Natural Births A Major Cause Of Post-Traumatic Stress? Wrong!

A Tel Aviv University researcher has linked natural birth with post traumatic stress disorder (PTSD).

Natural Births A Major Cause Of Post-Traumatic Stress

Interestingly, some people consider that PTSD is a very modern trauma

According to the Tel Aviv study, 1 in 3 postnatal women in their study sample showed signs of PTSD while a small percentage were severely affected.

What causes PTSD?  A posting on medical news today in 2009 states that PTSD is triggered by a traumatic event and that:

"The sufferer of PTSD may have experienced or seen an event that caused extreme fear, shock and/or a feeling of helplessness".

"a woman is four times more likely to develop PTSD than a man. Psychiatrists say this is probably because women run a higher risk of experiencing interpersonal violence, such as sexual violence"
Traumatic events that commonly trigger PTSD in women - these include rape, sexual molestation, physical attack, being threatened with a weapon, childhood physical abuse.

Given that labour and birth are innately highly emotional, vulnerable times for women - and that is to enable the liberation of the 'love hormone' oxytocin - the emotional 'fixative' for attachment, bonding and breastfeeding - the feeling is a natural 'high' - the reward for labour and birth;  care needs to be respectful, supportive, kind and competent for labour to go well.  Women need to feel in control, to have agency and feel safe during labour and birth.   Numerous studies have found that women labour and birth well when they have caregivers they know and trust.

Photo of joy filled mother with newborn

Women who have their emotional needs met in labour and birth enter motherhood feeling awesome!

Feeling good after giving birth is not about whether it was natural or not, it is not about whether you coped with the pain or not, although labour is much harder to handle when you are not in a good environment or in control of what's happening to you - it's about how you are treated, how well supported you are, how protected and private your birth territory is and how well you feel in control of what's done to you.

I think the good doctors need to investigate what is going on in their hospitals! They are 'barking up the wrong tree'.

The Cardiotocograph test: Absurd at best?

When I did my midwifery training in the 70's, the Cardiff Infusion pump was used to induce labour. The women were placed flat on their backs and monitored with a cardiotocograph machine. The cardiotocograph machine recorded an approximation of the fetal heart rate with an ultrasound transducer. There was also a capacity to record the uterine activity, but the uterine activity was actually monitored by the Cardiff pump machine. Women had their amniotic sac membrane broken with an instrument called a amnihook. A thin plastic tube with a pressure monitoring device was inserted into the woman's uterus through the cervix and into the sac next to the baby. The pressure monitoring device was hooked up to a machine called a Cardiff pump. The pump also provided a syntocinon (a synthetic hormone designed to induce labour) infusion into the woman's blood stream via a cannula in a vein in her arm. The rate of the infusion was set according to the pressure of the uterine contractions. The theory was that the rate of infusion of syntocinon would be governed to deliver the right amount of uterine stimulating drug and no more.

Of course there were problems with that process!

The Cardiff infusion pump has been phased out because of all the problems, but the cardiotocograph lives on, despite evidence that it is not reliable, overly useful, accurate nor does it enable women freedom of movement, known to provide the best opportunity to birth well and have optimal oxygenation of the woman and her baby.

The cardiotocograph machine has become the constant in the standard birth room and has taken the place of the midwife in the role of being 'with woman'.

An insightful honest account of the uselessness of cardiotocograph monitoring of labouring women is provided in the link below.

Test leads to needless C-sections | Philadelphia Inquirer | 04/26/2010

What's known is that the rampant use of cardiotocographs has increased the caesarean section rate with no benefit.

Dr Alex Friedman, a Fellow of Maternal-Fetal Medicine at the Hospital of the University of Pennsylvania said: 

"A 2006 analysis by the British Cochrane Collaboration, evaluating all available research, found that fetal heart monitoring failed to reduce perinatal mortality - the risk of a baby's dying late in pregnancy, during birth, or shortly after birth - and increased cesarean section rates and forceps deliveries, compared with listening to a baby's heart rate intermittently".

Steven Clark and Gary Hankins, two prominent obstetricians said

"A test leading to an unnecessary major abdominal operation in more than 99.5 percent of cases should be regarded by the medical community as absurd at best," they wrote in the American Journal of Obstetrics and Gynecology. "Electronic fetal heart rate monitoring has probably done more harm than good."

and The Doctors' Channel has an excellent video explaining that C-Sections, necessary or not increase maternal morbidity and mortality.

So why are they still done so mindlessly?

The answer is best summed up by this comment:

"Why do doctors cling to continuous fetal heart monitoring? An obstetrician will most likely point to the fear of being sued, but the complete answer is more complex. Our medical culture prizes technology and tests, even if they don't work and can cause harm".