GOLD Perinatal Care Conference News
By Robin Grille, BA, Dip Couns. / Interactive Psych
For a century, obstetrics has been the dominant paradigm for human labor, since obstetrician Dr Joseph DeLee, author of The Principles and Practice of Obstetrics, argued that childbirth is a pathologic process. In an article published in the first issue of the American Journal of Obstetrics and Gynecology, DeLee called for complete medical control over labor.
Until recently, this monocular approach had eclipsed the critical developmental neuropsychological needs of mothers and infants, with tragic results that are only now beginning to be widely accepted and understood. Furthermore, it is increasingly suspected that a large proportion of medical complications at labor, while seemingly justifying obstetric interventionism, are in fact iatrogenic. Much of birth and perinatal trauma could be forestalled if the mother’s psychological needs were prioritized.
In the last trimester of gestation, during labor and in the critical hours and days that follow; a most delicate bonding process unfolds in which the mother’s emotional wellbeing is absolutely central to the quality of mother-infant attachment, affecting breastfeeding, post-partum mood, as well as the psychological, digestive and immunological health of the child for a lifetime. Even without access to narrative memory of our own birth and the moments thereafter, ‘implicit memory’ systems in the brain enable us to remember the emotional content of experiences dating back to the third trimester – and these ‘implicit memories’ continue to influence us psychologically and physiologically for life.
Many of the interventions imposed in hospitals are incompatible with - even eclipsing of – the conditions that enable the vital, highly emotionally-charged (sometimes described as blissful), mother-infant bonding that is so foundational for optimal neuropsychological health. Prenatal and perinatal psychology and the science of Primal Health now make it clear that maternal wellbeing and emotional balance are paramount pre- and perinatally. Conventional hospital and birthing room practice must be re-evaluated to accommodate this emerging imperative.
Frequently, what is most supportive of a psychologically optimal passage through this formative period involves supporting (in the mother) the impulses that seem to come most naturally. However, it is important to note that the abundance of new information about the long-term health impacts of birth or perinatal trauma, and the crucial significance of primal bonding, can at times cause anxiety for parents, particularly if childbirth did not go according to plan.
If, as practitioners, we merely inform parents about the centrality of natural childbirth and healthy post-partum attachment, we risk contributing to their anxiety. Denying or minimizing the long-term effects of the prenatal and perinatal experience, on the other hand, is not an option. Knowledge must be backed up by support; both practical and emotional.
The conditions that enhance mothers’ psychological capacity for attachment revolve around healthy connectedness – to community, family and empathic practitioners – as well as freedom form conflict and overwhelming stress. Health practitioners can be brokers for the mothers’ connectedness. We can also provide an essential empathic milieu by validating her heightened emotional needs at this time.
Much anxiety can be allayed if we provide practical information about how to treat any post–traumatic stress - in the mother and her child - if optimal birthing conditions are not possible. Understanding trauma is essential so that a raft of responses can be provided. Touch, holding, rhythmic rocking, melodic sound, and oral satisfaction at the breast are just some of the most powerful armory of modalities that help to restore the child’s hormonal, cardiac and enteric balance to homeostasis after traumatic episodes. These resources for psychological and somatic healing can ensure a well-protected bonding time, as well as giving parents the confidence to respond to any unexpected hiccups that impact on early attachment.
Robin Grille is presenting The Pre- and Perinatal Gateway to Lifetime Wellness – a communication guide for practitioners at the GOLD Perinatal Online Conference 2013
