Psychiatrist Ibone Olza (Leuven, Belgium, 1970), founder and director of the European Institute of Perinatal Mental Health (IESMP) and one of the leading international experts in the field, devoted a fine essay to childbirth in 2017 (Give birthVergara editions, 2021) which was – and continues to be – a bestseller. In 2024, he takes a step back in the reproductive process to focus his attention on pregnancy. “Pregnancy is the only time in adult life when it is possible to experience a bodily transformation as powerful and as great as in childhood and as rapid, if not faster, than during puberty,” Olza writes in the pages of Gestation (Vergara, 2024), where he recalls that this physical transformation also occurs on a mental level: “With pregnancy, our psyche, our identity and our way of being in the world are transformed.”
This psychological transformation, favored by brain changes already demonstrated by science, makes this period, according to the psychiatrist, an ideal time for women to revisit their origins and childhood. “I think that studying this principle allows us to see ourselves from another place and understand ourselves better. Knowing what our mother experienced when we were in her womb and how these experiences may have affected us allows us to discover things about ourselves or to better understand our tastes, our philias and our phobias,” explains Olza, who regrets that neither psychology nor psychiatry have historically paid too much attention to these origins.
Why this disconnection with this first stage of life?
I don’t really know why. I know that my colleagues in psychiatry and psychology have been surprised, after treating patients for years, by how little they’ve thought about what they experienced in the womb. I think the denial is collective. Ultimately, mental health professionals haven’t investigated this because they haven’t even investigated their own personal history. My hypothesis is that there’s a trauma there, that we prefer not to investigate in case we don’t like what we find. But I think all of us who have done this work of revisiting our origins have found some super interesting data.
You point out that when a woman becomes pregnant, probably the most important psychological work she should do is to look at the baby she was and understand to what extent what she has experienced – or not experienced – she wants for her future son or daughter.
Thanks to psychotherapy, we know that this awareness of wanting to know how what we experienced affected us when we were in the womb or in the first years of our lives is a way of breaking the intergenerational transmission of abuse. Furthermore, we now know that the brain, during pregnancy, is particularly permeable to this type of investigative and in-depth work. This is the ideal time to enter into it. If pregnant women could allow themselves this psychic work, with the slowness that it requires, it would probably help them to enjoy pregnancy and parenting much more; and also, as I said, break these harmful and toxic relational patterns that most of us have inherited.
“If pregnant women could…” he just said. I don’t know if society as it is configured, the rhythms of life, the long working hours and the attention paid to pregnancy, contribute to this link.
Not at all. In fact, it is one of the things I would most like to be able to change. It is true that pregnancy is not an illness, but it is also true that we treat pregnant women as if they were not: we want them to work as if they were not pregnant, to do the same thing until the last day… I insist that pregnancy is not an illness, but that it is a very delicate, very precious, very important moment. As a society, we should take more care of pregnant women. Also so that they can do this work of preparation for the education of a human being.
Pregnancy is not a disease, but it is a very delicate, very precious, very important moment. As a society, we should take more care of pregnant women
Pregnancy, as she says, is not a disease, but she writes that it is treated “as if it were a time bomb waiting to explode.” What consequences does this have for the mother and the unborn baby?
This fear generates anxiety and stress. There are perfectly healthy pregnant women who spend their entire pregnancy very worried because they have been told that an index, a parameter or an analysis may be slightly altered; and this already generates a lot of fear that the baby is sick. And the problem is that this fear often conditions the entire experience of pregnancy and even makes many mothers continue to be very worried during the postpartum period, which makes it difficult to create a bond with the baby, to enjoy it… I believe that the medicalization of pregnancy has very disastrous consequences that sometimes only psychologists and perinatal psychiatrists see, because we talk about it very little. And it’s a shame, because pregnancy should be a time of enjoyment, pleasure, and a little rejoicing.
This, I suppose, also explains why many women give birth with great fear and why childbirth is increasingly medicalized.
Of course. Childbirth is already like the final fireworks. If pregnancy is medicalized, childbirth is even more so. Being able to enjoy a pregnancy, as I have already said, is a magnificent preparation for labor, which is a psychological journey in itself, a very profound psychological transformation, the greatest that we experience in our life. In the end, if we only pay attention to the medical and the physical, we miss everything else.
And to what extent does this also have to do with the fact that, even though there is a lot of scientific evidence on this subject, midwives cannot yet be considered the reference professionals in pregnancy and childbirth?
There is still a huge power struggle here. For me, this is a very important feminist issue that goes back a long way. There is little willingness to give power to midwives, which is what we women need. In other words, we need to be assisted by experts in female physiology and reproductive processes. I think medicine is still not up to par with women on this issue.
I think that medicine is still not up to par with women in the reproductive processes.
He opens several important melons in his book. One of them is egg donation.
The comparison made by the French obstetrician Michel Odent between industrial agriculture and its extractive logic, which only thinks in the short term, is very striking; with what assisted reproduction does to women’s bodies. The overall objective is to allow a few to obtain a very high and short-term economic benefit, but all the health consequences and all the psychological burden that these processes imply are not put on the table.
In the book he suggests that he thinks that some feminist currents don’t help much in this sense either.
For me, the big pending issue in feminisms is motherhood. Within the different feminist currents, many still perceive pregnancy as a burden, something that would be better avoided; or even see it as a renunciation and a patriarchal thing. Fortunately, there are other feminisms that demand seeing pregnancy as the power that it represents, as the spectacular moment of our sexual life that it can be… Of course, a very important fight is that all pregnancies are sought and desired, that a woman is not obliged to procreate, but in all this I am hurt by the statements of some feminists who defend, for example, surrogacy. In my way of understanding feminism, this defense does not fit.
“It is difficult for me to begin this chapter and I hesitate in the choice of each word,” he writes precisely when speaking of surrogacy.
Almost all of us already know boys and girls in our environment who have been conceived through a process like this. Obviously, it is not about stigmatizing these creatures, but on the contrary: part of my work also consists of trying to give keys to the families who raise these babies. And this cannot be done from the trial. But one thing is particular, but what is happening on a global level is another. If we make a social reading, for me it is obvious that we are talking about the sale and purchase of newborns.
In my understanding of feminism, there is no room for defending surrogacy. To me, it is obvious that it is the sale and purchase of newborns; it involves planning for orphanhood from birth.
In the book, he argues that in surrogacy, genes have supremacy. The client is assured that the genes do not come from the surrogate mother, but from the man who will keep the baby. “Therefore, the value and importance of gestation, which is seen as an oven where seeds ferment for nine months, are diminished,” he writes.
Gestation is seen as a procedure to obtain a product. But that doesn’t hold up. You can’t focus on genes and ignore the full impact that pregnancy has, which is brutal. It shapes us. Even if a baby has the genes of whoever they are, what they experience in the womb will greatly affect them. In fact, while surrogacy companies insist on guarantees that the baby will be healthy, mental health professionals are already seeing boys and girls who are experiencing significant difficulties related to this early life.
Often, one way to make surrogacy acceptable is to equate it with adoption. You claim that these are radically opposite situations.
It has to be made clear that surrogacy involves planning for orphanhood from birth. I think that’s crucial. It’s as if the mother of that baby died during childbirth. There’s no possible justification for that. You’re causing that baby a wound, a very profound damage, because you’re going to separate him from his mother at birth and, in many cases, you’re going to take him very far away, to another country, and we’re never going to know who conceived him.
