This article was apparently originally published in the Sunday Times (date unknown), and was reprinted in Spelling Progress Bulletin Volume VIII, No. 2, Summer 1968.
The decompression suit – popularly called the ‘birth suit’ – is the most unusual advance in obstretrics for many years. It is a South African invention, devised and now used extensive) in Johannesburg, which has spread to the United States and Britain.
This article, first published in the Sunday Times, London, tells how the ‘birth suit’ was devised as an aid to mothers in labour – and how, as the results were collated, it was found that it may have even greater benefits: brighter, healthier children.
At 11 months, Karl behave like an advanced two-year-old. To turn a door handle is difficult for an average two-year-old. Karl manipulated a telephone dial. He could also walk up a steep flight of steps, dragging his huge toy car behind him. Now he is nearly three and speaks four languages.
At 17 months Gerda spoke 200 words. The average 18-month-old child speaks five words.
At 3 months, Linda sat up without support – average 9-month behaviour. At 10 months she was talking. At 2½ she has a wide, fluent vocabulary. Reluctant to have her photograph taken for this story, she told us: “if you’re going to take a picture of me, then I’ll fetch Daddy’s camera and take a picture of you.”
At 2, Paul could tell you how an electric light worked. We watched him – now 2½ – playing with a radio tester, manipulating dials, plugging valves into sockets and carefully making contact between two leads so that the indicator dial would swing up. All this with uncanny dexterity, and strong, focused concentration.
These children and some hundreds like them – all born in South Africa – are clearly exceptional. What may have made them so was the treatment they received while still in the womb, and during the hours when they were being born.
The technique used on them is called Decompression, or Foetal Oxygenation. Ideally it is carried out for half an hour daily during the last ten weeks of pregnancy, and right through the first stage of labour.
Although it was first devised to speed up labour, with no prospect or wonder-children in mind, the South African doctors using decompression now think there is a good chance that two out of five decompression babies may be gifted – or highly gifted.
In spite of such dramatic possibilities, decompression itself is a simple process: a vacuum pump lifts about a hundredweight of atmospheric pressure off the womb – which, in pregnancy, has something like half a ton of pressure on it.
In labour, this means that the abdominal muscles are lifted off the uterus, enabling the total force of the uterine contractions to speed the expulsion of the child into the world.
Normally this force is dissipated in fighting abdominal pressure and tension, making the hazardous journey longer, with more chance of the child emerging battered or damaged.
In pregnancy the same apparatus enables the maternal blood, carrying vital oxygen, to flush more freely through the dense and sometimes obstructed labyrinth of the placenta. More oxygen available to the foetus means less chance of damage to some brain cells – and many obstretricians believe that infants in the womb do suffer from oxygen lack in the last ten weeks of pregnancy.
The placenta has stopped growing by then and is not always as efficient as it might be in supplying the needs of the foetus. If there is oxygen starvation for even a short time, brain cells are irreparably damaged.
Most children, of course, are born healthy enough. But some doctors suspect that given a better uterine environment, such as decompression seems to provide, they will grow more healthy still.
The difference is the difference of a seed growing in nutritious rather than poor soil; of a child reared in a palace rather than a slum. Though the infant isn’t in any way noticeably changed, he is stronger mentally and physically; able to make fuller use of his natural genetic potential.
Decompression was devised by Prof. O. S. Heyns, head of the Dept. of Obstretrics and Gynacology of the Univ. of the Witwatersrand, Johannesburg.
Its apparatus is a plastic suit, a fibre-glass dome to cover the abdomen, a pressure gauge and a vacuum pump from an ordinary household vacuum cleaner.
Once the mother has learned how to use it, she may take it home and do her daily half-hour sessions there. All the “decompression mothers” I met in South Africa positively liked the suit. They said it made them feel relaxed, and relieved backache dramatically (in fact, in one Johannesburg clinic, decompression is used for many cases of backache).
One mother said, “The first time I had it I could feel my baby kicking and stretching. I knew he was enjoying it! I sat up and laughed.”
Prof. Heyns himself says of the birth suit: “This may be the age of technology, but my thing isn’t a machine so much as a concept. Perhaps people would be more impressed if we rigged up flashing lights to go with it.”
Flashing lights or not, the concept is gaining ground. Already something like 10,000 babies have been born in South Africa by this method in the last ten years, with what appear to be remarkable results – a harvest of exceptionally bright children; another crop of children delivered alive who may well have died of toxaemia in utero or at birth; no cases of cerebral palsy – which in Britain is expected in two cases out of 1000; and shorter and much less painful labours for most mothers.
Most mothers (tho by no means all experience this) claim the pain reduction as sufficient justification on its own for decompression.
One said: “It was awful when they took me out of the suit to be examined. I coundn’t get back fast enough. I didn’t care if my baby was bright or not, the pain-killer was such a relief.”
And another; “When I was in the suit, I could actually talk to my husband right through contractions.”
In fact, the first research into compression was aimed only at shortening labour. Heyns says: “I was thinking that if we could knock out the action of the abdominal musculature pressing down on the uterus, the uterus would have freer play and labour would be speeded up.
“Some poor girls stay in labour for so many hours…. and the longer they do the worse it is for the little guy inside.
“First we tried a drug, but tho it worked it meant anaesthetising the mothers. Now who wants to deliver babies that way? Then I hit on the idea of lifting the pressure outside the mother.
“We also devised a gadget for the second stage. A little hand pump thing, called Gasyd, with a pressure dome. With it, you get a local reduction in atmospheric pressure over the baby’s head, and reduce the forces opposing the advance of the foetus.
“It’s like pulling a cork out of a bottle. Use that instead of forceps, and you don’t need to touch the baby.
“As time went on mothers would stick their heads in the door when they came to the clinic, and say how fine their babies were.
“At first I ignored it – you know how these girls will brag. But as time went on, and they were saying how advanced these little chaps were, and then the doctors and nurses began saying the same thing.
“In the clinic and the wards they were saying you could spot a decompression baby just by the way it looked. In the nursery it would be holding its head up at ten days, and all that sort of thing, more normal at a month. And they all spoke about the brightness and the disconcerting alertness of their gaze. So we thought it might be worth taking a closer look.”
From 1960 onwards, the team of gynaecologists did enough research to satisfy themselves that something was happening. They measured the fitness of newborn babies at the moment of birth by means of an Apgar Rating, which looks at tone, colour and so on – and found decompression babies scoring, on average, higher than others.
After their normal duties were over each day, the doctors would spend their free time testing decompression babies and ordinary babies too, to set themselves a norm. In a country without a national health service and registered patients, this often meant wasted days tracing families who might have moved three times in as many years.
Nor were parents always cooperative, as I discovered too. A mother refused to let me meet her child, regarded at his nursery school as a genius. “He’s so bright anyway, we want to try to keep things normal around here,” she said.
As they became more experienced, the doctors worked out a factor they called a Development Quotient – a kind of baby I.Q. – based on what the American psychologist Arnold Gessell had drawn up as norms for phases of a baby’s life up till 30 months. Just as in the I.Q., a D.Q. of 100 would indicate average.
The first tests were run in a home for unmarried mothers, chosen because they were a group of women conveniently together, who between them could keep one machine busy from morning to night.
The results were encouraging. Of a group of mothers classified as retarded or very retarded, only one of their babies fell below 100 in the D.Q. scores. The rest ranged between 110 and 173.
In time the tests became more rigid. In one of a final series, carefully controlled and scrambled, there was an overall difference of 15 points between decompressed and undecompressed babies at the age of nine months.
The doctors who have worked on the research admit 15 that the published D.Q. results on babies a few days old – which have provided scores soaring above 200-need some adjustment. One explained: “We worked out these scores on the basis of a child of 2 days doing something a child of 30 days normally would do, and some scores were astronomical. But now we think we should regard such children as more like six months and two days old because, after all, their life really starts in the womb about then.
This brings the scores down to levels still remarkable, but not quite in outer space.”
They also point out that a D.Q. may not turn into an equivalent I.Q.
Gessell’s norms test a child up to 30 months, and there are no tests after that which psychologists agree can indicate a child’s intelligence until the age of 10.
The oldest of the decompression babies with whom the doctors have contact is now only six. The research team is careful to point out that an I.Q. – in fact, testing of any sort – doesn’t tell the whole story. “I.Q. assumes that everyone has been to school and agrees that 2 plus 2 equals 4. But we’re really interested in something else, more to do with the overall quality of these chaps. For that you must surely trust your clinical judgement and experience and give weight to what your own eyes tell you, just as much as to formal tests.”
Having met about 70 decompression children, I take his point. Few of the children were over four (the past four years has been the period when the real observations got going) and their characteristics of brightness and liveliness are distinct but hardly out of the range of normal.
Karl Oertlé; nearly three, is one of the babies from what the team calls the “upper crust.” He sat at three months, walked at 7 months, talked at a year, and was answering the phone at 13 months.
His mother, who owns a garage, told me: “He’s very useful in the workshop, passing things, blowing up tubes. He uses the air pump on his own. He speaks the four languages he hears around him: English, Afrikaans, Zulu and German. He’s very independent. Goes off to the shops on his own to buy himself sweets and that sort of thing. But although he’s intellectually older, I’ve learned I must give him a lot of affection and never let him get frustrated.
“He rolled right over at three weeks, and I knew right then there was something special about him. When he was a year old, I took him to a pediatrician who didn’t know he was a decompression child. He said: ‘You’re privileged to have a child like this. I’ve never seen one like it before. It’s about a one-in-a-million chance.”‘
Yet the afternoon I met Karl, five children were present, all born within six weeks of each other, all more or less as bright as he. Of the other “upper crust” children, all had certain things in common. All walked at a year or earlier, a few at six months, and most at 9 or 10 months. Most had little or no trouble with teething. Most had started speaking before a year and some have the ability to chat with adults in that fluent, unconcerned way more often found in children of five or six.
On the whole, those children sent to nursery school haven’t lasted there. They were bored stiff, and their sense of outrage – ‘all they do is sing or play with blocks’ – makes them either miserable or mischievous. One 3-year-old waited till everyone was in the gardens and then went around locking all the doors in the school.
They are more mature and tend to look older than their years, and prefer the company of older children. They have outstanding memories for events of their early life. They have strong wills and quick tempers; immovable on matters to do with their sense of themselves.
A mother of five undecompressed children, who is also a psychologist, says of her three-year-old decompression baby: “My others were all placid, nice, easy babies. This one is very self-willed and quick on the uptake. He was lively in the uterus, and even more lively in the suit. Now he’s got more energy than the rest of us. He’s never really been a baby … more like a little old man, right from the start.”
At the same time as the effects of decompression at the top end of the scale were noticed, researchers found another effect at the bottom. The first case made medical history.
A 24-year-old African woman called Dora came to the hospital with severe toxaemia. The doctors all agreed to terminate her pregnancy immediately.
While they were waiting for the anaesthetist, someone suggested putting Dora in the “birth suit.” By the time the anaesthetist arrived, the foetal heartbeat and the mother’s blood pressure had begun to improve. They decided to continue and see what happened.
After a few runs in the suit, she was still improving. The doctor in charge told me: “From 24 weeks, when she came to us, until 30 weeks, Dora was a very sick woman. From 30 to 38 weeks, she was a healthy woman again, and at 38 weeks she delivered a live child.”
Since then, decompression has been used in Johannesburg on certain kinds of toxaemia in pregnancy – a condition which kills 40 mothers and 700 babies each year in Britain.
Decompression is not an accepted technique, even in South Africa. But criticisms against it turn out, on examination, to be less forceful than the way they are expressed. There is much inertia, and the inevitable orthodox resistance to change. It has been called a “fad” or “not proved.”
Some doctors freely call it a nuisance; it requires expert nursing attention. Others who have used the “birth suit” say they can’t produce the Wits. results in labour.
Whenever it has been possible to investigate these statements it has been found that the equipment has either been modified, or the doctors have given up long before they learned the timing and finesse that the South Africans now have.
A man who observed three “difficult” birth-suit labours writes: “Clearly much more work must be done. Doctors and nurses have to be experienced in the use of the suit for optimum results to be obtained; if they’re not, or not convinced of its effectiveness, the patient is likely to be discouraged.
“Also, the suit is mechanically inefficient to the point where the difficulties of operating it effectively tend to defeat the objectives.”
One very successful gynaecologist told me: “I wouldn’t use it. My practice is established. But if I were a young man just starting I would, and within five years I’d have made my name.”
Sporadic research into decompression in labour has been done in Britain, but no attention has been spent on the children themselves. The only sustained work on the babies is being done in Canada.
It is important to emphasise here that no one claims all decompression babies are brighter, but that on the average they may be; and that a small, but statistically significant number seem outstanding. Even so, decompression is gaining ground. In the Queen Victoria Hospital in Johannesburg there is now a daily clinic for 100 mothers. Two private clinics have opened recently.
Clinics are starting in America, and in Britain a group of people are studying the possibility of starting one in London – admitting that they hope the Health Service will finally take it over.
Two birth suits are available at University College Hospital, London. The doctor who works with them said: “If a mother asks for it, I tell her it certainly can’t do any harm. She can have it if there’s a suit free and she doesn’t mind being a guinea-pig for certain tests and measurements.” But that’s all.
Heyns doesn’t claim to know all the answers. No one in medicine ever can, he says.
“But we know from experience that decompression works. How is another matter. We started at the other end, you see.”
Editor’s note: The use of prenatal decompression in Johannesburg is the subject of a paper by R. Liddicoat in the South African Medical Journal of March 2, 1968, which reports on a piece of rigidly controlled research in this field which was spread over four years.