People love labels, and the psychotherapist Eric Maisel in his book on depression recently questioned the prevalent practice in the USA of labeling everyday events as a ‘syndrome’ or ‘disorder’. He calls this medicalization and means a process by which events become defined and treated as medical problems, usually in terms of illness and disorder.
For instance, it is normal to feel anxious about certain things – like making a speech when you are not used to it – but it is now named as ‘generalised anxiety disorder’ which makes it sound much more serious than the perfectly normal nerves most people would feel! Many women do suffer from post partum depression, or the ‘baby blues’ as their progesterone levels plummet after giving birth but I am not sure how helpful it is to consider natural births as a major cause of post-traumatic stress as a new study suggests.
Childbirth is many things, wonderful, stressful, fearful, painful and so much more but is it really as traumatic as a terrorist attack? Apparently Professor Rael Strous of the Faculty of Medicine at 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 what he calls the ‘the ordeal of labour.’
He seems to be saying that 80% of the women who opted for natural childbirth without pain relief would face PTSD sympoms. However there were other significant factors identified in the study such as what how positive a woman’s body image was and if she was uncomfortable being undressed during labour, or had to undergo an elective Caesarean section rather than the natural birth she had gone in for.
Fear in childbirth is natural: whether for the baby, or the experience of past complications in previous pregnancies or a family history of fear and difficulty around childbirth. This is a relatively small study of 89 women, and the symptoms observed included flashbacks of the labour, avoidance of discussion of the event, physical reactions such as heart palpitations during such discussions, and a reluctance to consider having another child. Challenging yes, upsetting certainly but whether that really is PTSD and childbirth a ‘traumatic’ event is still a controversial topic with doctors.
The main factor determining PTSD in his study was the level of pain experienced and the absence of pain relief. Professor Strous advocates that including better counselling about pain relief and making sure that patients’ bodies are properly covered during delivery could be an important factor.
Having information about the pain relief options available to you during birth is essential, as is having good support during the delivery. The dramatic drop in progesterone levels after giving birth can certainly impact women, particularly if they have any previous experience of history of depression, but it can be remedied. Supplementing with bioidentical natural progesterone has been found highly beneficial and Dr Tony Coope has written an excellent series of articles offering help and advice. You can read part one here, together with useful information for women concerned about premature birth or miscarriage: