How do you see Montessori “assistants to Infants” aid in the work of birth and the first moments of a child’s life - both now and in the future?

This is the final question on the newborn that I was asked at the Montessori Congress in July 2017. I recently attended a one day lecture and seminar with Michel Odent, a French doctor who writes books on what women need in order to have a "natural birth" and I found much of my answer to this question here. Natural birthing circles don't always agree with Michel Odent, but a Montessorian, Victoria Marshall-Cerins does. 

Victoria Marshall-Cerins is an Australian who works with birth to three. She gave a talk on “the Prepared Environment for Childbirth” at the 2017 Congress this summer, which unfortunately coincided with "The Cosmic Task of Birth to 3. A PDF of her talk is available on the Congress website if you click on the August 11 newsletter link and follow the links to the breakout presenters pdf's.

http://www.montessoricongress2017.org/newsletters-archive.htm

"In this workshop we will explore how the involuntary and reflexive processes of labour and childbirth are heavily dependent upon the environment for optimal functioning. We will look at what becomes possible for women and their babies when they are provided with an environment which meets their universal needs during this, ‘decisive moment for the whole of the future.’ Dr Montessori, The Absorbent Mind."

She is much more qualified to answer this question as she has many years of experience with birthing moms and has seen first hand the effect of the environment on labor. Her talk on the effect of the environmental conditions on the woman in labor reflects how the statement “help me do it myself” applies for birthing.

Labor and birth in the natural and non-medicalized sense is involuntary, and depend on the hormones that act on the primitive brain structures. The neocortex, or the prefrontal lobe, the new brain is responsible for many things, but not for birthing. Inhibition of this part of the brain must occur for natural labor, based on the cocktail of oxytocin, melatonin and endorphins.

Odent has written many books explaining this so if you find this argument interesting you can read about it. He says, more than anything, we need to protect the birth environment and we need to stay out of the way of the process. Protecting the birthing mother means giving her privacy and not stimulating her neocortical brain, mainly through language, external stimulation from light and noise and the sensation of being watched - which triggers the reaction of “thinking” about what others are doing and thinking. She needs to be protected from thinking about being judged for any instinctive acts, sounds, or movements.

If she wonders if her behavior is acceptable, this is her neocortex being activated. If she has to respond to a multitude of questions, this is her neocortex working. Every time her neocortex is stimulated it inhibits the decent that she must take into her primitive brain, it inhibits the production of oxytocin. If lights are bright, melatonin production is inhibited. If she is afraid (the doctor tells her if her cervix doesn't start dilating soon she may be a candidate for pharmaceutical labor drugs or even a cesarian) she may be producing adrenaline, and inhibiting the hormones of birth.

One of the ways a Montessorian can "aid in the work of birth" is to help the mother prepare for her labor by doing whatever it is that helps her move beyond her fears around birthing. During labor, the Montessorian can act as a veil to protect the mother from further provocations that might produce fear. 

Fear creates contraction, fear is an inhibitor to labor. Odent explains that nature works that way for a very good reason. If an animal is being menaced by a predator, she cannot go into labor, she must first protect herself, she is worried about survival. Fear will reverse a labor that has begun so more important things can be attended to, such as fleeing, or figuring out what to do next.

So as Victoria outlines in her Prague talk, and as Odent will continue to say in every book he writes until he is taken seriously... anyone present at the birth should avoid verbal communication whenever possible, eliminate any unnecessary forms of observation and protect the birth environment (maintain darkness, facilitate the use of warm water for deep relaxation such as a hot bath, birthing tub or shower). Anyone assisting birth must have a deep trust in the value of neocortical inhibition and protect the mother from all forms of external disturbance, use unobtrusive observation to asses the mother's needs, and identify and remove obstacles from the environment.

Most of all we have to let go of our conditioning that we can “help.” Just as we are conditioned to think we can help children learn and we think we are protagonists, but we are not. We cannot help a woman give birth, she and her baby must do it themselves, we can only prepare an environment that meets their needs. If we are clear on the actual physiology of labor, the way the hormones are activated not only by neocortical inhibition but also by clear environmental conditions, and we trust the process, we may be able to NOT become yet another obstacle.

Though an AMI Montessori 0-3 training offers a very strong theoretical base on Montessori psychopedagogy, there is typically no practical experience in birthing or postpartum environments. In the Montessori Assistants to Infancy School founded in Rome in 1947, Montessorians studying 0-3 would have spent many hours assisting at births and caring for mothers in the maternity wards in the days following. Without practical experience we only know things cortically, conceptually. This was why it was so important to have "work experience" so that this knowledge became personal through "activities of practical life" as we so clearly understand children must have to incarnate their knowledge. The training was designed so that half of the training was spent in practical experience and half was spent in a classroom discussing their experiences and integrating the theory. Montessori said it was important to start with practical experience and then move into theory.

This is truly a new frontier for modern 0-3 Montessorians. This question, the title of the blog, is one that I am working on every day. In 2013 at the Portland Montessori Congress I presented for the first time my research in Italy and on my research poster I listed this as a priority of the future development of the Montessori 0-3 work. I am committed to developing this training: Montessori 0-6 Months, designed after the original training in Rome, where practical experience is the foundation. 

Michel Odent knows better than anyone what it might mean "to be a Montessori Assistant to Infancy and aid in the work of birth and the first moments of a child's life." His mother was a Montessorian, so he was raised by a woman who knew how to follow the child. Odent talks about how important it is to follow the mother, only she knows what she needs, and he has observed in his experience that every woman goes about birthing in her own way. She must not be guided, she must have total freedom of choice and freedom of movement to get into any position that comes to her instinctively.

Odent, who studied with Leboyer, (the author of Birth Without Violence) has made major contributions, gathering together in a database much scientific knowledge of birth and the relationship of the first period of life, what he calls the Primal Period, from conception to 12 months, as being the vital period of construction of a person's health systems, immune, endocrine, etc. 

Odent talks about birthing as a part of sexuality. The hormones and the way the brain experiences orgasm, another involuntary act, can be understood as a model for the “fetal ejection reflex” or involuntarily pushing the baby out. If you start to think about what you will cook for dinner tomorrow night while you are having sex with your partner, most likely it will inhibit the climax. This is the neocortical inhibition of oxytocin release and the body's response to it.

So though modern natural birthing presupposes the involvement of birth support and coaches (the husband, the doctor or midwife, the birth doula), as a Montessorian, applying the concept of non-intervention is not such a far reach. The risk of inhibiting concentration by guiding or correcting a child can be understood in this context. We disturb the meditative state. We interrupt.

The first moments of a child's life are the first moments of a new relationship. Here too, we must recognize the sanctity of the intimate nature of this new love. We are conditioned to see both birthing and the moments after birth as a social experience between the community gathered for the birth. But in reality, this is not how nature intended bonding to be. If the mother's love hormones are still flowing strong (oxytocin release is at it's highest point right after birth if not inhibited by the neocortex: by language, by social stimuli, but thinking about others perceptions of her) she will know exactly what to do next. Putting her child near her breast and supporting his or her self-attachment to the nipple in the first hour maximizes the potential of the baby's instinctive reflexes to seek out what he needs on his own. This is the first act in his life of going towards life, actively engaging in life. If he is put on the breast, his face shoved into a nipple, he is robbed of this most incredible opportunity of "help me do it myself" (however, many babies won't be able to seek out his mother's nipple under medicalized birth scenarios).

So the role of the Montessorian should be to protect the privacy of these first hours and defend the postpartum environment from the invasion of external interruptions, in the home, and from protocols and bureaucratic processes in the hospital. Support can be provided but as with labor, in the most discreet way possible, always keeping in mind that the neocortical inhibition is also a positive state of mind for the first unfolding of a new love. After resting and gathering his or her wits after being born, the baby will begin to root and the reflexes that bring the baby back together with mom, after being expelled from the former home, will activate under unmedicated conditions. My own observations at the hospital have shown me that the first TWO hours are the window of opportunity for the innate reflexes of coming back together, either in eye contact or suckling at the breast, and only after a few hours sleep will overcome the newborn. 

The Montessorian can now assure that the mother's needs are met, and that the two of them can rest together skin to skin, in a position where the baby can hear the heartbeat, as he or she did before birth. These two things will offer the baby comfort because the smells of the mother and her heartbeat are familiar from before. All the newborn has ever known is a watery environment of the womb and the sounds of his mother's body. Clothing him and putting him in an incubator far from his mother must be understood as a form of normalized violence which does nothing to respect his primal needs. 

Of course, if it is medically necessary, that is another story.