What is been understood finally is that trauma of any form generates
damage to the brain itself that is real and must be healed properly.
In fact it is the major health syndrome out there that affects a
large part of out population. Fortunately most are able to self heal
in some way or the other.
I have observed however, that this healing is generally unguided and
is a direct cause of additional trouble and general grief.
We have learned recently that simply remembering trauma can be guided
to weaken the actual effect. This leads me to the suggestion that
nurses in particular need to be trained in the necessary methods of
trauma amelioration and even initial diagnosis.
It is still a learning curve for all, but I think that the process is
well begun and applying it throughout the health system is part of
that maturation.
One
in Three Post-Partum Women Suffers PTSD Symptoms After Giving Birth:
Natural Births a Major Cause of Post-Traumatic Stress, Study Suggests
ScienceDaily (Aug. 8,
2012) — Post-Traumatic Stress Disorder (PTSD) develops in
individuals who experience highly traumatizing situations such as
terrorist attacks and car accidents, but symptoms can also come about
after normal life events -- including childbirth.
A Tel Aviv University
researcher has found that approximately one third of all post-partum
women exhibit some symptoms of PTSD, and a smaller percentage develop
full-blown PTSD following the ordeal of labor. This surprising
finding indicates a relatively high prevalence of the disorder, says
Prof. Rael Strous of TAU's Sackler Faculty of Medicine, who completed
the study along with Dr. Inbal Shlomi Polachek of the Beer Yaakov
Mental Health Center and Liat Harari and Micha Baum of the Sheba
Medical Center.
Of those women who
developed post-traumatic symptoms, 80 percent opted for natural
childbirth without pain relief. Other significant factors identified
include the woman's body image (including discomfort with being in an
undressed state for the relatively prolonged period of labor and
undergoing elective Caesarean sections), fear during labor, and
complications in the present and earlier pregnancies and labors.
The study was
published in IMAJ, the Israel Medical Association Journal.
A painful reality
The debate over
whether or not childbirth qualifies as a "traumatic event"
is still controversial. Although childbirth is not a sudden and
unexpected event like an accident, childbirth is accompanied by a
very real and justified fear of danger, as expectant mothers worry
for not just their own safety but also for the health and well-being
of their babies, says Prof. Strous.
Researchers
interviewed 89 post-partum women between the ages of 20 and 40, first
within 2 to 5 days after delivery and then again one month after
delivery. They discovered that of these participants, 25.9 percent
displayed symptoms of post-trauma, 7.8 percent suffered from partial
post-trauma, and 3.4 percent exhibited symptoms of full-blown PTSD.
Symptoms included flashbacks of the labor, the avoidance of
discussion of the event, physical reactions such as heart
palpitations during such discussions, and a reluctance to consider
having another child.
According to Prof.
Strous, one of the most influential factors was pain management
during delivery. Of the women who experienced partial or full
post-trauma symptoms, 80 percent had gone through a natural
childbirth, without any form of pain relief. "The less pain
relief there was, the higher the woman's chances of developing
post-partum PTSD," he said. Of the women who did not develop any
PTSD symptoms, only 48 percent experienced a natural childbirth.
A full 80 percent of
the PTSD group reported feeling discomfort with being unclothed, and
67 percent had previous pregnancies which they described as
traumatic. Fear of the labor itself, both in terms of expected pain
levels and danger to themselves and their children, was also
influential. The researchers discovered to their surprise that
support during labor, in the form of a midwife or doula, had no
impact when it came to avoiding post-traumatic symptoms. Factors such
as socioeconomic and marital status, level of education, and religion
also had no effect.
Reading the warning
signs
Beyond gathering
information about prevalence, Prof. Strous and his fellow researchers
wanted to gain insight into possible risk factors for developing
post-traumatic symptoms and ascertain methods for minimizing its
impact. He suggests that doctors become familiar with the profile of
women who are more disposed to suffer from post-traumatic symptoms,
and be on the look-out for warning signs after labor. He also
advocates additional research into the phenomenon to develop better
treatment plans and making more resources available for affected
women.
There are some
immediate steps medical professionals can take, Prof. Strous says,
including better counselling about pain relief and making sure that
patients' bodies are properly covered during delivery. "Dignity
is a factor that should be taken into account. It's an issue of
ethics and professionalism, and now we can see that it does have
physical and psychological ramifications," he says.
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