Rumblings among psychotherapists early in the 20th Century pointed to the distinct possibility that birth was for most people a traumatic event which left marks--psychological marks. Physical marks could hardly be denied: marks from forceps delivery could plainly be seen and were sometimes carried as scars for years. Heads emerged from a difficult birth cone-shaped, reflecting a reaction to powerful forces impinging on the skull. But this was not supposed to matter. Some babies emerged blue and stiff with suffocation, and had to be brought back from the dead, but it was merely an incident. With an unfinished brain, babies were incapable of human sensations, emotions, or thoughts--only mechanical reflexes.

Sigmund Freud, the father of psychoanalysis, gave fleeting attention to birth as the possible source of anxiety symptoms presented by clients years later, but he found this idea incompatible with his beliefs about the immaturity of the brain at birth. He preferred to think of trauma as a fantasy created by clients for veiled reasons. Otto Rank, an early disciple of Freud, became convinced of the reality of birth trauma and devoted himself passionately to construction of a form of psychoanalysis which worked directly with birth (see The Trauma of Birth originally written in 1924).

Rank's novel approach dramatically shortened the process of psychoanalysis but was ultimately rejected by Freud, shunting the Rankian method away from the mainstream of psychiatry where it remains to this day. Only a handful of psychotherapists kept the insight alive that birth was an epochal event which left deep impressions and shaped personality, attitudes, and behaviors for many years to come. For a thorough historical review, see Elizabeth Noble (1993), Primal Connections. Current psychologists and psychiatrists for whom birth trauma is central to therapy include Arthur Janov (see his latest, The New Primal Scream, 1991), Stanislav Grof (The Holotropic Mind, 1992), and Lynda Share (If Someone Speaks, It Gets Lighter: Dreams and the Reconstruction of Infant Trauma, 1994).

Among the vast majority of psychiatrists and psychologists today, the notion persists that there cannot be any real trauma at birth because the immature brain cannot register it. This dogma has been the chief obstacle to progress in understanding babies and in understanding the prime importance of early trauma. In retrospect, this dogma, reflecting the age itself, failed to appreciate the holistic nature of babies, preferring to treat them as physical/material objects only. Experts thought the only matter that was real was brain matter, and the absence of brain matter eliminated all possibilities for sensation, emotional, and cognition. This idea is too small to fit the anecdotal, clinical, and experimental data now available.

Although controversy can still be generated, especially among persons who are not acquainted with contemporary findings, we should not proceed arrogantly with the routine traumatization of our infants at birth! Fortunately, an increasing number of therapists are being privately trained to recognize and work to resolve prenatal/perinatal trauma, but there could never be enough of them to do the work that is piling up. It would take an army of therapists to keep up with endless production line of trauma at birth! Their work could be--and should be--eliminated with the prevention of unnecessary traumas of contemporary obstetrics. But there is no end in sight at this time.