Preparing the Nest
WHAT IS THE NESTING INSTINCT?
At the end of her first pregnancy, Liliana was living in a hostel. One day she decided that the bathrooms and the corridors were dirty. She felt an urgent need to clean them. Then she got out of the building. She had to sweep the side-walk. The next day her labor started.
Iona decided to stay at home for the birth of her first baby, against all odds. She called me one afternoon as contractions forewarned her of the beginning of labor. Even before knocking at the door, I was intrigued by the noise of a vacuum cleaner. Between contractions, Iona was hoovering. During contractions, she was leaning on the back of a chair. I asked her afterwards if she usually did the cleaning in the middle of the afternoon. “What?! No!” she said. “I don’t know what made me do that today”.
Such behavior goes unnoticed by anyone ignorant of our mammalian condition. Or if it is noticed, it is incomprehensible. The “nesting instinct” is by no means exclusive to birds and insects that build nests. It is the behavior that drives the animal to prepare, in one way or another, the space in which it will welcome its offspring. There are even some mammals, such as the dormouse, who actually build nests.
STRIKING SIMILARITIES.
After thousands of years of culturally controlled childbirth and a century of industrialized childbirth, it seems difficult to rediscover the basic needs of laboring women. It is commonplace to go astray by raising negative questions, such as: how to reduce the rates of C-section? The primary question should be: how can we deviate as little as possible from the physiological model? The key is to listen to those who are familiar with the nesting instinct of non-human mammals. This is the case, for example, of veterinarians.
In the age of the web, everyone has easy access to expert advice about the birth of highly domesticated mammals, such as dogs. By chance, I found the site of a veterinary hospital in Albany, NY (www.shakervet.com/servicesC.htm). It is significant that the most detailed pieces of advice are about “preparation for whelping”. I read: ”Prior to whelping, it is important to prepare a secure location for the bitch to whelp. When secure, a bitch will tend to relax and be less likely to have a difficult birth. This is best accomplished by preparing a whelping box approximately 24”x 24” for a small dog and 40”x 40” for a large dog. It should have high walls on 3 sides to provide security and keep out drafts. One side should be low, about 8” to allow the bitch to get in and out…” After such a description of the “nest”, focusing on precise details regarding its size, the second group of recommendations is about how to make the nest familiar: “It is very important to get the dog used to the whelping box 1-2 weeks prior to whelping. A good way to accomplish this is to place the box in the room that will be used at whelping and feed the dog in the box. This will help to reduce anxiety for whelping time”.
When reading such advice on the web or having personal conversations with veterinarians, I cannot help thinking of the striking similarities with the preoccupations that guided me in the 1970s when I was in charge of the maternity unit of the Pithiviers hospital, France. My main objective was to improve the birth environment in order to facilitate the physiological processes. This is how the midwives, a group of mothers and I decided to transform one of the conventional delivery rooms into a small home-like birthing room…a small square nest. This room has been imitated in different maternity hospitals. Most of our visitors did not realize the importance of the size of the room, which should be as small as possible. They did not understand the reality and the nature of the nesting instinct.
Another of our aims was to enable the mother-to-be to gain familiarity with the birthing place. It is obviously easier to satisfy the need for privacy in a familiar place. It is not enough to have had a guided tour of the facilities and to be told the whereabouts of the midwives’desk, the birthing room, or the TV room. In order to become really familiar with a place you have to be there often and keep coming there to do something. And it is better if you are doing something pleasant. Those concerned with giving priority to the need for privacy must think about the sorts of activities adapted to pregnant women. The important thing is to ask questions. A variety of answers will be found according to the time, the premises, the kind of population being served, as well as the personality of the people in charge of the center. We found an answer that was perfectly adapted to our maternity unit. Once a week, the pregnant women and the staff would be given the opportunity to meet and sing around the piano. What could be easier, or more pleasant? It was not expensive. Somebody found that you can buy twelve secondhand pianos for the price of one electronic fetal monitor.
SHOULD WE DESHUMANIZE CHILDBIRTH?
There is no doubt that childbirth is at a turning point. It has never happened in any other society that most women could have babies without releasing a flow of love hormones. The future of our civilizations is at stake.
In order to rediscover the basic needs of laboring women we might express a simple rule of thumb: where labor, delivery and birth are concerned, what is specifically human must be eliminated and the mammalian needs must be met. The first step should be to get rid of the aftermath of all the beliefs (inseparable from rituals) that have disturbed for millennia the physiological processes in all known cultural milieus. The belief that colostrum is harmful is a typical example. Such beliefs conferred an evolutionary advantage as long as the basic strategy for survival of most human groups was to dominate Nature and to dominate other human groups. It was an advantage to develop the human potential for aggression. Today humanity urgently needs to invent new strategies for survival. In order to develop respect for Mother-Earth and to unify our global village, the priority is to develop a capacity to love rather than potential for aggression. So all the beliefs and rituals which disturb the physiological processes are losing their evolutionary advantage.
Let us add that a reduction in the activity of the neocortex is the most important aspect of birth physiology and that the neocortex is that part of the brain which is so highly developed among humans. All inhibitions during the birth process originate in the neocortex. That is why the spectacular development of the neocortex is our specific handicap in childbirth. When the activity of the neocortex is reduced the laboring woman is as if ‘on another planet’, cutting herself off from our world. She can become almost as instinctive as other mammals. This leads us to understand that the laboring woman needs to be protected against any sort of neocortical stimulation. Language, which is specifically human, is one of the most powerful stimulants of that part of the brain which is highly developed in our species. Not feeling observed and feeling secure both tend to reduce cortical activity: they are basic needs during the parturition of mammals in general.
I am amazed by the countless pleas I see for the humanization of childbirth. Today childbirth needs to be ‘mammalianized’. In a sense it needs to be de-humanized.
The time has come to learn from the legendary mother who gave birth to a man whose mission was to promote love. Her baby was born outside the human community, in a stable… among mammals.
