No flames, please.  I'm a home birther and a huge fan of Dr. Odent, but his
safe, sanitary, sheltered, skillfully supervised birth protocols are very,
very different from most traditional birth practices that have been
historically documented by antropologists.

I would be cautious extrapolating anything about the "evolutionary models"
for breastfeeding and birth if the inference is that bfg and birth worked
better in traditional societies.  For most of human history infant mortality
rates have been horrendous.  People had large families to insure that maybe
a couple of kids might make it.  I heard on the History Channel the other
night that in the USA in 1900 one of every four babies died.

One paper (L Hanson, The global responsibility towards child health, Aust
Paediatr J 1986; 22:157) states that:
"...infant mortality makes up only 2-3% of the total mortality in Europe or
the USA...it represents as much as 65% of the total mortality in
Africa...and is increasing....In Sweden, infant mortality is down to 7 per
thousand live births, but around 1800 it was more than 200 and in some areas
as much as 300-400 per thousand live births."   (!!!!)  We have lost all
sense of the fact that for most of human history, this was the reality
associated with child bearing.

The causes then, as now, often included poor sanitation, poor breastfeeding,
lack of breastfeeding, substitutions of inferior or contaminated foods for
human milk, infection,  lack of immunizations, diarrhea and injury.  Things
improved when public health campaigns began that essentially challenged
traditional behaviors, replacing them with more "scientific" care, if you
will.

A more recent description of the plight of infants in "natural" settings is:
T Wuhib, et al:  Underestimation of Infant Mortality Rates in One Republic
of the Former Soviet Union, Pediatrics 2003; 111(5):596.   "Each year, > 4
million infants (children younger than 1 year) in the world die before they
reach the age of 1 month."

Birth itself has historically been so risky that the average life span of
women hovered aound 40 yrs. In the late 1980's, the Women's International
Public Health Network News (vol 2, 1988) stated:  "Some 500,000 women
[probably an underestimation] throughout the world die each year from causes
related to prenancy...[they require] Assistance of a trained person for all
women in childbirth, at home or in hospital, and, women at higher risk, and
above all, those in dire emergencies of pregnancy and childbirth must all
have effective access to the essential elements of obstetrics."

  Data demonstrate that as child survival rates increase, number of children
per family decrease. Thus population control is directly connected to
improved maternity and child health survival.  Improved maternal education
is a huge factor in child survival, as are improved public health issues
related to sanitation in the birth setting and in the home environment.
Obviously bfg plays a huge role in protecting child survival and in
decreasing fertility.   For an extremely interesting discussion of this
rather well-documented issue, see:
Hanson L and Bergstrom S:  The Link between Infant Mortality and Birth
Rates -- The Importance of Breastfeeding as a Common Factor, Acta Paediatr
Scan 1990; 79:481-89.

We cannot imagine or  imply that things were better before the era of
perinatal "interventions" or of public health advances.  What we want to
strive for is a new synthesis.  This would marry the best of the low-tech/
high-touch approaches that we know make birth an empowering experience with
the safest practices that have been confirmed by science.


Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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