Ethical Issues in Reproductive Technology: JOPPPAH Interview with Dr. William Hurlbut
Interview by Rhodes, J. M.
Vol. 19 (1), 2004, 3-8

This interview is based on Dr. William Hurlbut's presentation at the APPPAH Congress held in San Francisco, CA in December, 2003. Dr. Hurlbut's presentation of scientific data and ethical issues surrounding repoductive technologies, particularly the topic of Cloning for Biomedical Research (CBR) was profound and moving. To quote from his closing remarks, "At this critical moment before we can go forward, we must recover some of the awe and wonder that is often absent in the practice of our science and even our ethical philosophy; we must pause in the rush of our progress to reconsider the full majesty of human life." In order to share some of the wisdom dispensed in his presentation and bring us up to date, JOPPPAH is proud to present Dr. Hurlbut's response to our questions.

The Impact of Trauma on the Embryo and Fetus: An Application of the Diathesis-Stress Model and the Neurovulnerability-Neurotoxicity Model
Thomson, P.
Vol. 19 (1), 2004, 9-64

Today embryology and fetal research offers consistent findings that nature and nurture overlap. The relational and environmental world of the mother powerfully influences the development of her embryo and fetus. Early pre- and post-natal experiences, including early trauma, are encoded in the implicit memory of the fetus, located in the subcortical and deep limbic regions of the maturing brain. These memories will travel with us into our early days of infancy and beyond and more importantly these early experiences set our ongoing physiological and psychological regulatory baselines. The diathesis-stress and neurovulnerability-neurotoxicity models are applied to the neuroscience research on stress, trauma and psychopathology and these same models can shed light on prenatal development. Given the knowledge on early brain development and the impact of trauma on both the mother and her baby, it is vital that we recognize and find ways to buffer and protect the mother and her embryo/fetus.

The Nature of Stress due to Terrorism on Pregnant Women and their Offspring
Benitzhak, Y. & Verny, T. R.
Vol. 19 (1), 2004, 65-74

Current literature demonstrates that stress during pregnancy can have long-term effects on offspring. The purpose of this paper is to examine the possible stress reactions of pregnant women exposed to terrorism. The main focus is on PTSD as the predominant reaction to terrorism and how it affects pregnancy. Conclusions: Although specific research linking terrorism and stress in pregnancy has not been studies/published, the literature reviewed shows evidence that stress caused by terrorism is acute. Women exposed directly or indirectly to terrorist attacks could be subjecting their offspring to a high level of long-term risk.

Suicide and Pre- and Perinatal Psychotherapy
Ward, S. A.
Vol. 19 (2), 2004, 89-106

The relationship between negative events from conception to birth, and suicide, is explored. From extensive experiential work with clients, based on the work of the British psychiatrist Dr. Frank Lake, the author stresses that something else is going on in every death by suicide, that is not visible. Hidden factors relating to suicide have their roots in the pre- and perinatal period, from as far back as conception to the birth itself. Case studies are included and types of suicide correlated to various pre- and perinatal trauma are discussed.

Graduation Address, July 28, 2004, Santa Barbara Graduate Institute
Written and delivered by Allan N. Schore, Ph.D.
Vol. 19 (2), 2004, 107-114

"Faculty, students, and guests. It is a privilege to be here with you celebrating this graduation ceremony of Santa Barbara Graduate Institute. This day is an important and meaningful event, not only for those who have worked so diligently to become scholars in their fields, but also for this institution, which stands in a unique position of offering doctoral degrees in areas of knowledge that are central to understanding the human condition, prenatal and perinatal psychology, and somatic psychology...."

Primal Health Research: Two Essays: I. Margaret Thatcher and Oxytocin: 1979, and II. Gestational Diabetes: A Diagnosis Still Looking for a Disease?
Odent, M.
Vol. 19 (2), 2004, 115-130

I. History can be explored from multiple perspectives. The roles played by political leaders appear as a dominant and highly popular aspect of history...In contrast the history of the different energy sources human beings have used through the ages provides another perspective.... II. Nowhere in obstetrics is there such a discripancy between evidence and practice as in the matter of gestational diabetes...(taken from the articles).

Malattachment and the Self Struggle
Axness, M.
Vol. 19 (2), 2004, 131-148

         The author's doctoral dissertation, Malattachment and the Self Struggle, offers an in-depth portrait of
         intergenerational attachment disruption, its relationship to depression and defensive personality disorders, and
         approaches to healing--all within the context of the fictional narrative of Pearl....

On Tyrants as Abortion Survivors
Sonne, J.
Vol. 19 (2), 2004, 149-168

          In this paper, an extension of an earlier paper (Sonne, 2002), the author advances the thesis that murderous sibling
          rivalry, one of the psychological and social consequences of the threat of being aborted, is a major dynamic perative
          in "ethnic cleansing," eugenic movements, racial, religious and international conflict, mass murders, serial killings, and
          sometimes even in marital and parenting behavior. Destructive acting out in a variety of social contexts is a universal
          phenomenon that has been operative throughout the history of the human race for centuries, and it is still prominent
          today. To explain these behaviors....

Obstetrics and Attachment
Oliver, R. J. 
Vol. 19 (2), 2004, 169-174

In the last 30 years there has been an increasing amount of psychological investigation into attachment. At the same time there appears in this literature to be a gaap in the discussion of what may be the origins of early detachment of the child from his/her caretakers. This article suggests that the beginning lies in obstetrical care in today's highly interventional and technocratic management of pregnancy and childbirth. Specifically, what drives this situation is the attempt of obstetricians and medical professionals to avoid the highly litigious system. The result of the effort to reduce risk at all personal cost, creates a stressful situation for the mother and decreases the emotional satisfaction of the family. In short, the power of birth has moved to the professional and remains causal in dis-attachment of child to parent.

Postpartum Stress Symptoms and Child Temperament: A Follow-Up Study
Di Blasio, P. & Ionio C.
Vol. 19 (3), 2005, 185-198

The aim of this research is to investigate whether postpartum stress symptoms may persist through time and whether these symptoms may be connected to temperamental characteristics of the child. The underlying hypothesis is that child temperament may both affect stress symptoms persistence and itself be a stress source for the mother. The results indicated that women with chronic stress symptoms had symptoms only after delivery and women that had never showed stress symptoms had children classified as "easy".

Maternal Anxiety During and After Pregnancy and Infant Temperament at Three Months of Age
Coplan, R. J., O'Neil, K., & Arbeau, K. A.
Vol. 19 (3), 2005, 199-216

The purpose of the current study was to explore associations between maternal anxiety and infant temperament. Participants (n=60 women) completed measures of state and trait anxiety during the third trimester of pregnancy and again three months postpartum, as well as an assessment of infant temperament. Maternal trait anxiety predicted infant distress to novelty and limitations, and difficulty soothing. Antenatal state anxiety predicted less infant positive affect and lower attention-span. Postnatal state anxiety was related to infant activity level and distress to limitations. Results are discussed in terms of conceptual mechanisms that may underlie the complex inter-associations between different types of maternal anxiety and infant temperament.

Post-Institutionalized Adopted Children Who Seek Breastfeeding from their New Mothers
Gribble, K. D.
Vol. 19 (3), 2005, 217-236

Reports of 32 adopted children who sought breastfeeding from their mothers are presented. Children were 8 months to 12 years at placement and sought breastfeeding from the day of placement to several years after. Some children suckled only a few times whereas others breastfed frequently over a protracted period. Suckling was comforting to children and assisted some in expressing grief over birth mother loss. Mothers felt that breastfeeding assisted in attachment development. It is proposed that the reason why children desired breastfeeding is associated with their first maternal relationship. Children may be seeking breastfeeding as a conditioned response to stimuli provided by the adoptive mother, have memories of breastfeeding or the mother child relationship, or be exhibiting regression in response to stress. Suckling at the breast could provide comfort and stress relief to the child and promote maternal responsiveness. The frequency of the adopted children seeking breastfeeding is unknown however adoption professionals should advise adoption applicants of the possibility. It may also be appropriate for adoptive mothers to pursue breastfeeding in the event that the child does not.

Infant Feeding Decisions and Practices in the U.S. and Colombia
Ramirez, A. Bravo, I. M. & Katsikas, S.
Vol. 19 (3), 2005, 237-250

Infant feeding decisions and practices were examined in a preliminary cross-cultural sample of the U.S. and Colombia using the Theory of Reasoned Action (TRA) and Transtheoretical Model (TM) (Humphreys, Thompson & Miner, 1998) as a theoretical framework. The sample consisted of 80 participants in the third trimester of pregnancy, 40 were recruited in the U.S. and 40 in Colombia. As hypothesized, breastfeeding rates were significantly higher in Colombia than in the U.S. Breastfeeding rates were not significantly mediated by income, and perceived social support for breastfeeding was significantly higher in Colombia.

Implications of Perceived Control for Recovery from Childbirth for Unplanned Cesarean, Planned Cesarean, and Vaginal Deliveries
Gray, J. A..
Vol. 19 (3), 2005, 251-268

This study examines relationships between perceptions of control, postpartum depression, and physiological symptoms in women who gave birth vaginally or by cesarean. Extrapolating from a cognitive framework, it was hypothesized that women who gave birth by cesarean would exhibit lower levels of perceived control and higher levels of depression and physiological symptoms as compared with women who gave birth vaginally. Results were supportive of the hypotheses, suggesting that it may be helpful to explore ways of assisting women to experience greater control over their childbirth. Future research should assess the desire for and the value placed on perceptions of control in childbirth.

Maternal Drinking Patterns and Drug Use Increase Impact of Terrorism Among Pregnant Women Attending Prenatal Care
Lewis, M.W., Lanzara, B. L., Stein, J. L., & Hasin, D. S.
Vol. 19 (4), 2005, 275-288

This is the first known study of the psychosocial impact of terrorism among pregnant women. Ninety-nine women attending prenatal care in New York City were interviewed after September 11, 2001 and classified by drinking patterns. Current drinkers with a history of alcohol dependence perceived less social support following the disaster compared to other women. History of illegal drug use prior to maternal awareness of pregnancy was related to the weaker maternal-fetal bond. Greater exposure to trauma predicted stronger subjective effects and more depressive symptoms. These data support findings in non-pregnant samples that exposure of terrorist attacks predicts the subjective experience.

Transitioning to the West: Gender Attitudes about Contraception and Pregnancy in a Former Soviet Union Country
Speckhard, A. & Mufel, N.
Vol. 19 (4), 2005, 289-302

Over the past 70 years former Soviet Union women have had relatively different reproductive lives and histories than their European counterparts. Since the break-up of the Soviet Union those countries that have European roots now have the possibility to transition toward a Western standard of living. Belarus is a country bordering Poland and in three years will likely be one of the counties just outside of the European Union borders. This article reports on the results of the National Survey of Belarusian Mens's and Women's Reproductive Attitudes and Behaviors (Borkovskaya & Kurilovich, 2002) as well as a smaller qualitative study of one hundred and fifty women following their abortion experiences (Mufel, Speckhard, & Sivuha, 2002) and discusses how current attitudes and behaviors may influence or impede Belarusian women's transition into modern Western roles.

Healing and Birth
Renggli, F.
Vol. 19 (4), 2005, 303-318

Franz Renggli, Ph.D. presents an in-depth discussion of his work as a psychoanalyst and body psychotherapist in Basel, Switzerland. This discussion is enhanced by the inclusion of several case studies.

The Varying Behaviors of Fathers in the Prenatal Experience of the Unborn: Protecting, Loving and "Welcoming with Arms Wide Open," vs. Ignoring, Unloving, Competitive, Abusive, Abortion Minded or Aborting
Sonne, J. C.
Vol. 19 (4), 2005, 319-340

In this paper the author explores varying behaviors of fathers during the prenatal life of the unborn from a psychoanalytic and family system perspective, enriched by studies from the field of prenatal psychology. He suggests broadening the meaning of behavior to encompass communication s that are not clearly visible, audible, or tangible, and emphasizes the importance of the communication of affect in assessing whether an expression of caring and love is genuine and sincere. This is not only important to adults, but especially so for the unborn, who cannot speak or understand adult language, and who are especially sensitive to picking up on affect. The threat of being aborted is discussed, and the consequences of this in the creation of abortion survivors. It is essential that therapists be alert to the possibility that understanding of metaphors, polysema, synesthesia, and similes as a measure of the creativity involved in having meaningful relationships is stressed, and note is made of the remarkable change of speech in this direction that occurs when abortion survivors recover. After exploring positive and negative behaviors of men, the author also deals with the phenomenon of depreciation of men in today's society, which makes it difficult for men to find support, respect, and encouragement, particularly in their roles as fathers and husbands. The overall dehumanization of our culture and society has reached a point where love and responsibility have taken second place to narcissism and materialism. This also has affected the relationship between men and women, and their relationship with the unborn. In the closing section suggestions are made for making positive changes to remedy this situation, and in particular to improve the behaviors of fathers -- and mothers -- in their relationship with the unborn, with each other, and with their families in a rewarding, committed marriage.

Birth: Hospital or Home? That is the Question
Oliver, R.
Vol. 19 (4), 2005, 341-348

Reflections of a practicing obstetrician on the question of hospital vs. home birth, specifically addressing the issue of increased interventions, in ways know to be traumatic to babies, that are typical of many hospital births. This increased intervention has created increasing dissatisfaction in mothers of the birth experience. The attempt is made to simplify the arguments that support home birth when compared to the hospital management of labor and birth.

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