, trust in birth and hospital procedure having a wide variance across the country.  Social conditioning means that birth is feared, and caesarean sections may be considered fashionable or more socially acceptable. The negative side effects of caesarean sections are not widely discussed or understood, and many physicians can treat what is major abdominal surgery in a rather offhanded matter. Part of the problem may be, that while caesarean sections have risks for both baby and mother, they bear very little practical or litigious risk to surgeons who perform them.

With thanks to Michel Odent who was kind enough to take the time to answer our questions and talk through the big issues with us.


Michel Odent is a retired medical doctor. He was born in France in 1930 and studied medicine at Paris University. Since then. his work has been influencing the history of childbirth and health research for several decades. As a practitioner he developed the maternity unit at Pithiviers Hospital in France (1962–1985). With six midwives, he was in charge of about one thousand births a year and achieved excellent statistics with low rates of intervention. Odent is known as the obstetrician who introduced the concept of birthing pools and home-like birthing rooms. He later founded the Primal Health Research Databankin England. He is contributing editor to Midwifery Todayand is the creator of Womb Ecology. Odent has published upwards of 50 scientific papers, including the first article on the initiation of lactation during the hour following birth. He has written 11 books which have been printed in 21 languages and published throughout the world. He has been featured in eminent medical journals such as The Lancet and in TV documentaries such as the BBC film, Birth Reborn. After his hospital career he practiced homebirths.

Michel Odent has been formative in much of our current birth research and has built a much clearer understanding on the physiology of birth.  He has been controversial at times, but he has always advocated for woman’s ability to birth on her own terms.