The paleo-fantasy of birth


Homebirth midwives, doulas and childbirth educators have a problem. They are obsessed with a paleo-fantasy of birth that has nothing to do with the reality of birth. And because they base their efforts on the paleo-fantasy, instead of reality, almost all their empirical claims are flat out false.

What’s a “paleo-fantasy”? According to Professor Marlene Zuk, author of the new book Paleofantasy: What Evolution Really Tells Us About Sex, Diet and How We Live:

It is striking how fixated on the alleged behavior of our hunting-and-foraging forbearers some educated inhabitants of the developed world have become. Among the most obsessed are those who insist, as Zuk summarizes, that “our bodies and minds evolved under a particular set of circumstances, and in changing those circumstances without allowing our bodies time to evolve in response, we have wreaked the havoc that is modern life.” Not only would we be happier and healthier if we lived like “cavemen,” this philosophy dictates, but “we are good at things we had to do back in the Pleistocene … and bad at things we didn’t.”

Starting with Grantly Dick-Read, and extending to contemporary homebirth midwives, doulas and childbirth educators, natural childbirth advocates have adopted the belief that birth evolved under a particular set of circumstances and that changing the way we care for childbearing women without those women’s bodies having time to evolve in response, has wreaked havoc on women and babies.

Zuk is not writing about childbirth, but her thesis applies just as well to childbirth as to contemporary beliefs about diet.

Zuk detects an unspoken, barely formed assumption that humanity essentially stopped evolving in the Stone Age and that our bodies are “stuck” in a state that was perfectly adapted to survive in the paleolithic environment. Sometimes you hear that the intervention of “culture” has halted the process of natural selection. This, “Paleofantasy” points out, flies in the face of facts. Living things are always and continuously in the process of adapting to the changing conditions of their environment, and the emergence of lactase persistence indicates that culture (in this case, the practice of keeping livestock for meat and hides) simply becomes another one of those conditions.

In other words, hunter gathers were never “perfectly evolved,” they represented the best adaptations to conditions as they existed at that time. Conditions have changed dramatically over the past 10,000 years, which means that what was good for them, has no relevance for what is good for us. Moreover, and this is the critical point that is completely ignored by the paleofantasists, we have continued to evolve in keeping with our changing environment. For example, consider:

… “lactase persistence” (the ability in adults to digest the sugar in cow’s milk), a trait possessed by about 35 percent of the world’s population — and growing, since the gene determining it is dominant. Geneticists estimate that this ability emerged anywhere from 2200 to 20,000 years ago, but since the habit of drinking cow’s milk presumably arose after cattle were domesticated around 7000 years ago, the more recent dates are the most likely. In a similar, if nondietary, example, “Blue eyes were virtually unknown as little as 6000 to 10,000 years ago,” while now they are quite common. A lot can change in 10,000 years.

The idea that contemporary women should be attempting to emulate the births of their foremothers, ignores evolutionary science and is fairly idiotic to boot.

There was never a time that women were “perfectly designed” to give birth, because there has never been a time that any species has been perfectly evolved for anything. Every species, at every time, represents a host of compromises that, together, make that species competitive within a specific environmental niche. As soon as the environment changes, and it always changes, sometimes very rapidly, the species, while exactly the same as it was before, is suddenly no longer as competitive. That’s why most of the species of animals and plants that have ever existed are already extinct. They couldn’t change fast enough and died out as a result.

Human beings have the added advantage of technology. We can change our environment and we can change ourselves in ways that evolution would never allow. Ten thousand years ago if a woman began labor with her baby in a persistent transverse position, both she and her baby were guaranteed to die, a slow, agonizing death. Today, the mother would have a C-section and both mother and baby would survive. Ten thousand years ago, that mother and baby would have been evolutionary losers. Today they are evolutionary winners, because the currency of evolution is offspring. If your offspring survive, you win. If they die, you lose. It is just that simple.

There used to be an evolutionary advantage to being able to give birth vaginally. Now, with the advent of the C-section, there is absolutely no advantage, evolutionarily or otherwise, to a vaginal birth. Venerating vaginal birth and attempting to emulate it as it supposedly occurred in nature makes as much sense as polar bears venerating their original brown fur and attempting to emulate it. The environment has changed and the evolutionary winners and losers have changed as a result.

Scientists are sometimes caught out as paleofantasists as well. Consider the latest “research” about C-sections and the infant gut microbiome. There are scientists insisting that C-sections prevent infants from obtaining the “good bacteria” that they previously acquired during vaginal birth. If there is one thing that we can say for sure, it is that the microbiome of the female genital tract is nothing like it was 10,000 years ago, or even 1000 years ago, because no microbiome is like it was 10,000 years ago or even 1,000 years ago. Bacteria evolve far more rapidly than humans and the idea that there are “perfectly designed” vaginal flora that are “perfectly designed” for the infant gut is nothing short of absurd.

The bottom line is that in the game of evolution, she who has the most living descendants wins. There are no extra points for vaginal birth, or breastfeeding, or any other attempt to emulate our foremothers. The woman who has lots of C-section born, bottle fed, fully vaccinated children who survive to reproduce is the winner. That woman is “perfectly designed” for the environment in which we live. Everyone who is obsessed with trying to emulate our hunter-gatherer past is much more likely to be a loser.