A Journey to Oms
On July 2, 1996, after a long, twisting drive, Donna and I reached the village of Oms, France and the Centre for Research and Development of Haptonomy, perched in the Pyrenees overlooking fertile valleys and orchards near the border of Spain. Few Americans are familiar with this institution or with the man behind it, one of Europe's influential octogenarians, Frans Veldman, M.D. And what in the world is haptonomy? It is the science of affectivity and touch and it reaches to the core of what it means to be human. Touch, the first sense, carrying the freight of intention, emotion and thought, is the stuff from which a baby builds a basic sense of safety, trust, and confidence. Haptonomy is especially pertinent to how mothers and fathers relate to babies in the womb and how obstetricians relate to babies at birth. Veldman believes that much of the violence addiction, and aimless behavior seen in youth today is related to negative engrams of touch at birth. Revered in obstetrical circles in Europe, where Societies for Psychoprophylaxis in Obstetrics are alive and well, Veldman has had a steady influence for fifty years. Unfortunately for us, his writings and the Proceedings of the major professional conclaves on haptonomy are in French or German. Originally from the Netherlands, Veldman has made only two brief teaching visits to America. In 1982 he taught at St. Johns University in Minnesota and lectured in Boston and New York, and in 1988, at the invitation of Elizabeth Noble, he offered his basic seminar at Cape Cod. Today, Veldman and his team of forty instructors, are kept busy doing week-long workshops at his mountain top retreat mainly for obstetricians who have reserved their places a full year in advance. An engineering marvel is a large classroom that lifts, chairs and all, to the ceiling revealing a full-size swimming pool underneath! As guests, we were treated to other marvels: lunch with exotic cheezes, wines and newly-harvested cherries, topped off with Frans' favorite dessert, Haagen Dazs ice cream. The real marvel of Oms is, of course, what is taught here about the immediate and long-term effects of touch and affectivity during pregnancy and birth. They have been at this for half a century and have the research to prove the merits of their approach. Veldman, his teaching colleagues, and thousands of diplomates scattered through Europe have in fact created what we can only envy-- an obstetrics that is quintessentially psychological. Twisting back down the mountain from Oms, our Haagen Dazs lurching from side to side, we knew there was no Centre like this on the whole North American continent. Or anywhere else.
Don't Miss This Research
Pregnancy outcome following genetic amniocentesis at 11-14 versus 16-19 weeks' gestationby C. G. Brumfield, S. Lin,W. Conner, P. Cosper, R.O. Davis, and J. Owen (1996). Obstetrics and Gynecology 88 (1), 114-118. The last half century of obstetrical practice has been characterized by unprecedented applications of new chemical substances, technologies and procedures which became popular before they could be tested for long-term consequences. Many obstetrical routines were begun and still continue in use without scientific evidence to justify them, and in some cases, even in spite of scientific evidence disproving their usefulness. (See, for example, a Synopsis of The Cochrane Pregnancy and Childbirth Database in Birth 22 (2), June 1995.) In this broad context, studies like this one are welcome and bring objectivity--and integrity as well--to increasingly popular procedures which carry risk to mothers and babies. These authors arranged a matched-control study with 314 patients and 628 controls comparing outcomes of amniocentesis when done earlier (11-14 wks.) or later (16-19 wks). Those having early amniocentesis were significantly more likely to have post-procedure fluid leakage, vaginal bleeding, and fetal loss within 30 days. The loss rate was 2.2% (2.2 deaths per hundred) for early testing compared with 0.2% for later testing. Drug-hormone interactions on neurobehavioral responses in human neonates. By E.K.Emory, L.J. Schlackman and K. Fiano (1996), Infant Behavior and Development 19 (2), 213-220. The impact of obstetrical drugs on the newborn's developing nervous system is a subject of ongoing importance although research on this topic has declined over the two decades since Yvonne Brackbills's notable researches of the late 1970's. While researchers have been studying the hormonal changes which occur in reaction to stress, they have not looked at how these functions are altered by the pain killing drugs used during labor. Studies continue to report high analgesia use among women giving birth vaginally. A fresh look at this issue raises concerns that subtle, and perhaps insidious, effects of pain medication may affect immature systems vital to general health, and ultimately behavioral and social development. Drugs could alter stress responses, lower resistance to infection, and impair early social interactions between mothers and infants. In this study of 42 healthy vaginally delivered newborns, mothers received either no anesthesia, an epidural with a local anesthetic only (Marcaine), or an epidural with narcotic sedatives (Demorol or Fentanyl). Newborn reactions were tested with the Neurologic and Adaptive Capacity Score (NACS) developed in 1982 by Amiel-Tison and colleagues (See Anesthesiology 56, 340-350). The test revealed many significant differences between the three groups. Without epidurals with narcotics (which depress the central nervous system) babies were more responsive to visual, auditory, and light stimuli, showed faster learning (habituation), and were more responsive to attempts to console them. Generally, the more sedatives or narcotics used the lower the neurobehavioral scores. The authors found the short-term effect of obstetrical drugs significant. Within the limitations of this study, they could not address the long-term effects.
Effects of perinatal medication on the developing brain.By M. Mirmiran and D.F. Swaab (1992). In J.G. Nijhuis (Ed.), Fetal Behavior (pp. 112-125), Oxford University Press, London. Mirmiran and Swaab of the Netherlands Institute for Brain Research point to the susceptibility of the rapidly growing brain to drugs and chemicals during the perinatal period. They cite evidence that 80% of pregnant and lactating women are given drugs for conditions like hypertension, epilepsy, depression, and premature labor. Disturbances caused to the brain by substances during this time period are not usually of a grossly physical nature which can be easily observed. Instead, they find permanent microscopic and biochemical alterations in the formation of neurones, their migration, the formation of neurites, synapses, transmitters, receptors, and alterations in behavioral states. The effect of functional deficits induced in the child in this way is called behavioral teratogenicity or functional neuroteratology because neuroendocrine systems or temperature regulation may be affected. Brains that appear to be "normal, the authors warn, are, in reality, functionally handicapped.
Pain and its effects in the human neonate and fetus.by K.J.S. Anand and P.R. Hickey (1987). New England Journal of Medicine 317 (21), 1321-1329. In this invited article, the authors provide a comprehensive review of all studies relating to pain in both fetus and newborn, based on 200 citations in medical literature. They leave no doubt that these babies have all the anatomical prerequisites and neurochemical systems associated with pain. Babies demonstrate this pain by physiological and behavioral changes, and show memory/learning associated with painful experiences. Anand and Hickey played an historic role in helping to convince surgeons around the world to give up the century-old practice of operating on premature and newborn babies without anesthesia. Making precise measurements of babies undergoing surgery, with and without anesthesia, they were able to prove that (1) babies were having acute and life-threatening stress during surgery without pain-killers, and (2) the use of anesthetics was indeed safe and beneficial to infants having to undergo surgery. This series of experiments, beginning in 1985, was conducted at Oxford University in England.
Editor's Note: For further information on obstetrics and midwifery, see On Line Birth Center.