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COVID-19 and reproductive injustice
Published in J. Michael Ryan, COVID-19, 2020
Research demonstrates that support persons, particularly doulas, improve birth outcomes in hospital settings by minimizing unnecessary medical interventions that place women at greater risk of birthing complications (Gruber, Cupito, and Dobson 2013). Doulas also play an especially vital role in shielding women of color from obstetric racism (Oparah et al. 2018). Obstetric racism, defined by Davis (2019) as the racism experienced by women during maternal healthcare processes, comes in many forms, including “critical lapses in diagnosis, being neglectful, dismissive, or disrespectful; causing pain; and engaging in medical abuse through coercion to perform procedures or performing procedures without consent” (Davis 2019, 562). Doulas can provide a vital buffer between birthing women and providers by supporting mothers in self-advocacy (Oparah et al. 2018; Wint et al. 2019). Benefits to doula-assisted births include a decreased risk of cesarean surgeries and birthing complications, a decrease in reported birth trauma, and greater likelihood of initiating breastfeeding (Gruber, Cupito, and Dobson 2013). Doulas also serve as witnesses for women of color, often the only birth workers to report incidences of obstetric abuse during labor and delivery (Morton et al. 2018).
Integrating primal wisdom with the modern Western worldview
Published in Antonella Sansone, Cultivating Mindfulness to Raise Children Who Thrive, 2020
Exploring the contrast between primal wisdom and the dominant Western worldview can provide a key to understanding the dysfunctions in our society and why humanity has reached a major crisis. In a study of 9,508 adults who had completed a standardised medical evaluation and responded to a questionnaire about adverse childhood experiences, more than one-half reported difficult childhood experiences and household dysfunction, including stormy divorces, neglect and abuse, which affected their health and were even leading causes of death in adults (Felitti et al., 1998). The effects of trauma, including prenatal and birth trauma, are long-lasting, ranging from anxiety to post-traumatic stress disorders to physical illness. The latest scientific discoveries teach us that neurobiology is interpersonal. The brain is a social organ that is affected by the environment, particularly by the psycho-emotional environment. But by focusing solely on the role of family and parenting in childhood trauma and consequent brain changes, we miss the bigger picture. Society and culture play a significant role, as they are embedded through mechanisms of perception and create mindsets (way of thinking) that guide our behaviour, posture and gestures (including parenting), and become psychophysical reality (Ruggieri, 2001). If I fit in a social system, I need to perceive it, elaborate it, form a representation and connect it with other brain functions.
Post-traumatic stress disorder
Published in Alison Brodrick, Emma Williamson, Listening to Women After Childbirth, 2020
Alison Brodrick, Emma Williamson
Post-traumatic stress disorder (PTSD) is a constellation of symptoms resulting in an individual feeling a sense of current, ongoing danger, despite the threatening trigger event being in the past. PTSD is rooted in the way in which the brain processes trauma, and has probably therefore been a human response to frightening events since the human brain evolved. As a clinical entity, PTSD was not formally identified until 1980 with much of the emerging evidence coming from observing war veterans throughout the conflicts of the twentieth century (Foy et al, 1984). These early incarnations of PTSD are well known to us through the terms ‘shell shock’ or ‘combat fatigue’ as it was recognised that huge numbers of war veterans seemed to suffer from a symptoms such as intrusive flashbacks, nightmares, excessive emotional reactions and hypervigilance, or a sense of being permanently ‘on guard’. As PTSD began to be formally recognised, attention slowly shifted to understand how it can occur in populations other than military veterans, such as people who have been involved in natural disasters, accidents, or sexual violence. In was not until the 1990s that clinicians and researchers began talking about the possibility that the term ‘birth trauma’ may refer to more than just physical injury: childbirth – including ‘normal’ births – could also be psychologically traumatic and result in PTSD (for example, see Reynolds, 1997).
“Doulas shouldn’t be considered visitors, we should be considered a part of [the] team”: doula care in Georgia, USA during the COVID-19 pandemic
Published in Sexual and Reproductive Health Matters, 2022
Daria Turner, Alyssa Lindsey, Priya Shah, Ayeesha Sayyad, Amber Mack, Whitney S. Rice, Elizabeth A. Mosley
Doulas are non-medical, trained professionals that provide continuous support (informational, emotional, physical) during pregnancy, labour and childbirth, and postpartum.1–5 Doula support is associated with improved maternal-child health outcomes including better birthing experiences, less likelihood of induction or augmentation with synthetic oxytocin, shorter length of labour, higher rates of vaginal births, lower rates of Cesarean delivery, lower use of pain medication, higher Apgar scores, reduced postpartum depression, and increased breastfeeding.1–4,6–12 For all pregnant people – but especially those who have experienced trauma or are living with post-traumatic stress symptoms – trauma-informed doula care can also reduce the risk of birth trauma or re-traumatisation during birth.10,13,14
The relationship between women’s perception of support and control during childbirth on fear of birth and mother’s satisfaction
Published in Journal of Obstetrics and Gynaecology, 2022
Gulbahtiyar Demirel, Nurdan Kaya, Funda Evcili
It is important to take a supportive approach in care for physiological, psychological and social changes the mother may go through during delivery (Uludag and Mete 2014). The mode of delivery, insufficient supportive care during delivery, or perception of supportive care received is among the causes of trauma among women. Birth trauma causes women to experience stress, anxiety, fear and loss of control, and maternal and foetal/neonatal health is adversely influenced during the delivery and postpartum period (Isbir and Inci 2014). However, the fear of childbirth experienced by mothers who receive quality care before and during delivery and whose physiological, psychological and social needs are met has been reported to be reduced (Cosar and Demirci 2012; Byrne et al. 2014; Masoumi et al. 2016). Women experiencing fear during delivery are known to have longer duration of labour (Adams et al. 2012).
Subsequent Childbirth After a Previous Birth Trauma: A Metaphor Analysis
Published in Issues in Mental Health Nursing, 2021
In their systematic review DeGraaff et al. (2018) reported that up to 44% of women experience traumatic childbirth. Severe fear of childbirth has been found to arise from previous adverse birth experiences (Stramrood & Slade, 2017). Clinicians need to identify as soon as possible women who are struggling during a subsequent pregnancy with the aftermath of a previous birth trauma. “Please teach people about us. We are special needs” (Beck & Watson, 2010). This is what one woman urged as she discussed her pregnancy after a previous traumatic birth. Decreasing the risk of women experiencing subsequent birth as another traumatic event needs to be a priority for mental healthcare providers as a birth trauma can have long-term negative implications on women and their loved ones (Beck, 2015). Predictors for a subsequent traumatic birth are identifiable during pregnancy and need to be addressed prior to another childbirth. By being knowledgeable of metaphorical expressions women use to describe a subsequent pregnancy, psychiatric-mental health nurses can be attentive to listening for these metaphors to help determine women who may still be struggling with the aftermath of their prior birth trauma.